AccountId: 011433970860
ContactId: 90d7c3db-9fa5-4bda-91c3-2b113696d042
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 619190 ms
Total Talk Time (AGENT): 257533 ms
Total Talk Time (CUSTOMER): 263329 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/90d7c3db-9fa5-4bda-91c3-2b113696d042_20250128T21:08_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Yes, hi, [PII]. um, I have a dental appointment and I just wanna make sure that it's covered under the dental insurance I have with you guys.
[AGENT][NEUTRAL] OK, I can look at your policy for you today. Um, can I have your name please?
[CUSTOMER][NEUTRAL] Yes, my first name is [PII].
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, Ms. [PII], and do you have that policy number handy?
[CUSTOMER][NEUTRAL] No, I do not.
[AGENT][POSITIVE] No worries. I can look it up with your social if you're the subscriber, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] All right, Ms. [PII], could you verify for me, please, your last name and date of birth?
[CUSTOMER][NEUTRAL] The what? Yeah, yeah.
[CUSTOMER][NEUTRAL] Uh, where's the tape at?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and that last name?
[CUSTOMER][NEUTRAL] Uh, [PII] Where's the tape at? Because that's what I was using to put the stickers on the helmets.
[AGENT][POSITIVE] Wonderful.
[CUSTOMER][NEUTRAL] Just give it to me. Uh, do you have the green tape?
[CUSTOMER][POSITIVE] Oh yeah, it's just because I use it for the helmets, but I got you, bro.
[CUSTOMER][NEUTRAL] I'm sorry, what was that, ma'am?
[AGENT][NEUTRAL] No worries. Um, I just need to verify your mailing address, email, and phone number.
[CUSTOMER][NEUTRAL] Uh, I think you guys, my email address is my first [PII].
[AGENT][POSITIVE] Wonderful.
[CUSTOMER][NEUTRAL] Phone number is [PII].
[CUSTOMER][NEUTRAL] Yeah, phone number is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I believe you guys have the mailing address for um as uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And then uh [PII].
[AGENT][NEUTRAL] OK, I do have you in [PII], and on [PII], but it looks like I have a different, different numbers.
[CUSTOMER][NEUTRAL] Yeah, that'd be [PII].
[AGENT][POSITIVE] OK, perfect. Is that the right one we want?
[CUSTOMER][NEUTRAL] Yeah, that one's fine.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so I do see on your policy um that you're current and active with us is what I have listed. Um, what is there something in particular, is there like were there policy codes you're wanting me to look up and see if they were approved under your policy or?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Thank you. Um, yes, I actually, so, oh, so I have a dental appointment that was recommended by, there's a few things, two things actually. I have a dental appointment.
[CUSTOMER][NEUTRAL] Scheduled coming up soon for having a removal of 3 teeth surgically.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, so I just need to make sure that that's covered. If not, I can, you know, go with another company that's in a network or whatever.
[CUSTOMER][NEUTRAL] Um, or
[AGENT][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So let me pull up like your benefit information that has like all those codes on it real quick.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see what I have.
[AGENT][NEUTRAL] Dental
[AGENT][NEUTRAL] So there are a couple options. So if you're, if they need to do any like major um dental work, anything that falls under those major expenses, which are like the more extreme sort of extractions, um, that does fall under a 12 month waiting period which you will not have it until June.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's an extraction.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] There is a code that falls under the basic for a basic extraction and that one you do have coverage on if it's coded as that but I wouldn't be able I mean I can never guarantee over the phone it's all about what comes in on the claim form but it's I guess depending on how.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] In depth it is and what they decide to code it as.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, as far as our policy goes though, you don't have a network, so we'll honor your benefits anywhere you go.
[CUSTOMER][NEUTRAL] Got you, so I'll have to see what the.
[CUSTOMER][NEUTRAL] OK, so before they would do, before I would have them do anything, I would have to make sure that how they would code it is the word.
[AGENT][POSITIVE] Yes, and they can do um we have these like documents that we can send to your dentist that like give them every code that you are approved for and they can like do a workup and like help you with an estimate.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, OK, so I guess when I see them before they try to do anything, just see how they would code it and you guys would send them documents.
[AGENT][POSITIVE] Yeah, absolutely, and you can even.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] I mean you might call and ask if they wanna do like a.
[AGENT][NEUTRAL] If they could work you up an estimate and look at those codes, um, this policy that I'm looking at you have access to all this information through our online service center. I don't know if you've set up like our online portal but you also have access to like all these codes that you're approved for.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I thought I did. What's the, what's the website?
[AGENT][NEUTRAL] Yeah, it's secured. Apub. AM is short for American [PII].
[CUSTOMER][NEUTRAL] And public.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Let me bookmark this real quick.
[CUSTOMER][NEUTRAL] And I think I, I'm not entirely sure what I would have put.
[CUSTOMER][NEUTRAL] My username, let me take a wild stab in the dark, um.
[CUSTOMER][MIXED] OK, oh shit, that works, excuse my language, but yes, um.
[AGENT][POSITIVE] You're OK.
[CUSTOMER][NEUTRAL] So I am in.
[CUSTOMER][NEUTRAL] And I did, I know, OK, yeah, so this website I did up that was gonna be my second question. I did upload a claims form because I had went to get an X-ray just to kind of see where I was at, um.
[CUSTOMER][NEUTRAL] But I forgot that I had dental dental coverage, so they told me to just upload that information which I did, so I just need to know if that was approved or not.
[AGENT][NEUTRAL] OK, I do see that we received something 121. Would that have been the day you uploaded it?
[CUSTOMER][NEUTRAL] Because I think I spent $200.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK perfect so it hasn't been processed yet but it has been received.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Where would I go for those codes you were saying?
[AGENT][NEUTRAL] Yeah, so when you get into that, um, there should be somewhere and let me open up my side of it so I can, I want to direct you to the right way. it should say like my coverage and it will say like the name of it and then it will say the policy number and you should be able to click the policy number to view your policy documents.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] All I see from the very top is the let me go to the homepage maybe.
[CUSTOMER][NEUTRAL] OK, so I'm at the home page says contact claims form help and then walk and it says my name and when I hover over that says policy contact notification preferences and payments preferences and then log out.
[AGENT][NEUTRAL] OK, so when you're in that home page and you scroll down like um there should be somewhere maybe above my claims it would say my coverage and then next to it it would have like your ID card it'll say like my ID cards and my coverage side by side.
[CUSTOMER][NEUTRAL] I don't see any
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, my claims upload documents.
[CUSTOMER][NEGATIVE] Nothing that says my coverage.
[CUSTOMER][NEUTRAL] I see my ID card sample.
[CUSTOMER][NEUTRAL] Let me see there's a little PDF here hang on.
[CUSTOMER][NEUTRAL] And it's just a
[CUSTOMER][NEUTRAL] This is just a copy of my ID card.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] Yeah, this isn't, no, I don't see anything in here that says my coverage.
[AGENT][NEUTRAL] OK, that is
[AGENT][NEUTRAL] I mean, I, I don't, I wish I like could see your screen with you um but what I can do, ma'am, if you want I can.
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I see my, I'm sorry, I see my coverage and it says group volunteer dental.
[AGENT][NEUTRAL] And then does it have the numbers right next to the dental like where your policy number would be?
[CUSTOMER][NEUTRAL] And then short term
[CUSTOMER][POSITIVE] Yes, it does. Yes it does.
[AGENT][NEUTRAL] You should be able to click that to view your documents.
[CUSTOMER][NEUTRAL] OK, let me click on that.
[CUSTOMER][NEUTRAL] OK, I see it now.
[CUSTOMER][NEUTRAL] And they said they should have codes on here that they would be able to see.
[AGENT][NEUTRAL] Yeah, somewhere down along the way you'll start seeing like it'll say like procedure code. The first one listed is 00120.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I do. I see. I, yeah, I did a control F to find codes and so it came up and has a services limitations, procedure codes like you're saying.
[CUSTOMER][NEUTRAL] Yeah, basic expenses.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, I was just blind early. I don't know why I didn't see that. I mean, I was looking at it, but I knew.
[AGENT][NEUTRAL] No, that's OK.
[CUSTOMER][NEUTRAL] I didn't see that. OK, so I will print these pages out.
[CUSTOMER][NEUTRAL] To them, um.
[CUSTOMER][POSITIVE] And see the best way to go with this so we can get covered.
[AGENT][POSITIVE] Yeah, absolutely, and if you need any more information from us like just don't hesitate to reach out we're always here to take care of you.
[CUSTOMER][NEUTRAL] OK, see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Yeah, it's my pleasure. Is there anything else I can do for you, Miss [PII]?
[CUSTOMER][POSITIVE] Uh, no, that'll be all. Thank you so much.
[AGENT][POSITIVE] Hey, it's my pleasure. Thank you so much for calling APL and I hope you have a fabulous day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] I think
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Bye bye.