AccountId: 011433970860
ContactId: 6d5d2be7-0015-4fa8-87b1-2e508c0202ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 921159 ms
Total Talk Time (AGENT): 449158 ms
Total Talk Time (CUSTOMER): 226880 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/6d5d2be7-0015-4fa8-87b1-2e508c0202ea_20250128T16:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, how you doing, [PII]?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] I got a couple questions.
[CUSTOMER][NEUTRAL] Uh, this.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Trying to
[CUSTOMER][NEUTRAL] Trying to figure all this this stuff out with the insurance.
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] I have uh.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Appointment for my dentist.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I have a and and um I'm just trying to make sure like and see how much am I gonna have to pay and all this other stuff because it seems like I gotta keep calling to.
[CUSTOMER][NEGATIVE] I, I don't know, they, uh, everybody keeps saying that they don't take this insurance, and I'm just like, OK, well I'm paying all this money. I need to figure out what's going on.
[AGENT][NEUTRAL] OK, well, let's take a look. What's, what policy number do you have? Do you have one?
[CUSTOMER][NEUTRAL] Yes, let me find it.
[CUSTOMER][NEUTRAL] Let me pull it up
[CUSTOMER][NEUTRAL] Um, for my dental or health cause my health when I'm, I'm, I scheduled a vasectomy and they were like, well, we don't even know if we take that insurance. I'm like, oh my fucking God. So I'm just, well, do I need to give you the policy number for, for both or?
[AGENT][NEUTRAL] Um, you can.
[AGENT][NEUTRAL] You could give me either one. Yeah, it doesn't matter.
[CUSTOMER][NEUTRAL] Then it's
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is the policy number is 0251.
[CUSTOMER][NEUTRAL] 1320.
[AGENT][NEUTRAL] All right, let me pull this up.
[AGENT][NEUTRAL] All right, and then I'll need to verify please your first and last name, date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And then what's the address we should have on file?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK and then the email address on file is a Gmail account, is that still a good email address for you also?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] So.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. So first thing, um, on the dental policy, um, I can either verbally give you some providers within your area, or I can send you a list, whatever works better for you.
[CUSTOMER][NEUTRAL] Um, the list.
[CUSTOMER][NEUTRAL] And also, if I already got an appointment set up, and they said that they were gonna call, they were gonna call you guys, um, I don't know if it went through or not or you won't be able to tell.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Let me see if I see any notes in here.
[AGENT][NEUTRAL] So I don't see any recent notes from like a provider calling to verify like benefits um anytime that.
[AGENT][NEUTRAL] You know, we have a provider call just to check and make sure you're eligible for benefits. We do notate your account, so I don't see anything as of yet.
[CUSTOMER][NEUTRAL] Yeah, cause I'm supposed to go Th uh Friday to get a tooth pulled.
[CUSTOMER][NEUTRAL] And every time I go somewhere, get appointments set up, get there, then they say, well, we don't take that insurance.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] So yeah, so I'm just like, OK, like I don't know if I need to get new insurance, so what's going on? I just need to figure out what's going on cause I, like I, I'm a semi driver truck driver so I can't keep taking off for nothing, you know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Yeah, I mean, you should be able to, there's no.
[AGENT][NEUTRAL] Quote unquote network required to like use the plan so I'm not sure why they're telling you that they.
[AGENT][NEUTRAL] I mean, they don't have to accept the insurance, obviously, um, but we don't have like a specific network that you have to stay within to like use the dental plan. Um, the dental plan, yeah, you should, shouldn't have any problems with that, so.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you know who you're going to see later this week?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yes, I got a.
[AGENT][NEUTRAL] Do you know their name?
[CUSTOMER][POSITIVE] Yes, [PII] uh.
[CUSTOMER][NEUTRAL] I gotta see if I can call me. I gotta, I will have to call my wife to get the actual name, but.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She, she kinda set it up.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] I mean you can go to [PII] which is our website, and you can type in providers in the search bar and it will bring up a search engine so you can search for providers in your area if you want to do that just to make sure whoever you're going to see is on that list.
[AGENT][NEUTRAL] Again,
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] But you shouldn't have [PII] like I said they should be um you should be able to use it anywhere you need to go there's not a specific quote network you have to stay in if that makes sense.
[CUSTOMER][NEUTRAL] Right, cause uh I just start scheduling a vasectomy and they were just like, well, we don't know again if we take that, I'm like, oh my Jesus, man, like.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, well, let me call because I need to figure this out because.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] So let me go to the other, your other policy.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] So, do you only have this one medical? You don't have any other medical with any other company?
[CUSTOMER][NEUTRAL] Nope
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Not, not that I know of. I'm only, yeah.
[AGENT][NEUTRAL] Uh, yeah, I was, I was just asking. I wasn't sure. So, um, let me pull this up here. Give me a second.
[AGENT][NEUTRAL] All right, [PII], so, um, with the medical that you have, this is what we call, it's called the limited benefit plan or a um hospital indemnity plan. So if you don't know what that means, it basically pays just a set amount depending upon what you're being seen for.
[AGENT][NEUTRAL] Um, it's not like a major medical in the sense that it's paying a percentage towards like a surgery or procedure.
[AGENT][NEUTRAL] So it is different in that aspect, um, as far as what it will pay towards and all of that.
[CUSTOMER][NEUTRAL] OK, so there's like no way to knowing on what would be paid for or nothing, huh?
[AGENT][NEUTRAL] Um, well, let me pull up the policies. I mean, I can pull up the policy certificate and tell you exactly.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] What the benefit goes, like what the benefits are, so.
[AGENT][NEUTRAL] Let me see here.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Yeah, I thought this was a good insurance. I'm like, OK.
[CUSTOMER][NEUTRAL] Man, yeah, I'm not I'm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see here.
[CUSTOMER][NEUTRAL] So uh.
[CUSTOMER][POSITIVE] That's good.
[AGENT][NEUTRAL] Um, yeah, I was trying to see.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So they list on your policy, like a bunch of different, oh here we go.
[AGENT][NEUTRAL] So it does have on the surgical benefits, it does have vasectomy listed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it looks like, so it says it pays a benefit amount of $830.
[AGENT][NEUTRAL] So, we don't have any way of knowing, you know, what, um, as far as like surgeon you go to, what they're gonna charge for that. But that's basically what the benefit would pay towards that. So, if the surgeon or doctor charges $2000 then we would pay that amount towards the, towards that.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] As far as a lot of the other benefits are, um, you know, for outpatient surgical facility, it'll pay a facility charge. On the low end, it's like up to 450, up to 1000.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So the max it would pay towards that would be like 1000. So, um, because it wouldn't be anything inpatient, it would be like an outpatient procedure.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, so that's kind of the amount that it would pay towards that. Um, as far as it's the same as far as the dental goes, like I'm sorry that you're having a hard time finding somebody to even use it cause you should, it's a limited benefit plan good with anybody that will accept it. There's not any sort of quote unquote like network for it.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Right, they be saying, well, every time we, they say, this is what they say, every time we call, it takes somebody too long to pick up or something like that.
[CUSTOMER][NEUTRAL] Um, this was the last, there was like, um, so I don't think we take that because every time we call nobody picks up the phone to say anything about your policy or whatever plus we never heard of it.
[CUSTOMER][NEUTRAL] So I'm just like man.
[AGENT][NEUTRAL] Well, I mean, we're, yeah, I mean, we're here Monday through Friday so we're here to answer any of those questions or call. I don't know if, you know, make sure they're calling, I guess the right number, this number that you called um it's the number on your card, um, to verify the benefits, um.
[CUSTOMER][NEUTRAL] I don't know. I'm just
[CUSTOMER][NEUTRAL] Mm mhm.
[AGENT][NEUTRAL] Yeah, I mean,
[CUSTOMER][NEUTRAL] Yeah, OK, so I think last time I was at a dentist too it was on a Saturday too, so yeah, that makes sense.
[AGENT][NEUTRAL] Oh well if it's on the weekend that's yeah that's a that's unfortunately a different story because yeah we don't have anybody in office on the weekend but I mean we can verify that you're eligible and that your plan is active and.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All of that information. So, um, I'm sorry it's, you know, you've been having a hard time with it, [PII], but
[AGENT][NEUTRAL] Aside from searching online for dental providers, that would be, you know, the next step that you could take if you have any issues with the dentist this week, um, and then in regards to like the medical, um, you know, you can always um call yourself, you know, with a provider on the line and speak to one of us and we'll, you know, verify all of it with you on the line as well. I mean, that's another step that you could take, but.
[CUSTOMER][NEUTRAL] Yeah, it, it, OK.
[AGENT][NEUTRAL] Um, yeah, I don't know that I would accept just that they can't get a hold of anybody because we have people here all the time that can verify your benefits.
[CUSTOMER][NEUTRAL] Right, right, OK, so, alright, that's what I'll do next time. I'll just call myself and have them on the line, cause right now they're, they're, she just told me to send a picture of my benefit card to them to see if they accept it.
[AGENT][NEUTRAL] Yeah, and just
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I was like, OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Alright, well, yeah, and, and you know, and tell them if they have any questions or concerns, the [PII] number on the card they can call and speak to an agent regarding the plan and we're happy to help them in any way we can so.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. You have a good rest of your day, [PII].
[CUSTOMER][NEUTRAL] Alright, alright, you too.
[AGENT][NEUTRAL] Bye bye.