AccountId: 011433970860
ContactId: 93fa9376-f5f7-490e-a180-0cebe28a5d58
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 378260 ms
Total Talk Time (AGENT): 133686 ms
Total Talk Time (CUSTOMER): 132777 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/93fa9376-f5f7-490e-a180-0cebe28a5d58_20250611T18:12_UTC.wav
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[AGENT][NEUTRAL] [PII], this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. My husband's got insurance um with you guys and um I'm wanting to know, he, he was at the dentist, two different dentists today. He's got an extraction that his tooth needs to come out. And um I want to know.
[CUSTOMER][NEUTRAL] They are requiring a copay.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is, I mean, is that, is dental not covered?
[AGENT][NEUTRAL] I would need to look at his policy. Do you have his policy number?
[CUSTOMER][NEUTRAL] Yeah, give me your policy number.
[CUSTOMER][NEUTRAL] It's 02619366.
[AGENT][NEUTRAL] OK. And then what's the name on the policy?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And then can I get date of birth and address?
[CUSTOMER][NEUTRAL] [PII]. Address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And I apologize, but is he, he's having an extraction done?
[CUSTOMER][NEUTRAL] Yeah, it's an emergency. Um, he's got a toothache that has been bothering him and we have been to two different dentists today. One of them was wanting a co-payment of $200 and the other one, I think it was like $80.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the plan that, the dental plan that he has, it is a dental plan. So dental is covered cause that's the type of plan it is. The plan itself has preventative and basic coverage, that would be it. So, the only type of extraction that's covered is what they call a simple extraction. Um, I don't know how, you know, what type of extraction it is. Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But yeah, I mean.
[AGENT][NEUTRAL] That's basically what the plan covers. So, if it's a basic
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][POSITIVE] So a simple extraction it covers.
[AGENT][NEUTRAL] Yeah, so if it's a simple extraction, the plan covers.
[CUSTOMER][NEUTRAL] What about the X-ray?
[AGENT][NEUTRAL] Well it covers 80% of the cost, so whatever the remaining is would then be your responsibility.
[CUSTOMER][NEUTRAL] OK, well, they didn't even call him in the back and gave him a copayment.
[CUSTOMER][NEGATIVE] So I don't understand that.
[AGENT][NEUTRAL] Well, if they know that it's not gonna be considered.
[CUSTOMER][NEUTRAL] I don't know. I mean, I would, I would think.
[CUSTOMER][NEUTRAL] I think it would be a basic pulling, I mean.
[CUSTOMER][NEUTRAL] But they wouldn't know because they haven't looked in his mouth. I mean.
[AGENT][NEUTRAL] So preventative is the only thing that's covered at 100%. So that facility itself may just require some sort of payment up front before they can render services. That's honestly at their discretion. We don't have any control over that.
[CUSTOMER][NEUTRAL] OK, well, what would, what type would he need for it to be covered all the way like 100%?
[AGENT][NEUTRAL] I'll be honest with you, ma'am. I've never
[CUSTOMER][NEUTRAL] That's the point of having.
[AGENT][NEUTRAL] I've never seen a dental plan that covers any sort of extraction at 100%.
[CUSTOMER][NEUTRAL] She says she's never seen any dental plan that covers at 100%.
[AGENT][NEGATIVE] Not for an extraction.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][POSITIVE] I know Blue Cross Blue Shield did cause that's what he had last and it covered everything. He didn't have to pay probably nothing out of pocket.
[CUSTOMER][NEUTRAL] And if it was, it was only like 15 to $20 at the most.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] The coverage that we generally um have that I've seen preventative is covered at 100.
[CUSTOMER][NEGATIVE] She did a basic extraction would be, it would cover it, but she don't.
[CUSTOMER][NEUTRAL] But the X-ray covers up to 80%.
[CUSTOMER][NEUTRAL] That's what she's saying.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] OK, well, how, how can he go about canceling this and we'll go somewhere else to get insurance?
[AGENT][NEUTRAL] Let me see if we can cancel it or if it needs to be canceled through the group. Give me just a second.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Cause I mean they ain't no sense in taking it out and you got the, you just go about the Blue Cross Blue Shield.
[AGENT][NEUTRAL] OK, so the plan is offered it looks like through benefits and a card and that's who would cancel the coverage if you guys wanted to do that and I can give you their phone number and transfer you, um, whatever works best.
[CUSTOMER][NEUTRAL] OK. You can give me the number.
[AGENT][NEUTRAL] Their phone number
[CUSTOMER][POSITIVE] I think I got it.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] All right. Thank you, ma'am.
[AGENT][POSITIVE] You're welcome. I hope you have a good rest of your day.
[CUSTOMER][NEUTRAL] All right, you too, bye.