AccountId: 011433970860
ContactId: 8819c28a-8f51-4b08-b23b-d777dc850a17
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 749750 ms
Total Talk Time (AGENT): 350222 ms
Total Talk Time (CUSTOMER): 237714 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/8819c28a-8f51-4b08-b23b-d777dc850a17_20250527T15:13_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have a policy with you guys for dental.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And um I just talked to my uh dental office, and they do not accept this insurance. They said that I would have to uh file it myself.
[CUSTOMER][NEUTRAL] Um, is, is that possible? Can you tell me how much it would cover?
[AGENT][NEUTRAL] Sure, I can help you with your policy. Um, may I have a good contact number in case we're disconnected and then your policy number?
[CUSTOMER][NEUTRAL] Uh, yes, my cell number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And my policy number.
[CUSTOMER][NEUTRAL] Is 02.
[CUSTOMER][NEUTRAL] 59
[CUSTOMER][NEUTRAL] 4706
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] OK, and I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Uh date of birth is [PII].
[CUSTOMER][NEUTRAL] My email is [PII].
[CUSTOMER][NEUTRAL] My mailing address is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment.
[AGENT][NEUTRAL] Um, so, let me take a look. Do you know if your dentist's office gave us a call or if they just looked at it and just said they didn't take it, or?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, she asked me if I had new insurance and I told her yes. And she asked me what it was. I told her American Public Life, and she said that they do not accept it, but I could pay for it.
[CUSTOMER][NEUTRAL] And submit the paperwork to have it to be reimbursed.
[AGENT][NEUTRAL] OK, so if you like, um, I can call your, you know, if you want to together, we can call them just to let them know about the dental policy. Um, a lot of places think that American Public Life is the insurance. We're the insurance company, but the product is, it's Carrington PPO that your insurance is with, um, but yes, you do have the option to file the claim um on your own if you like, um.
[AGENT][NEUTRAL] Or I can verify the benefits with them too, whatever you prefer.
[CUSTOMER][NEUTRAL] OK, well, how much does it cover?
[AGENT][NEUTRAL] So per calendar year, um, the policy would pay up to $500. There is a $50 deductible.
[AGENT][NEUTRAL] Um, this policy covers preventative.
[AGENT][NEUTRAL] And basic, and then your um full mouth x-rays as well. Preventative would be um
[AGENT][NEUTRAL] Like your evaluations, your fluoride, your sealants, um, any spacers, basic, um, would be more like fillings, um.
[AGENT][NEUTRAL] Different things for, for basic. It could be a basic extraction, um, but you do have the dental coverage on the policy. It doesn't cover major expenses.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I, I should be able to just pay a $50 deductible.
[CUSTOMER][NEUTRAL] And then the rest should be covered. If it's just a cleaning, it's $115 for a cleaning.
[AGENT][NEUTRAL] Right, cleanings once every 6 months, um, since it is preventative would be at 100%.
[CUSTOMER][NEUTRAL] OK, so, so I wouldn't have to pay a $50 deductible.
[AGENT][NEUTRAL] Right, um, the deductible doesn't apply to preventative.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] All right, can, can you look in that area and give me a list of people in my area that might accept this?
[AGENT][NEUTRAL] Um, so, let me see.
[AGENT][NEUTRAL] I'm just waiting for our website to come up. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And our systems are going slow, so I don't know if that's affecting the website, so I do apologize.
[CUSTOMER][POSITIVE] And I can give you the phone number to my dentist office too.
[CUSTOMER][NEUTRAL] I mean, if you just, if you wanted to call them and see if they would take it.
[AGENT][NEUTRAL] I mean, sure, it's up to you. I just know how providers, you know, can give a hard time sometimes when they're not sure it's easy to turn away. Um, if you want me to give them a call, I definitely will. And what's the phone number?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, it is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Let me double check that. Hang on one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes. [PII]
[AGENT][NEUTRAL] All right, um, hold on one moment for me, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling Doctor [PII]'s office.
[AGENT][NEUTRAL] Hey, my name is [PII]. I'm calling from American Public Life. Um, we have a mutual patient and she's trying to use the dental coverage but was told
[AGENT][NEGATIVE] They're not, we're not accepted.
[CUSTOMER][NEUTRAL] That's right, I've never heard of that um insurance we're not taking it.
[AGENT][NEUTRAL] So you, are you not familiar with Carrington or just APL, our insurance company?
[CUSTOMER][NEUTRAL] A.
[CUSTOMER][NEUTRAL] So it's with Carrington, she didn't say anything about it being with Carrington.
[AGENT][NEUTRAL] Right, that's why I'm calling. So American Public Life is the insurance company, the product is Carrington PPO.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK hold on just a minute.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Yeah, she turned you away because she didn't, she wasn't familiar with APL. They accept [PII], so I'm getting ready to give her the information now, but she just didn't ask any questions.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So she put me on hold.
[CUSTOMER][NEUTRAL] Let me call him
[AGENT][POSITIVE] We're on the phone with them now.
[CUSTOMER][NEUTRAL] Um, I had an appointment for tomorrow
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] They could put me back down on that appointment.
[AGENT][NEUTRAL] OK, I'll, I'll, um, once I give her all the insurance information, you shouldn't have any issues. They should have taken your card and given us a call to verify the benefits before they turned you away.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Alright, so whenever I
[CUSTOMER][NEUTRAL] Whenever I call to make appointments, whatever I need to tell them that it's [PII]. For calling [PII]'s office.
[AGENT][NEUTRAL] No, hold on one second. Hi, um, I don't, is this a new person?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] OK, hi, my name is [PII]. I'm calling from APL. We have a mutual patient and she was turned away because the rep.
[AGENT][NEUTRAL] He American public life and just said it wasn't accepted. She didn't ask about the insurance. So I'm just trying to give you all her insurance information and verify anything. Um, I can fax over the fax back if you need to.
[CUSTOMER][NEUTRAL] What is who is the insurance with?
[AGENT][NEUTRAL] It's on the Carrington PPO network.
[CUSTOMER][NEUTRAL] Yeah, we don't take that one.
[AGENT][NEUTRAL] OK, the benefits are the same whether you are a Carrington provider or not.
[CUSTOMER][NEUTRAL] Right and we told her that, but you know if uh she will have to pay and then you guys can reimburse her but we don't take that one, so she'll have to bill it herself.
[AGENT][NEUTRAL] OK, so you're refusing to bill. OK, thank you.
[CUSTOMER][POSITIVE] Yeah, now I'm not refusing a bill. It's just that you know we're not in network with you guys, so, um, you know she can turn it in herself and then, you know, but we'll be more I'm glad to see her.
[AGENT][NEUTRAL] Right, but there's no in or out of network benefits, so it would be billed as regular. But OK, so how does she, well, we'll see how she wants to handle it. Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, yeah.
[CUSTOMER][NEUTRAL] She'll just, yeah, yeah, she will just pay and then we'll give her all the information to turn the insurance into you guys.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Yes, you're welcome bye bye.
[AGENT][NEUTRAL] Did you need a copy of her benefits or anything? Well, you're not billing. OK, thank you.
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hey.
[AGENT][NEUTRAL] Yeah, they just don't want to bill it. So, um, you, I mean, I've already, if you want to check your email, I've already sent you a list of providers in your area.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it may have went to the spam folder, so you might want to check that just in case, but, um, so basically you're
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The dental policy is on the Carrington PTO network. Whether your provider is a Carrington provider or not, all of your benefits are still the same. The difference is if they were a Carrington provider, there's like a percentage of the balance you would get. If they're not, you just don't get the percentage off the balance, but you still have all the same coverage. So they
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, could bill us, they, they're just refusing to bill. So they want you to, if you're going to be staying there, they want you to pay everything upfront and then bill us as the insurance company and um get reimbursed for whatever the policy will cover, which could be equal or less or
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Or you can, um, if you want to try one of the the dentists from the list that I sent over, you have that option as well. Um, it's up to you.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's what I'll do. I'll go over that list and um.
[CUSTOMER][NEUTRAL] And uh see if I can find one in the area.
[CUSTOMER][NEUTRAL] And uh and call them.
[AGENT][NEUTRAL] OK, and at any time, um, if they give you any pushback or anything, just give them our the insurance card and the phone number and just um have them give us a call to verify the benefits.
[CUSTOMER][NEUTRAL] So that'll work.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you so much I appreciate it.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Um, yeah, matter of fact, 11 more thing, do you mind sending me a list of, um, the eye doctors also?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Well, APL doesn't, we don't provide vision insurance, so I'm not sure who that would be with.
[CUSTOMER][NEUTRAL] Oh, OK, let me see. OK, it must be somebody else.
[CUSTOMER][NEUTRAL] OK, it's it's something else.
[CUSTOMER][NEUTRAL] Like I have to call this other number.
[AGENT][NEUTRAL] Alright, well, was there anything else I can help with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] No, I think that was it. Um, I'll look over that list and pick one out.
[AGENT][POSITIVE] Alrighty.
[AGENT][POSITIVE] Alrighty, well, thank you so much for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.