AccountId: 011433970860
ContactId: a6f18a1a-0a1c-4622-93f4-23694617b90d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 810140 ms
Total Talk Time (AGENT): 273771 ms
Total Talk Time (CUSTOMER): 208776 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/a6f18a1a-0a1c-4622-93f4-23694617b90d_20250415T21:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, this is [PII].
[CUSTOMER][NEGATIVE] I'm having a problem with the insurance.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] You have your policy number?
[CUSTOMER][NEUTRAL] I'm trying to get in.
[CUSTOMER][NEUTRAL] To see the dentist.
[CUSTOMER][NEUTRAL] My, my policy number?
[CUSTOMER][NEUTRAL] It's 00.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Yeah, 007789.
[AGENT][NEUTRAL] OK. You said you're, yes, I'm here. You said you were trying to go to the dentist, is that right?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yeah, and
[CUSTOMER][NEGATIVE] They're telling me the insurance won't pay for filling.
[AGENT][NEUTRAL] OK, let me, uh, let me see. I pull this up.
[CUSTOMER][NEUTRAL] They're saying y'all gonna pay for fillings.
[AGENT][NEUTRAL] OK, let me pull up your policy.
[CUSTOMER][POSITIVE] I got a few points.
[AGENT][NEUTRAL] What's your birthday, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And your telephone number?
[CUSTOMER][NEUTRAL] Uh, probably got a new 1, [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK, let's see. So, let me check and see what we've got covered on your policy. Give me just a moment.
[CUSTOMER][NEUTRAL] I've been a member since [PII].
[AGENT][NEUTRAL] Yeah, it looks like you have been for quite a long time. Let's see.
[CUSTOMER][NEUTRAL] Yeah, that's why I'm wondering why ain't I getting dental insurance.
[AGENT][NEUTRAL] See what we've got going on.
[AGENT][NEUTRAL] OK, I'm pulling this up. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and they're wanting to check on a cra uh filling, is that right?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I need some filling and a crown and I need a partial maize.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] I can't, I need the fillings done pretty quick.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. I'm looking at your policy and this is not a guarantee of payment, it's a basic outline of your policy.
[AGENT][NEUTRAL] Um, so I show coverage for fillings. Um, it depends on like what type you get. There's a certain dollar amount that it'll pay out.
[AGENT][NEUTRAL] So, I don't know if they
[AGENT][NEUTRAL] Let me see if we got a call from a provider, um.
[CUSTOMER][NEUTRAL] So I got a call from 2 of them.
[CUSTOMER][NEUTRAL] Cause I checked with 2.
[CUSTOMER][NEUTRAL] And uh
[AGENT][NEUTRAL] Yeah, looks like uh we got a call from Lotus Dental.
[AGENT][NEUTRAL] And
[CUSTOMER][POSITIVE] Yeah, that's the one I really wanted to go to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, yeah, we sent them your, we sent them a breakdown of what your plan covers.
[AGENT][NEUTRAL] So, like, you know, fillings, for example, it just, it just depends on what kind of filling you get. There's just certain dollar amounts that'll cover.
[AGENT][NEUTRAL] So it's not, it's not that it's not covered, it just, it'll only pay a certain dollar amount.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I'm not sure what they checked on.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but like for fillings, it, it can pay anywhere from
[AGENT][NEUTRAL] $12 to $85. It just depends on what you're getting.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] $12 to $85.
[AGENT][NEUTRAL] Yeah, so it's a
[CUSTOMER][NEUTRAL] I might need to upgrade my policy.
[AGENT][NEUTRAL] Yeah, so it just like I said, it just depends on what you, what type of filling it is and the dollar amount it will pay.
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEUTRAL] Because they want uh they want to charge around $320.
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] And if it's just $85.
[CUSTOMER][POSITIVE] My goodness
[CUSTOMER][NEUTRAL] Is there an upgrade? OK, could I upgrade my billing?
[AGENT][NEUTRAL] Um, let
[AGENT][NEUTRAL] So do you have this, it looks like you have this, um.
[AGENT][NEUTRAL] You'd have to talk to uh your agent. where did you get this um policy from? Was it through your employer when you worked for them?
[CUSTOMER][NEUTRAL] Yeah, it was uh through uh.
[CUSTOMER][NEUTRAL] Department of Transportation and Development.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I've had it since [PII].
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] They probably don't even offer it no more.
[CUSTOMER][NEUTRAL] I wouldn't think, as far as I know, I retired 12 years ago and
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] As far as I knew then, they wouldn't offering no dental plan.
[AGENT][NEUTRAL] Yeah, I don't. Let me, let me double check something. Can you hold on one moment, sir?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] OK. You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Are you busy? Sorry.
[AGENT][NEUTRAL] Oh, OK, um, hey, I've got a guy on the line.
[AGENT][NEUTRAL] Um, he retired from his group plan 12 years ago. It's dental select dental plan.
[AGENT][NEUTRAL] So now he's on his individual plan, um, it's not tied to the group. My question or his question was, can he upgrade his policy? Do we, do we sell individual policies?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, it is, and it's, it's a really old policy. It was effective, uh, [PII].
[AGENT][NEUTRAL] I know, goodness gracious, I know, like gee whiz. Um, OK, it looks like policy is 604-631.
[AGENT][NEUTRAL] And it's, it's like one of them select dental plans where it only pays a small dollar amount for like fillings and such, um.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, OK, perfect. Thank you.
[AGENT][NEUTRAL] Uh, yeah.
[AGENT][NEUTRAL] No, somebody I used to know, that's the one I know.
[AGENT][POSITIVE] Really cool.
[AGENT][POSITIVE] Oh, love him. OK, yes, I will look it up. I'll look it on YouTube tonight.
[AGENT][NEUTRAL] Yeah, OK, all right.
[AGENT][NEUTRAL] Ah.
[AGENT][NEUTRAL] OK, sorry about that, sir. Thank you for holding. Um, so our cus our customer service department, um, should be able to help you if they can upgrade the policy. I'm not sure if that's possible, um, but before I get you over to them, is there anything else I can help you with about like what the plan covers, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] As long as I've been with y'all, you should pay everything, uh.
[CUSTOMER][NEGATIVE] No, I don't get you.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, but you do want to check and see if you can get a better policy, is that right?
[CUSTOMER][NEUTRAL] Let me
[CUSTOMER][NEGATIVE] Yeah, because apparently the one I got not doing nothing for.
[AGENT][NEUTRAL] OK, OK, well let me let me uh get you over to our customer service and they'll be able to help you look into that, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] on the care team. I've got a member on the line that I've verified. Um, he wants to know if he can, uh, change his dental plan.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] Like add somebody to it or?
[AGENT][NEUTRAL] No, he wants to like change coverage, and I don't know if that's possible.
[CUSTOMER][NEUTRAL] OK, what's the policy number?
[AGENT][NEUTRAL] Policy number is 604631.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Select dental.
[AGENT][NEUTRAL] It's a really old policy.
[CUSTOMER][NEUTRAL] And he's got option
[CUSTOMER][NEUTRAL] Yeah, he's got option A, gosh, I don't.
[AGENT][NEUTRAL] I didn't know if he could upgrade or not because he, you know, it was a group policy, then he retired and then it became an individual policy, I guess he ported it.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I, I didn't know what to tell him because he wants better coverage, so I didn't know how that works.
[CUSTOMER][NEUTRAL] I really don't know either, but let's see.
[CUSTOMER][NEUTRAL] I guess he can in July he can upgrade.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] We would just have to send him an application and he can upgrade on his anniversary date.
[AGENT][NEUTRAL] OK, can you talk to him and let him know that and you can mail it to him.
[CUSTOMER][POSITIVE] Yes, I will.
[AGENT][NEUTRAL] OK, is it
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I just wanna make sure that y'all handle this part right? or do I need to do it?
[CUSTOMER][NEUTRAL] No, we do, we do. I, I was just in the middle of something, but yeah, yeah, no. Just go ahead and send it to me. I'm, I'm fine. I'm just stressed. I'm sorry.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Uh, I get it. I understand. Thank you so much. I appreciate you.
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Uh, good afternoon, Mr. [PII]. This is [PII] in customer services. How are you?
[CUSTOMER][POSITIVE] Uh, pretty good.