AccountId: 011433970860
ContactId: b32d9cf4-6ed5-43c1-bfbe-fa264af00739
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 939400 ms
Total Talk Time (AGENT): 295806 ms
Total Talk Time (CUSTOMER): 178780 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/b32d9cf4-6ed5-43c1-bfbe-fa264af00739_20250423T14:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], I'm trying to see if I, if.
[CUSTOMER][NEGATIVE] If uh my insurance was charged for a service that I had not, that was not completed.
[AGENT][NEUTRAL] OK, so like if a claim was filed uh regarding a service, is that kind of what you're looking for?
[CUSTOMER][NEUTRAL] Yeah, yes ma'am. I, I had, I had some work done with my dentist dentistry.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] And I wouldn't, I, I wasn't pleased with, with, with their service.
[CUSTOMER][NEUTRAL] So I wanna see if they file file on my insurance.
[AGENT][POSITIVE] OK, do you have your policy number? I'm happy to take a look.
[CUSTOMER][NEUTRAL] Let's look at uh see if just the number 064.
[CUSTOMER][NEUTRAL] 798.
[AGENT][POSITIVE] Alright, thank you so much. Give me just one moment please.
[CUSTOMER][NEUTRAL] I, I have a group number too.
[AGENT][NEUTRAL] 064798.
[AGENT][NEUTRAL] What would the name on the policy be?
[CUSTOMER][NEUTRAL] It uh it was issued to [PII].
[AGENT][NEUTRAL] That doesn't come up with that name on it, but if you don't have any other numbers I can search.
[CUSTOMER][NEUTRAL] Uh, how about, how well, how about [PII]?
[AGENT][NEUTRAL] Hmm. No.
[CUSTOMER][NEUTRAL] The, the card, the card I'm looking at has a uh Cassandra A. [PII], a family coverage.
[CUSTOMER][NEUTRAL] Uh, and, um, a policy certificate number.
[CUSTOMER][NEUTRAL] Uh, uh, 604-798, a group.
[CUSTOMER][NEUTRAL] No, uh, LA.
[CUSTOMER][NEUTRAL] 0685.
[AGENT][POSITIVE] All right, let's try that.
[AGENT][NEUTRAL] OK, there we go. I had it as 64798. I missed that 0 between the 6 and the 4. I apologize.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, all right, uh, and then Mr. if I can just get your date of birth, please, Mr. [PII], and then address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] And it would have been under your name, is that correct?
[CUSTOMER][NEUTRAL] It would have been under my name, that's correct.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right. Thank you so much for your patience, Mr. [PII]. So, I don't see any claims for you since [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, so that was a claim made in [PII]?
[AGENT][NEUTRAL] Well, I'm just saying, was, did you go see them in [PII]? When did you see them?
[CUSTOMER][NEUTRAL] I, I'm, I'm thinking with, um, what it might have been that time, ma'am, [PII] or [PII].
[AGENT][NEUTRAL] Oh, let me, let me check and see what this is for then.
[AGENT][NEUTRAL] I thought it was maybe recently.
[CUSTOMER][NEUTRAL] No, I, I walked away from it. I'm just not thinking about what, what could have happened.
[AGENT][NEUTRAL] Uh, let's see here, one moment.
[AGENT][NEUTRAL] So, it looks like the provider comes up as a Rachel Byers DDS. It doesn't have the place of service.
[AGENT][NEUTRAL] It looks like there was, it was for an oral exam.
[AGENT][NEUTRAL] Um, and just some, and just some X-rays. That was it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then prior to that,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim prior to that was from [PII].
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And those were just X-rays and examination too, right?
[AGENT][NEUTRAL] Yeah, it looks like it was a different dentist back in [PII], but those are the two, those are the two most recent things on your policy, so I don't see anything for [PII] that's been claimed or [PII] this year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] So what am I, what, what would I be eligible for right now?
[AGENT][NEUTRAL] Um, so it looks like.
[AGENT][NEUTRAL] You had X-rays showing in [PII]. 1 moment.
[AGENT][NEUTRAL] So you could still use your insurance. You are eligible for an examination once every 6 months. You could have X-rays again because you're eligible for those once every 6 months.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I mean, your plan does have coverage for like any major work if you needed major work done, you could go see somebody for that as well, of course.
[CUSTOMER][NEUTRAL] When you call, when you say major, what would be major cause I, I don't, I had, I had my uncle.
[AGENT][NEUTRAL] Like oral surgery.
[CUSTOMER][NEUTRAL] Oh OK, I have my, uh, I had my upper, all my upper teeth removed.
[CUSTOMER][NEUTRAL] So major wouldn't be implants, huh?
[AGENT][NEUTRAL] Well, it would be extractions, you know, um, and things like that. I don't know if this policy covers.
[AGENT][NEUTRAL] Any sort of implants. Let me see.
[CUSTOMER][NEGATIVE] Cause I hate, I hate dentures, man.
[AGENT][NEUTRAL] Yeah, I mean, it covers dentures, um.
[CUSTOMER][POSITIVE] Yeah, I know, I got a set of them. I mean, I got some upper dentures and I'm, I'm trying to get something to do better than that.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Burges.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, I just see, it would have, you know, it covers extractions, but I don't see anything on here for implants.
[AGENT][NEUTRAL] Crown.
[CUSTOMER][NEUTRAL] Do you have a coverage that that that cover implants, ma'am?
[AGENT][NEUTRAL] Um, well, we do offer some other different plans you would have to go through since you're getting this through an employer.
[AGENT][NEUTRAL] It looks like
[CUSTOMER][NEUTRAL] To an employer?
[AGENT][NEUTRAL] Well, it looks like it's coming.
[AGENT][NEUTRAL] [PII], it looks like is a subscriber on this, and it looks like the plan is being supplied through Villa Valencia Hospital.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] That was, that was our retirement, yeah, that's, that's what we to retired from, right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I don't know.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Let me look at
[CUSTOMER][NEUTRAL] Ar.
[CUSTOMER][POSITIVE] Because is making real progress for me.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] I'm wondering, so the plan is through it looks like [PII] you may wanna speak with them as far as the different.
[AGENT][NEUTRAL] Options because you have option B, it looks like.
[AGENT][NEUTRAL] There is an option, there is an option C and D, um, let me see.
[CUSTOMER][NEUTRAL] Uh, let me look at it uh.
[AGENT][NEUTRAL] I don't see it.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah, I have option B now.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and she's, she's retired from that, so she's not there anymore, correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But we still I still carry the insurance.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, yeah, it looks like um plan options, there's a different number for that and I'm happy to transfer you to them, but did you wanna take down the number, um, just so they could go over the different options it looks like.
[CUSTOMER][NEUTRAL] You're
[CUSTOMER][NEUTRAL] OK, one second there, let me grab a pen.
[CUSTOMER][NEUTRAL] OK, ma'am, I'll take that number.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] a
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Support the
[AGENT][NEUTRAL] So [PII] and let me call over there, get somebody on the line, um, and they could go over that with you if you wanted to look at maybe making some changes for a different plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, one moment please.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][POSITIVE] Thank you for calling Carrington.