AccountId: 011433970860
ContactId: 7d413a00-6479-459a-a780-df041a111aa6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 402260 ms
Total Talk Time (AGENT): 238575 ms
Total Talk Time (CUSTOMER): 121640 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/7d413a00-6479-459a-a780-df041a111aa6_20250218T21:42_UTC.wav
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[AGENT][NEUTRAL] [PII], how may I help you?
[CUSTOMER][NEUTRAL] Um, hi, this is [PII] in customer services. How are you?
[AGENT][POSITIVE] Pretty good how are you?
[CUSTOMER][NEUTRAL] I'm good. I have an insured on the phone and she's needing to know uh her benefits on her policy, and she, when you get through with her, uh she's also got a medical and she needs to know the benefits on it as well.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, I can help with that.
[CUSTOMER][NEUTRAL] Alright, and her policy number on the dental is 256-065-8.
[CUSTOMER][NEUTRAL] And I verified all her information. Her her callback number is the same one in the system.
[AGENT][NEUTRAL] OK, so this is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, [PII]. OK. Yes, I can help.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Alright, and hold on just a second. Oh, here she is, thank you.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] [PII], my name is [PII]. My name is [PII]. I'm in the claims department. I've pulled up your policy. Um, now I understand from [PII] that you had some questions about your benefits. Is that correct?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Well, your policy has $1500 for calendar year as the, the maximum, and what it covers is, uh, your basic dentistry such as two cleanings a year, the examination of your teeth, the filming of your teeth, um.
[AGENT][NEUTRAL] And uh also if you needed fillings, anything like that, uh, is there anything in particular that um
[AGENT][NEUTRAL] That you uh had a question about?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um, uh, so it pays for clean, if I could go anywhere to any place?
[AGENT][NEUTRAL] That's correct, yes. Uh, you can go to any, uh, dentist that you want, um, and you do have two cleanings per year. Uh, now, what, uh, if you don't have a dentist then on our website, we do have a list of dentists that you go to in your area, um, but you can go to any dentist at all. Um, and, uh, if they have any questions about your policy or they need to have, uh, information on where to send their claims, uh, we do have a fax back for them.
[AGENT][NEUTRAL] Um, but yes, you can go to any dentist at all. Now, I'll tell you that uh there is a 12 month waiting period for this, for the, um, services such as, uh, if you need to have oral surgery, um, or, uh, anything that is considered major, um, but, uh, what is available right now are your are your cleaning, your examination of your teeth, the filming of your teeth, if you needed to have a tooth pulled, um, fillings, that sort of thing.
[AGENT][NEUTRAL] Uh, that's, that's what your $1500 can cover right now.
[CUSTOMER][POSITIVE] That's what, that's what it covers and I won't have to pay a copay or anything like that.
[AGENT][NEUTRAL] Uh, the, now, if you needed to, there is a $50 deductible for, uh, services such as, uh, um, uh, if you need, if you had like a full mouth X-ray, or if you had a tooth pulled, if you had, um, if you had something like, uh, um,
[AGENT][NEUTRAL] I don't know, fillings. Uh, there is that $50 deductible for that. Um, but, uh, otherwise, uh, what we do is we pay 100% of, of your preventative services such as the cleanings, um, the examinations, that sort of thing. You would really only have a co-pay if you, if you had something like a toothold or something.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] And how much is the co-pay on the tooth poon?
[CUSTOMER][NEUTRAL] If I had to get one
[AGENT][NEUTRAL] That's a $50 deductible. Um, yeah, it, it's a $50 deductible and then, and then we would pay anything over that.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK, and then you cover like fillings and stuff?
[AGENT][NEUTRAL] Yes, uh, yes, we do cover fillings.
[CUSTOMER][NEUTRAL] What is my dental insurance name? What is it called?
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] It's called APL it's called APL.
[CUSTOMER][NEUTRAL] ATL, so I just call the people and ask them, do they take ATL insurance?
[AGENT][NEUTRAL] Yes, and if they have any questions, uh, as I mentioned before, we do have a form that we send out uh it's not an HMO or a PPO, uh, we do have a form that we can send to them letting them know where.
[AGENT][NEUTRAL] Or to submit their claims, but yes, that, that was, is what you would tell them is uh APL or American Public Life.
[CUSTOMER][NEUTRAL] American Public who?
[AGENT][NEUTRAL] American Public Life, that's it's APL.
[CUSTOMER][NEUTRAL] ATL American Public Life. OK. I, I, I, my question was about my surgery, so I had surgery, uh, I had to get my gallbladder removed, and I wanted to know, did y'all cover any of that? Did anything get covered? Because I got a really big bill sent to my email and I gave them my insurance.
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] What I
[AGENT][NEUTRAL] Yeah, yeah, let's see what we have here because it's um
[AGENT][NEUTRAL] I'm trying to see what your medical insurance covers, um.
[AGENT][NEUTRAL] What, what you have with us. I'm just gonna check that.
[AGENT][NEUTRAL] Now, what, uh, that, uh, for that sort of service, um, you, we don't, we don't cover your medical. Um, I, I realized that your card shows that APL on it, but the people who cover your, your medical services, it's a different company entirely. So if you have a, um, a pen, I can, uh, I can give you the, the number of the people you need to call for your medical services. Now the, the dental I can help with, but the medical is something else.
[CUSTOMER][NEUTRAL] OK, medical
[AGENT][NEUTRAL] Now the, the phone number for that.
[CUSTOMER][NEUTRAL] I want.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and then um for my dental, what's the um fax number that I give them for you all so that y'all can send over the things to get billed or whatever.
[AGENT][NEUTRAL] Uh, no, no, we fax it to them.
[AGENT][NEUTRAL] They they don't fax anything to us we fax the the um.
[CUSTOMER][NEUTRAL] OK, so I'm in, I'm in Aurora, Colorado. I'm looking at a modern, modern smile, uh, to place.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I don't know the address.
[CUSTOMER][NEUTRAL] But do y'all work with modern smile?
[AGENT][NEUTRAL] Yeah, we, we work with any we work with any dentist. It's just um it's just that they, if they have any, if they have any questions, then, um, uh, then they can contact us or you can give us their phone number and we can fax them the information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] OK, if there's anything else we can help with, thanks for contacting ATL.