AccountId: 011433970860
ContactId: 61a592d5-eabe-4b9e-8abe-bd75574e13d2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 237789 ms
Total Talk Time (AGENT): 106294 ms
Total Talk Time (CUSTOMER): 139362 ms
Interruptions: 5
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/61a592d5-eabe-4b9e-8abe-bd75574e13d2_20250205T16:49_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hey, um, I just had a few questions. I went to the, about like some claims cause honestly, I get these papers in the mail and I'm not too sure if they're saying like, oh, basically, if I'm reading them correctly. But um I did called me the other day and they were saying that something was um I guess.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] A hold up on their end, so I didn't, they didn't know if I need to do something on my side to see if I was able to get some um.
[CUSTOMER][NEUTRAL] Amount of money back for like you know how they, when you go to out of uh what is it called?
[AGENT][NEUTRAL] At a network
[CUSTOMER][NEUTRAL] Out of, uh, yes, there you go. When you go to like an out of network dentist.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But I know they usually I like to usually pay them and then they'll like do the claim, but they were saying that I guess they were seeing something where it was like they didn't know if I need it like it was pausing something so they didn't know if I needed to do something on my end or
[CUSTOMER][POSITIVE] We were all good to go.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, go ahead and give me your name and your policy number. Let me do some research.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you. My name is [PII].
[CUSTOMER][NEUTRAL] And then my policy number is 02492651.
[AGENT][NEUTRAL] Alright, [PII], thank you for all that information. Now while I'm pulling this up, go ahead and give me a good return telephone call number please, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], thank you for that. Now I verify your date of birth and your address for me, please, ma'am.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Alrighty, [PII], thank you all for that, all that information. OK, so your dental plan went into effect [PII]. It is current and active, but I must advise that verification of coverage is not a guarantee of payment on the claim. But let's see, let me look at your history right quick and see.
[CUSTOMER][NEUTRAL] Right, cause they'll send me these letters and I'm just like, I mean, I I just pay it and then like I don't the first time I don't think when I did my cleaning I got any money back, but I just be trying to read what this stuff say and I'm like I don't know.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Let's see, um, yeah, I see a claim for [PII]. Yeah, it is here and I do see that, yeah, uh, the information that we was requesting from your employer has been submitted so that claim will be released. I'd give it about 5 working days before you get your EOB though, Avery, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the ELB is just the like say the um like say I had this from like a previous one or whatever.
[CUSTOMER][NEUTRAL] They say, oh you paid $100 for this blah blah for a certain claim. So when it has the remark description, when it says with this check, the maximum benefit payable for this data service has been met. So that means like they paid all that they would pay for.
[CUSTOMER][NEUTRAL] But my thing was over. Is that what that means?
[AGENT][NEUTRAL] Yes, if it says [PII], that's, that's what that means, yes.
[CUSTOMER][NEUTRAL] OK, so that means, so that basically I wouldn't get reimbursed that so I don't have to do anything with these papers.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, but you don't have to do anything, but you'll get this, um, you'll be on this [PII] shortly though, OK?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, so I'll
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Well, yes, ma'am, [PII], is that all I can help you with?
[CUSTOMER][NEUTRAL] Um, as of right now, unless I get it and I'm still confused on what it says, but hopefully.
[AGENT][NEUTRAL] Oh, yes, ma'am. If you're confused, you call us back.
[CUSTOMER][NEUTRAL] It's just that this is a different um
[CUSTOMER][NEUTRAL] Yeah, it's just that now that I'm working with like a contract, it's my first time doing like a contract job. So this insurance is like different than I've ever had. So it's like even being out of network and stuff it's like weird. So yeah. So yeah, thank you though. Hm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh, OK. Yeah.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Yeah. Well, you just call us back if you have any questions. Oh, yes, ma'am, I, anytime then and I guess if that's all you have, then thanks for calling APO and you have a great rest of your day, OK?
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][NEUTRAL] Yes, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] No.