AccountId: 011433970860
ContactId: b6d01d04-edc2-41c2-a02b-db2c7015c655
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1399290 ms
Total Talk Time (AGENT): 333258 ms
Total Talk Time (CUSTOMER): 258919 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/b6d01d04-edc2-41c2-a02b-db2c7015c655_20250522T13:04_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Good morning, [PII]. My name is [PII]. I'm calling from a provider's office in the state of [PII]. We're hoping to inquire upon eligibility for a subscriber and a dependent that we have here.
[AGENT][NEUTRAL] OK, well, I can help you with the eligibility. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] That's gonna be [PII].
[CUSTOMER][NEUTRAL] And the policy number for the uh at least I have here the ID number will be 023.
[CUSTOMER][NEUTRAL] 562-57
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] That's gonna be [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. Um, it's been effective for this, um, for the policyholder since [PII].
[AGENT][NEUTRAL] Um, and then did you also need for the spouse?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] Uh, and can you verify her name and date of birth?
[CUSTOMER][NEUTRAL] I have here [PII], date of birth [PII].
[AGENT][POSITIVE] Thank you for that and um her part of the policy is also active. It's been effective since [PII].
[CUSTOMER][POSITIVE] Thank you for that just a few more moments.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, may I just ask, firstly, were these going to be for dental benefits or medical only?
[AGENT][NEUTRAL] Um, let me see what type of policy. Hold on one second.
[AGENT][NEUTRAL] This is medical only. You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Thank you for that. So do they have any, uh, dental associated with their policy or not at this time?
[AGENT][NEUTRAL] Um, they do have a dental policy, but this particular policy is medical.
[CUSTOMER][NEUTRAL] Thank you for that, ma'am. Are you able to give me information on the dental portion of their policy?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Mm, hold on one moment.
[AGENT][NEUTRAL] Let me get that.
[CUSTOMER][POSITIVE] Thank you
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Alright, so the dental policy for both have been active since [PII].
[CUSTOMER][NEUTRAL] Does the plan cover it maybe that's.
[AGENT][NEUTRAL] I'm waiting for the benefits to populate now. Hold on one second.
[CUSTOMER][POSITIVE] Thank you, ma'am.
[AGENT][NEUTRAL] You're welcome. And did you need a copy of the fax back or uh you just have particular questions?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'll, I'll ask next, um, through whom it's gonna be and if we're able to see that online, uh, if not, we'll go ahead and ask for the fax back during this phone call.
[AGENT][NEUTRAL] OK, um, so,
[AGENT][NEUTRAL] Who is it with? It's with American Public Life. Um, this isn't on like a Carrington network or anything. It goes by usual and customary charges. Um, there's no fax back available online yet, um, but I can fax it to you if you like.
[CUSTOMER][NEUTRAL] Thank you for that. Yes, we'll go ahead and request the fax back of benefits. May I ask, for instance, um, is it gonna be the same for both of them or will they each need their own individual facts if they have different benefits?
[AGENT][NEUTRAL] Oh, no, the benefits the same for everyone on the policy.
[CUSTOMER][NEUTRAL] Thank you for that. Am I able to provide for you the fax number?
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Sure, I'm ready when you are.
[CUSTOMER][NEUTRAL] Yes, so it's gonna be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And should that be attention [PII]?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, and just to confirm it was [PII]?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] All right, so I'm faxing this over to you now. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yes, um, I did have uh just a few more general questions regarding the policy, for instance, um, is there gonna be any downgrades associated with this policy?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, no, there's no downgrades.
[CUSTOMER][NEUTRAL] And uh any waiting periods and we need to be aware of?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] There is a 12-month waiting period for major expenses. Major for us includes endodontic, periodontic, prosodontic, and oral surgery codes. Um, so they'll be available for. Hold on one second.
[AGENT][POSITIVE] I'm glad I just noticed that.
[AGENT][NEUTRAL] Wait a minute.
[AGENT][NEUTRAL] Hold on one second, because for the dental policy, let me make sure I'm not reading this. This is a different spouse. Hold on one second.
[CUSTOMER][POSITIVE] Take your time, ma'am.
[AGENT][NEUTRAL] OK, because I just realized, hold on, yeah.
[AGENT][NEUTRAL] Let me go back to that medical policy.
[AGENT][NEUTRAL] OK, [PII], do you mind if I place you on just a brief hold? The um fax back is still the same, but there's two different spouses on these policies. Um, do you mind if I place you on just a brief hold?
[CUSTOMER][POSITIVE] Thank you, ma'am. I'll hold.
[AGENT][NEUTRAL] You're welcome, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Thank you so much for holding. I just wanted to check back with you. I'm getting ready to reach out to um our customer service department so I can try to get some clarity on this. Um, I just wanted to check on you. Do you mind if I place you on just another brief hold, um, to see what happened with these policies?
[CUSTOMER][NEUTRAL] I'll hold them.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Ferring
[CUSTOMER][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you doing?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] I'm doing good. Um, can you look at these two policies with me? I'm very confused.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And you think I'm kid.
[AGENT][POSITIVE] Yes, I, I hope.
[CUSTOMER][NEUTRAL] That they can be.
[AGENT][NEUTRAL] Um, so the, the medical policy is 2356257.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, uh, I can me put a note in my policy.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um.
[CUSTOMER][NEUTRAL] OK, what was that policy number again?
[AGENT][NEUTRAL] It is 235-6257.
[AGENT][NEUTRAL] They have a dental and a medical policy. So at first they gave me the
[AGENT][NEUTRAL] The medical policy number, but they were really looking for dental benefits. So we ended up verifying on the medical. Then when I went to the dental, I noticed that the spouses are different, but both policies are active.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh uh.
[CUSTOMER][NEGATIVE] That's not good.
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] So I just stopped quoting everything. It was like, uh, hold on one second.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And then.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Do you know which one is correct?
[AGENT][NEUTRAL] Well, OK, so the one he verified was, hold on, is this the, which one am I in? Sorry, I'm going back and forth between the two.
[CUSTOMER][NEUTRAL] Let me look at that.
[AGENT][NEUTRAL] Um, the one he verified was [PII], um, on the medical policy. He has her name and date of birth.
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] OK, we got that on our on the phone.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Just down on [PII].
[CUSTOMER][NEUTRAL] I get that.
[CUSTOMER][NEGATIVE] It's very, very complic it's not complicated, it's very confusing the, the file that they sent for uh UTBA.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So it very well could be let me check.
[CUSTOMER][NEUTRAL] [PII] is looking for.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] I need 10 screens, I'm telling you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I don't know what I just did, but.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] 675,780.
[CUSTOMER][NEUTRAL] And there's.
[CUSTOMER][NEUTRAL] It's got [PII] in there. Where did I get?
[AGENT][NEUTRAL] On which one?
[AGENT][NEUTRAL] Oh, you're talking about on the file from the job.
[CUSTOMER][NEUTRAL] On the dental?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Wait, what did you say?
[CUSTOMER][POSITIVE] [PII] is correct.
[AGENT][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Let me go back.
[CUSTOMER][NEUTRAL] And where's the date of birth?
[AGENT][NEUTRAL] Oh, what just happened? Hold on line.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 2356209.
[CUSTOMER][NEUTRAL] [PII], is that right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] You say, wait, I'm confused now. You're saying [PII] is on the dental policy?
[AGENT][NEUTRAL] Are you just asking me if she's the correct spouse?
[CUSTOMER][POSITIVE] She's correct. She's correct. She's the correct one.
[AGENT][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] You telling me or asking me?
[CUSTOMER][NEUTRAL] Oh, I see what.
[AGENT][NEUTRAL] Because you can see, I'm confused.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] You're telling me or asking me about [PII] because I don't know which one is right, but, but he confirmed [PII].
[CUSTOMER][NEUTRAL] OK, he probably had a wife before her.
[CUSTOMER][NEUTRAL] That was the other name.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Because that was from [PII], so when I changed it to couple, I probably didn't verify the name.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] But I've got it correctly.
[CUSTOMER][NEGATIVE] So it is not.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 600.
[AGENT][POSITIVE] Alrighty, well, thank you.
[CUSTOMER][NEUTRAL] I know you gotta double check if I had a a wife before.
[AGENT][POSITIVE] Oh my gosh, that was hilarious. I was like, wait a minute, and he has multiple wives and he has policies.
[CUSTOMER][NEUTRAL] That's something.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] How did he do that?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Oh my God.
[CUSTOMER][NEUTRAL] I can listen to the.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, this is our Wednesday live.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] No, no, it's crazy.
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] Please tell me it's fine.
[AGENT][NEUTRAL] Alright, well, let me go back.
[CUSTOMER][NEUTRAL] It is for
[AGENT][NEUTRAL] I can't hear you.
[CUSTOMER][NEUTRAL] It's not
[CUSTOMER][NEUTRAL] You said Wednesday, but it's Thursday. I said, please don't tell me it's Wednesday.
[AGENT][NEUTRAL] Today is Thursday.
[CUSTOMER][NEUTRAL] Today's Thursday.
[AGENT][NEUTRAL] I mean, so, wait a minute.
[AGENT][POSITIVE] And I just say happy Hump Day in the chat.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Today is totally Thursday.
[CUSTOMER][NEUTRAL] And I thought it was Friday when I woke up.
[AGENT][POSITIVE] Oh my gosh, that's, that's how long. OK, this week, we've been, we've been getting to it. OK. Let me go back out. Thank you, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you. Goodbye.
[AGENT][NEUTRAL] All right, bye bye.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Oh my God, that's hilarious.
[AGENT][NEUTRAL] Hello, [PII].
[AGENT][NEUTRAL] Hello, [PII].
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, [PII].
[AGENT][NEUTRAL] If you can hear me, I can hear you. Please give us a call back at [PII]. Thank you.