AccountId: 011433970860
ContactId: 69d6b11a-e526-48d6-94cf-524ef993f5ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 808200 ms
Total Talk Time (AGENT): 268126 ms
Total Talk Time (CUSTOMER): 218648 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=-1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/69d6b11a-e526-48d6-94cf-524ef993f5ab_20250402T18:45_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, my name is [PII], and I was calling, uh, to check on, uh, my dental service plan.
[AGENT][NEUTRAL] OK, well, I can help you with your dental policy you want like you want to see if it's active.
[CUSTOMER][NEUTRAL] No, I know it's active, but I had called last week because my daughter is scheduled to have um surgery tomorrow. And I was trying to see how much you guys would pay and she said she hadn't received the information from the dentist yet, but they said that that was sent out on [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, so it's like an estimate, OK.
[CUSTOMER][NEUTRAL] So over, you know, over 30 days ago. Yes.
[AGENT][POSITIVE] Yes, I can definitely look into it for you. And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] I don't know what it is. I have a sponsor social.
[AGENT][NEUTRAL] OK, that's fine.
[CUSTOMER][NEUTRAL] 427.
[CUSTOMER][NEUTRAL] 61
[CUSTOMER][NEUTRAL] 859 2
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Just waiting for the policy to come up here and um may I have the first and last name on the policy?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Here we go, OK, it just popped up. Hold on one second.
[AGENT][NEUTRAL] OK, and [PII], I just need to verify the policy. Um, can you verify your date of birth and the mailing address on file?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And do you mind if I place you on just a brief hold so I can look at um what has come in?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And just to make sure I understand, so the estimate from the dentist was sent back in February um for us to, OK.
[CUSTOMER][NEGATIVE] Yes, that's what they told me. And she, she, I called, I called about 2 weeks ago and you guys or someone I spoke with told me that they hadn't got it yet, so they resent it that day. So they sent it over twice.
[AGENT][NEUTRAL] OK, hold on one moment, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] First thing I'm wondering is who you talk to because
[AGENT][NEUTRAL] speaking with Universal Trucking.
[AGENT][NEUTRAL] It's the only
[AGENT][NEUTRAL] OK, that's the first thing because was that the only no one here?
[AGENT][NEUTRAL] Yeah, that's the only note.
[AGENT][NEUTRAL] And this is the only policy, yeah, she must be, she must be calling you TBA OK. Anywho, let's look for what came in.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, Mrs. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, thank you so much for holding. I apologize for that wait. So, I'm not sure where it's been received. Do you know where they're sending it to? They may be sending it to Universal Trucking.
[CUSTOMER][NEGATIVE] I don't know. Whatever is listed um that they have, I don't, I don't know where they're sending it, but they're saying that they've sent it twice. And so I don't, I don't really really know what the policy covers but I know she's having an extraction and they were wanting me to pay a portion out of pocket. And I told them I said well I don't feel comfortable paying a portion out of pocket if you haven't even, you know, for the insurance doesn't even know.
[CUSTOMER][NEUTRAL] You know, what they're needing to cover.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Let me ask you this.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] What the um what's being done, is it like a, do you know if it's like a sim, it may be, do you want, is there a way for you to call them like with all with me on the line?
[CUSTOMER][NEUTRAL] Yeah, I can get out 3-way them. Yeah, I can 3-way them.
[AGENT][POSITIVE] OK, good. OK, that's good.
[CUSTOMER][NEUTRAL] Yes, hold on, give me, give me one second, OK?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, hold on.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][NEUTRAL] So they're actually on lunch right now, but could you give me the number? I know she's having an extraction done. She's having one tooth pulled tomorrow.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and I believe they're just using the nitrous oxide.
[AGENT][NEUTRAL] So here's the thing, this is
[CUSTOMER][NEUTRAL] So, cause I didn't want her put under for that.
[AGENT][NEUTRAL] This is the reason I'm asking. So, you all have, so overall, you do have major coverage. Major includes oral surgery, gum, like major expenses, but there is a 12-month waiting period.
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] So if she's having a basic extraction, that is that um you could um they could file a claim for for the basic extraction, but if there's anything major, um, you all won't be able to use the policy until [PII], it's 12 months from when it became effective. So I hope I'm hoping it's a basic one. OK, good.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, it's basic. Yeah, it's basic.
[AGENT][NEUTRAL] So in that case, um, so for basic, the policy will cover up to 80%.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if there's anything preventative like your cleanings, um,
[AGENT][NEUTRAL] Certain images, um, if it's considered preventative, it will be covered at 100% fluoride treatment, all of that. So if it's a basic extraction, then yes, it'll be um the 80%.
[CUSTOMER][NEUTRAL] OK, what is, what, where should they be faxing this stuff to?
[AGENT][NEUTRAL] So, our um fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, she has her, and they said they could bill bill it to me and keep the uh keep the balance on the account until this goes through, but I'm gonna take this to them tomorrow and I'm gonna take them my insurance card as well because there should be no reason why they haven't been able to get. I mean they did get something to you guys so I know they have it. I'm sure they could I seen where I got something from you guys where that you paid a bill for me.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So that's the exact same, that's where we all go.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK. I mean, I don't.
[CUSTOMER][NEGATIVE] So I don't know why they couldn't get you.
[CUSTOMER][POSITIVE] You know, what they needed for her, but they were able to, you know, run stuff for me.
[AGENT][NEUTRAL] And it's the same because I did look at the notes also and they call um back in January to get like the breakdown of y'all's coverage. So they had all this information. They, they, because it doesn't change unless you know, like you add something or take something away from your like your selection, but we sent it to them back in January, um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So I'm not sure what the question was for them then because
[AGENT][NEUTRAL] It literally shows like a list of codes of covered codes and then like I just gave the 80%, 40%, that's all on there too.
[AGENT][NEUTRAL] Maybe they think it changes yearly.
[CUSTOMER][NEUTRAL] Is there a way you can, can you send that to me?
[AGENT][NEUTRAL] Yeah, I can send it to you. Um, how would you like me to send it? Email?
[CUSTOMER][NEUTRAL] Uh, email, yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That way if they have any questions I could say, well, hey, look, this is what they gave me.
[AGENT][NEUTRAL] Yeah, and they can always call to verify the benefits. I mean, I'm the only [PII] here, but any of us will will be able to assist with.
[AGENT][NEUTRAL] Verifying coverage.
[CUSTOMER][NEUTRAL] Oh, can she, can I ask for you tomorrow?
[AGENT][NEUTRAL] Yeah, they can.
[CUSTOMER][NEUTRAL] What's your name? Yeah, I'm just, I mean just so I like to keep it familiar but I can, I mean I could just say, hey, I spoke with her, you know, she's somewhat familiar.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the first initial to my last name is [PII]
[CUSTOMER][NEUTRAL] Do you have like a extension?
[AGENT][NEUTRAL] I don't.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, it's fine. I'm sure they'll be able to get a hold of you.
[AGENT][NEUTRAL] Yeah, I'm the only [PII] here.
[CUSTOMER][NEGATIVE] OK. If you could um email me that too cause I, I, I want to have everything, cause I kinda think they're just dropping the ball like they've had since February and then I've seen where I went to the dentist um emergency and they already got that submitted and got, you know, got it paid so I don't understand why.
[CUSTOMER][NEUTRAL] It's taken them that long on a procedure that they had planned for a while, you know?
[AGENT][NEUTRAL] Yes, especially if it's tomorrow.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, it's tomorrow um so if you could send that, um, my email address is [PII].
[AGENT][NEUTRAL] Hold on one second. Now, I have to send it to the email address on file.
[CUSTOMER][NEUTRAL] What is, what's the one on file?
[AGENT][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, send it to that one and he'll he'll just send it to me.
[AGENT][NEUTRAL] That's OK. OK.
[CUSTOMER][NEUTRAL] That's fine, yeah.
[AGENT][POSITIVE] Alright, so I'm sending it over now, so y'all should receive this in just a few minutes. I'm typing it up now.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII]. I appreciate it.
[AGENT][POSITIVE] You're very welcome. You're welcome, um, Mrs. [PII], was there anything else I can help you with?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] Alright, well, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you bye