AccountId: 011433970860
ContactId: a9990d0b-2b48-4bc7-8ada-e15981d6dd9e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 758059 ms
Total Talk Time (AGENT): 151465 ms
Total Talk Time (CUSTOMER): 149745 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/a9990d0b-2b48-4bc7-8ada-e15981d6dd9e_20250508T19:25_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Try to talk to somebody about the uh dental insurance.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, can I get your policy number?
[CUSTOMER][NEUTRAL] I don't have that. I have my phone number and my social.
[AGENT][NEUTRAL] OK, what's your social?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And while I'm pulling that up, can I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And your name?
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and you're calling on the dental, is that correct?
[CUSTOMER][NEUTRAL] Yeah, the, uh, billing department had a merged. I don't know if they're still.
[CUSTOMER][NEUTRAL] I don't know if she hung up or not.
[CUSTOMER][NEUTRAL] Uh, but I was in a 3 way because just a mix up with the billing or something.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] They're they're saying not everything got covered by you guys that you said you were gonna cover, but I sent the ELBs for two different appointments and I thought it indicated differently.
[AGENT][NEUTRAL] OK, alright, can I verify your address and your email address and then I can get somebody that in claims that can can look that up for you.
[CUSTOMER][NEUTRAL] Uh my email address is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then what else do you need?
[AGENT][NEUTRAL] Uh, your address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and uh since you're calling about a claim.
[AGENT][NEUTRAL] Um, I will need to get you with our claims department. Is there anything else I can help you with in customer service before I get claims for you?
[CUSTOMER][NEGATIVE] No, I had her on the phone and she was supposed to hold on, but I think she she hung up.
[AGENT][POSITIVE] OK, alright, well let me get, get you connected and you have a good weekend and.
[AGENT][POSITIVE] A good day. I'm sorry.
[CUSTOMER][NEGATIVE] Yeah, whatever.
[AGENT][NEUTRAL] And thank you for calling APL. Hold on just a moment.
[CUSTOMER][NEUTRAL] Currently no agents staffed. Goodbye.
[AGENT][NEUTRAL] What?
[AGENT][NEUTRAL] They're all in meetings.
[AGENT][NEUTRAL] OK, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, I do apologize, but the, um, the claims team are all in a meeting, um.
[AGENT][NEUTRAL] I'm gonna send them an email and they'll give you a call back on your your claim. Do you have a claim number that you're calling on?
[CUSTOMER][NEGATIVE] I have no idea. These are two different things they're talking about. They say that a portion portion wasn't covered. I proved differently. They call me back 2 weeks later, say different appointment, a portion is covered, but not the rest.
[AGENT][NEUTRAL] OK, that's fine.
[CUSTOMER][NEGATIVE] Like it was supposed to be the EOB is proving that didn't happen either. And then I last I heard this today earlier that there was a positive adjustment meaning that they upped the bill, and then they call back and say what's up with the positive adjustment? They say that didn't happen, but that the insurance didn't cover what they said they were gonna cover.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] So they're saying I owe like 600 to $700 more than what I initially was told and walked out the door paying.
[CUSTOMER][NEGATIVE] So even after paying and walking out the door thinking that this should be squared away now I still owe almost $700.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, they should be out of their meeting shortly um and I, I do apologize but I will get them to call you back and, and help you with, but I don't have access to.
[CUSTOMER][NEGATIVE] I'm just confused. It's not like a $100 difference here like.
[AGENT][NEUTRAL] Right, I understand.
[CUSTOMER][NEGATIVE] And they called the insurance company and this is what they were told was covered. So why am I being told things weren't covered? $700 please.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I, I don't have access to the claims so I would be very happy to look that up for you, but I don't have access to that.
[CUSTOMER][NEUTRAL] Does that happen often?
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Like I said, I
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] My supervisors saying that to hold on just a moment, um, she's gonna try to get somebody that can talk to you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, hold on just a moment.
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Transferring.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] in customer services. How are you?
[CUSTOMER][POSITIVE] Oh hey [PII] good how are you?
[AGENT][MIXED] I am good. I do have an upset customer on the phone.
[AGENT][NEUTRAL] Calling about a claim.
[CUSTOMER][NEUTRAL] Uh oh.
[CUSTOMER][NEUTRAL] OK, um, are they just needing clarification on a claim or are they checking on it?
[AGENT][NEGATIVE] Well, he, he said that it's a dental claim and the dentist office called, was told that something was covered and how much it was gonna pay and now they're not paying it and he's owing $700 more than he thought he was. And the last person he called before me hung up on him and.
[CUSTOMER][NEUTRAL] Mm yikes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But um
[CUSTOMER][NEUTRAL] 00 man OK fun all right um do you have his name?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] His name is [PII]. Policy number is 220.
[CUSTOMER][NEUTRAL] [PII], uh huh.
[AGENT][NEUTRAL] 1664. [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's called that
[CUSTOMER][NEUTRAL] Do you have a callback number for him?
[AGENT][NEUTRAL] Yeah, it's the one he's calling on.
[CUSTOMER][POSITIVE] Yes thank you.
[AGENT][NEUTRAL] That [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got it. OK, thank you. All right.
[AGENT][NEUTRAL] And he, he's fully verified.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK awesome thank you for that yep, you go ahead and send him over.
[AGENT][NEUTRAL] All right, here he is.
[CUSTOMER][POSITIVE] Thanks.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hi [PII]