AccountId: 011433970860
ContactId: ad5fbf29-739f-4af3-9a93-a901356eca7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 480059 ms
Total Talk Time (AGENT): 259595 ms
Total Talk Time (CUSTOMER): 148967 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/ad5fbf29-739f-4af3-9a93-a901356eca7b_20250121T16:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was calling about my uh dental insurance through you guys, um.
[CUSTOMER][NEUTRAL] I, I actually needed to file a claim because I have.
[CUSTOMER][NEUTRAL] My I had an X-ray of my teeth done and I wasn't sure if I had any insurance for you guys and so I was told to call and have that reimbursed to me.
[CUSTOMER][NEUTRAL] The X-ray.
[AGENT][NEUTRAL] OK, yeah, so you can file a claim either online you can send it in the mail or you can do it through fax, whatever is easiest for you um would you wanna do it you think online? I can, uh, give you information on that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes, I'll probably wanna do it online.
[AGENT][NEUTRAL] OK, so we have an online service center. It's at our website, which is [PII]. That's [PII], the word [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] When you get to the website um you're gonna see on the top right hand side of the screen there's gonna be a link there to log in when you click that link it takes you to the secure site then and you're gonna click I'm a new user to create a log in.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, you're an individual with an APL policy, so you're gonna select the first option, and then it's gonna ask for your last name, social, zip code, email, and date of birth.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Once you get all that created, you'll get your username that up. Once you get in, um, you're gonna see under my claims there's a green button there it says upload files. That's where you file your claim at.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Upload
[AGENT][POSITIVE] Yeah, it's pretty.
[CUSTOMER][NEUTRAL] Do I need to scan the receipt?
[CUSTOMER][NEUTRAL] That they gave to me?
[AGENT][NEUTRAL] Yeah, so that was my next thing I was gonna give you. So,
[AGENT][NEUTRAL] The only other thing that you'll need to do um is get, oh, it looks like not required. Let's see.
[AGENT][NEUTRAL] OK, so it looks like we have a dental claim form on our site. It does say that it's not required.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Um, it says if your dentist does not file your insurance claim, they'll provide you with an ADA claim form, American Dental Association form, and this will detail all the dental work performed. Submit that with your, uh, claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it looks like we'll accept that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I do have a question because the work that I did have them look at for the visit, they said, um, it's gonna require surgery. Now, of course I would want to go through the insurance that I do have, is there, uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there like information like what's in my network? what's available to me?
[AGENT][NEUTRAL] I can definitely, yeah, I mean I can definitely check your policy if you want. Most of our dental policies you can see anybody as far as a provider goes, um, they're just, just gonna pay like a certain percentage usually towards whatever you're having done.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and your dentist should also, if you have to have something like that done, you should be able to provide them with your insurance, and if you want, they can send us like a pre-determination. That way, you kind of know what your cost would be out of pocket before you have the work done.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so contact them, see what.
[CUSTOMER][NEUTRAL] The cost basically would be and then they would contact you guys with it.
[AGENT][NEUTRAL] Yeah, I mean they should be able to tell based off of your insurance and what they charge for the work you're having done. They should be able to tell you based off of that like what your cost, if any, is going to be for work that you need to have done absolutely.
[CUSTOMER][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] Now as far to see my policy, how would I go about doing that? Would I be able to see it with the APL where I'm logging in?
[AGENT][NEUTRAL] Yeah, I believe once you log in you can actually see it. Let me one second.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I just created the account.
[AGENT][POSITIVE] OK, great.
[AGENT][NEUTRAL] I believe when you um yeah so when you log in.
[AGENT][NEUTRAL] Um, you'll see that it's gonna say my coverage and then it'll say product type, and you'll see a policy number there. If you click on the policy number, it will download your complete policy and you can um view it or print it, whatever you would like to do.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, uh, you kinda lost me there. Where, where am I clicking on?
[AGENT][NEUTRAL] You should see your policy number it highlighted in a light blue.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, if you click on that.
[CUSTOMER][NEUTRAL] Yeah I have 2 here, short term and and in group volunteer oh dental. I got a group. I see dental. So I clicked on that's loading.
[AGENT][NEUTRAL] Yeah, so it should download in the right hand, yeah.
[CUSTOMER][NEUTRAL] OK, downloaded.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So alright, so I see this information you said in here we'll have what I need 5.
[CUSTOMER][NEUTRAL] Uh, what am I looking for on in this package?
[AGENT][NEUTRAL] Well, I mean, that's just your policy if you're wanting to look at what your policy covers and everything like that.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Got you. OK, I see what you're saying. Got it. Thank you for that. How many pages did I say? 36, wow, OK.
[CUSTOMER][NEUTRAL] Um, OK, so I have that.
[CUSTOMER][NEUTRAL] And then you said when I log in.
[CUSTOMER][NEUTRAL] Upload file for my claim, OK, and this is where I would put it?
[AGENT][NEUTRAL] Mhm, yep, you click the upload files, you're gonna select who you're filing the claim for.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then you're gonna select the plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yea[PII], the dental plan. OK, alright, so what I'm gonna do then I put the um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The next step is to contact the people that they recommended that I get the surgery through.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] See if they accept my plan. If not, then I have to go through what's through what's covered under it. Is that correct as far as what's within my network?
[AGENT][NEUTRAL] Yeah, yeah, so I would contact them, just provide them your health insurance. They like I said, yeah, you shouldn't have any problems with them accepting it, um, and then they should be able to, if they need to call us to verify your eligibility, and then they should be able to give you kind of an estimated cost of what it's going to be.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK, um, I will go ahead and take it from here then.
[AGENT][POSITIVE] All right sounds good if you have any other questions or concerns feel free to call us, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.