AccountId: 011433970860
ContactId: a84cfd98-07c0-4ba3-9eb6-1ad6870f0423
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1055770 ms
Total Talk Time (AGENT): 376681 ms
Total Talk Time (CUSTOMER): 369877 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/a84cfd98-07c0-4ba3-9eb6-1ad6870f0423_20250321T15:24_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, I was wondering if you could help me find out what is covered under my plan.
[AGENT][NEUTRAL] Um, sure, I can help you find out what's covered. Um, can I have your name?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] And [PII], do you have your policy number?
[CUSTOMER][NEUTRAL] Uh yes, it's.
[CUSTOMER][NEUTRAL] 024859
[CUSTOMER][NEUTRAL] 69.
[AGENT][NEUTRAL] OK [PII]
[AGENT][NEUTRAL] Can I have your date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Just have a few other pieces of information to verify. Could you provide your um.
[AGENT][NEUTRAL] Address, your home address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then lastly can you
[AGENT][NEUTRAL] your email address.
[CUSTOMER][NEUTRAL] Oh crap, I don't know which one I have on there. Um, I think it's [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes, that's correct. And then good.
[CUSTOMER][NEUTRAL] With a period in between? OK.
[AGENT][NEUTRAL] Yep, that's what I've got, um, and then your callback number just in case I lose you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK, it's not a guarantee of payment, just a basic outline of your policy. Is there a specific thing that you're looking for or you just wanna kind of go over what you have?
[CUSTOMER][NEUTRAL] Um, well, I have no clue being that you guys don't have any information on the website.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Drives me batty. I can't look up stuff myself.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, but I need a cleaning and I think I have a cavity for the first time in 30 years. So, um, so those are the two things that I'm really worried about, uh, whether, what you cover.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Let's look up and see what what you have.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] So it looks like.
[AGENT][NEUTRAL] 8
[AGENT][NEUTRAL] So you have a $500 calendar year maximum benefit.
[AGENT][NEUTRAL] There's also I can
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I can send you a kind of a breakdown of all this too by email if that's helpful.
[CUSTOMER][POSITIVE] Oh, that would be awesome.
[AGENT][NEUTRAL] OK, is that email that we just discussed is that a good email?
[AGENT][NEUTRAL] I can send you this.
[CUSTOMER][NEUTRAL] Yes, that would be
[CUSTOMER][POSITIVE] Yep, that would be great.
[AGENT][NEUTRAL] OK, perfect. OK, um, so $500 calendar year maximum.
[AGENT][NEUTRAL] Um, preventative services are gonna pay 100%, so it'd be like your cleanings, um, basic, um, or your cleanings, um, and exams, and then for fillings.
[AGENT][NEUTRAL] Looks like that's gonna pay 80%, um, up to that $500 maximum after you.
[AGENT][NEUTRAL] Be a $50 deductible.
[CUSTOMER][NEUTRAL] A $50 deductible. OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And, and I pay that deductible at the time of service, is that how?
[AGENT][NEUTRAL] It just depends on typically that's how it works.
[AGENT][NEUTRAL] Works, but that's dependent on the provider that's up to them um when you pay so usually that's how it works so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I, I guess I, I haven't looked to see, can I go to any dentist or?
[CUSTOMER][NEUTRAL] Are there stipulations on that as well?
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] See if you have a network.
[AGENT][NEUTRAL] Uh, can I place you on a brief hold for just a moment?
[CUSTOMER][NEUTRAL] Yeah, that'd be fine.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, D4 FFSB. What's the Carrington.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Oh, I'm trying to see.
[AGENT][NEUTRAL] Review the uh button.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, sorry, I see.
[AGENT][NEUTRAL] I see the edit button.
[AGENT][NEUTRAL] I don't see that's what I was trying to see if I easily can find out if she uses Carrington or not.
[AGENT][NEUTRAL] Is that where it is?
[AGENT][NEUTRAL] Oh, you're on mute.
[AGENT][NEUTRAL] Are you there? You're on mute.
[AGENT][NEUTRAL] 248-596-9.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Just the employer's big.
[AGENT][NEUTRAL] Request and insured may have an MEC plan administered by IMA.
[AGENT][NEUTRAL] I don't see oh Carrington Network there we go. Carrington Network, OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, OK, that's where I see it. OK, thank you, sorry, I was trying to figure it out and I was trying to figure it out without.
[AGENT][POSITIVE] I know, I know. OK, thank you.
[AGENT][NEUTRAL] All right bye.
[AGENT][POSITIVE] OK, sorry about that, [PII]. um, thank you for holding.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] Uh, yes, so you actually do have a network that you can utilize, um, that's gonna be through the Carrington network for your dental, um, we don't require you to use it, but if you use it, it can provide discounts potentially so, um, uh, this, this, this will be included in the information that I send you by email but if you do wanna jot down their number you can look, you can call them and get a network provider.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] So but again I'll send this to you by email um that way.
[CUSTOMER][NEUTRAL] 23
[AGENT][NEUTRAL] You've got a copy of it, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then did you have any other questions about your policy?
[CUSTOMER][NEUTRAL] Um, no, I'm just curious why, um, the company doesn't have all that stuff online.
[AGENT][POSITIVE] Yeah, that's a good question. Um.
[CUSTOMER][NEGATIVE] So, I hate calling.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] No
[CUSTOMER][NEUTRAL] I just tell people it's like.
[AGENT][POSITIVE] I totally get it.
[CUSTOMER][NEGATIVE] I just want to look it up myself. I'm independent. I don't want anybody's help.
[AGENT][POSITIVE] I, I totally understand. I'm like that.
[CUSTOMER][NEUTRAL] Alright. Yup.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] I avoid calls just as much as I can.
[AGENT][POSITIVE] That's funny, um.
[CUSTOMER][POSITIVE] Yup, yep, exactly, and, and, and this is the first insurance company I've ever had that I've had to call for everything, and I'm just like, wow.
[CUSTOMER][NEGATIVE] They spend a lot of money in customer service where they could just get a web designer and.
[CUSTOMER][NEUTRAL] Call it a day, but
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][POSITIVE] I'm, I'm glad you have a job.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] I understand that. I really do.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I was just curious about that if if they had a reason or.
[CUSTOMER][NEUTRAL] Or not, but
[AGENT][NEUTRAL] Well, I don't
[AGENT][NEUTRAL] Let's see, I'm trying to find and make sure I'm not missing anything.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, I think that's all I needed that's uh.
[CUSTOMER][NEGATIVE] What I need the most is to know, you know, if they're gonna cover my cleaning and um I haven't had a cavity since [PII] and one of my back teeth is doing something weird. So, so I'm kind of freaking out. I'm like, oh my [PII], do I have a cavity?
[AGENT][POSITIVE] You're doing a good job
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I was like, shoot, you better get to the dentist before that tooth falls out or something, so.
[AGENT][NEUTRAL] OK, I was double checking. It, it shows that you should be able to download your policy certificate on the online, um.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Service center so.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You registered on the online service center?
[CUSTOMER][NEUTRAL] Um, I'm on, uh,
[CUSTOMER][NEUTRAL] AMP, uh, what is it? [PII].
[AGENT][POSITIVE] Yeah, so it's secure. A secure it's actually secured. [PII] OK and then let's see.
[CUSTOMER][NEUTRAL] Is what I'm on.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that's, that's what I'm on right now.
[AGENT][NEUTRAL] OK, let me, let me, let me, if you'll just, if you have a moment, I'm gonna see if I can.
[AGENT][NEUTRAL] We could look at this together to make sure because my understanding is you should be able to download your policy certificate and that's that's your policy in its entirety so um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's look real quick if you don't mind.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][NEUTRAL] Just wanna make sure that um we're looking at the same thing. Hold on just a second.
[AGENT][NEUTRAL] Because I understand, you know, if you can get it online, that's really.
[AGENT][POSITIVE] The most beneficial.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Let me pull up another.
[CUSTOMER][NEUTRAL] Yeah, and I click to.
[CUSTOMER][NEUTRAL] Um, I clicked on the APL in the upper left corner and that took me to.
[CUSTOMER][NEUTRAL] Um, just the regular.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] But even there it doesn't.
[AGENT][NEUTRAL] Yeah it should be let me see.
[CUSTOMER][NEUTRAL] Claims the form.
[AGENT][NEUTRAL] So it has claim forms. What else does it show on there? Does it have um.
[CUSTOMER][NEUTRAL] Claims and forms is one tab, claim status.
[CUSTOMER][NEUTRAL] Uh, sign in, um, about solutions products.
[CUSTOMER][NEUTRAL] Uh, for brokers, for groups, and then contact.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that's just our regular website that you're that you're looking at. You do have to type in secured. [PII].
[CUSTOMER][NEUTRAL] That's what
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yep, yep, and I'm on that one as well.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] OK, on that one, are you?
[CUSTOMER][NEUTRAL] Is that uh
[AGENT][NEUTRAL] That's the one.
[AGENT][NEUTRAL] Are you logged in?
[CUSTOMER][NEUTRAL] OK, so the blue.
[CUSTOMER][NEUTRAL] Oh, it's getting a file. I clicked on the blue number for my voluntary dental.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I want to download.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Um, the letter notice.
[CUSTOMER][NEGATIVE] Grievance writer.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh your son.
[CUSTOMER][NEUTRAL] Definitions effective date.
[AGENT][NEUTRAL] Uh, benefits should start on page 9. Check out page 9.
[CUSTOMER][NEUTRAL] fine.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Well, how about that?
[AGENT][NEUTRAL] There is that it?
[CUSTOMER][NEUTRAL] That is a preventative 100%.
[CUSTOMER][NEUTRAL] X-rays and and stuff are 80%.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I mean it doesn't give like major information but.
[CUSTOMER][POSITIVE] Better than nothing.
[AGENT][NEUTRAL] Um, if you
[AGENT][NEUTRAL] Yeah, yeah, if you keep scrolling down it should I mean there's the let's see, trying to pull this back up.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] I'll give you.
[AGENT][NEUTRAL] Uh, let's see, so.
[AGENT][NEUTRAL] Try to see where it'll give more details.
[AGENT][NEUTRAL] Yeah it doesn't have any major coverage so it is just note that it is just uh preventative and basic only.
[AGENT][NEUTRAL] So you kind of have that whole section missing um because it's not under the policy, so.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But yeah that would be basically what I'd be sending you as well so um does does that help?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, uh definitely.
[AGENT][POSITIVE] OK, good, good.
[AGENT][NEUTRAL] OK. Well,
[CUSTOMER][NEUTRAL] Yeah, I just wanna make sure that I know approximately what I'm gonna have to pay for and, and what's gonna be covered and and all that good stuff because.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Totally, you know.
[CUSTOMER][NEGATIVE] Um, my insurance is gonna be messed up because I got hurt at work on Tuesday, so I haven't been back to work and we're paid weekly through the, through Doherty and
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So when you don't work 2 or more days, they don't take your insurance out?
[CUSTOMER][NEUTRAL] It's, it's the weirdest thing, um.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEGATIVE] Everything about this experience is weird.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The, the insurance, you know, I'm used to Blue Cross Blue Shield, uh, insurance, um, most of my life, so going through this with, you know, APL and stuff is like, what?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The whole new learning experience, so.
[AGENT][NEUTRAL] Yeah, I understand.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] But yeah, so I think uh.
[CUSTOMER][NEUTRAL] Seeing that uh some of the stuff is basic and some of it is preventative and the preventative is what's covered 100%, correct?
[CUSTOMER][NEUTRAL] Make sure I understand that correctly.
[AGENT][POSITIVE] That's correct and there's no deductible, yeah, that's correct, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Alright, well I will give that [PII] number a call and see who I can see and.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Praying I don't have a cavity.
[AGENT][POSITIVE] Yes, yes, absolutely.
[AGENT][NEUTRAL] I, I feel you there, so, yeah.
[CUSTOMER][NEUTRAL] I worked really hard to not have one.
[CUSTOMER][POSITIVE] So, all right, well thank you so much for all your help. I appreciate it.
[AGENT][POSITIVE] Totally understand.
[AGENT][POSITIVE] OK, [PII], if there's not anything else I can help you with, I hope you have a terrific weekend.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yes, you too. Bye bye.
[AGENT][POSITIVE] Thank you for calling APL bye.