AccountId: 011433970860
ContactId: bbef9ef0-dde1-4eb6-983b-f3adc0ab544b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 762070 ms
Total Talk Time (AGENT): 376608 ms
Total Talk Time (CUSTOMER): 334799 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/bbef9ef0-dde1-4eb6-983b-f3adc0ab544b_20250609T15:16_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes ma'am. My name is [PII], and I have a question for you. First of all, I've been with uh American Public Life for over 50 years, you know, with this policy, and I wanna ask you a question.
[CUSTOMER][NEUTRAL] Uh, on one of my wife's benefit thing it says benefit name not found. What does that mean?
[AGENT][NEUTRAL] Are you trying to set up on the online service center?
[CUSTOMER][NEUTRAL] No, no, no, no, no, no, no, I'm trying to find out.
[CUSTOMER][NEUTRAL] You know how you do the they have a service description, OK, and my wife is on on my policy. OK, now if it have ADA code, then they have a service depar date and all that and how much they pay and how, how much the charges and how much you pay and then for one of the uh benefits it said benefit not found 1201206 ADA code. What does that mean?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, Mr. [PII], what is that policy number so I can look up the claim.
[CUSTOMER][NEUTRAL] The policy number is.
[CUSTOMER][NEUTRAL] 00615237
[AGENT][POSITIVE] OK, thank you so much, give me one moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK, thank you so much. And Mr. [PII], verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] Uh, my date of birth [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What else you want? Uh.
[AGENT][NEUTRAL] Uh, mailing address and email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much. And do you see a claim number on that information, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, I see a reference yeah, claim number is 3608647.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] 22
[AGENT][NEGATIVE] It looks like they pay for the cleaning exam and bike wings. There was another code which was for fluoride, which is not covered under the policy.
[CUSTOMER][NEUTRAL] 000 that's what that means, OK, so.
[AGENT][NEUTRAL] Well, fluoride is covered, but there is an age limit as far as fluoride.
[CUSTOMER][NEGATIVE] That's ridiculous.
[CUSTOMER][NEUTRAL] What's the age limit?
[AGENT][NEUTRAL] Uh, for fluoride is under the age of [PII].
[CUSTOMER][NEUTRAL] So they got to be under the age of [PII].
[AGENT][NEUTRAL] Mhm. In order for fluoride to be covered. Mhm.
[CUSTOMER][NEUTRAL] Right?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] That's terrible, man, that's terrible. That's all I can say. I've been in this thing over 50 years, and my wife and I since we started teaching and, and, and, and benefit not available.
[CUSTOMER][NEUTRAL] OK, so they should have coded to something else then, but still, you look at the fact that the
[CUSTOMER][NEUTRAL] Uh, the, the, the cleaning the, the, the visit was $251 and out of $251 you paid $75.
[AGENT][NEUTRAL] Yes, sir, cause your policy, it pays by what's on the policy fee schedule. So for that code for that cleaning, the max payable is $40 for the exam, uh per your policy.
[CUSTOMER][NEUTRAL] $15.20 dollars, yeah, I see all that. I see.
[AGENT][POSITIVE] Correct, yes, sir.
[CUSTOMER][NEUTRAL] But it, it ain't much of a policy. Y'all still writing policies for dinner?
[AGENT][NEUTRAL] Uh, not for individuals, no, sir.
[CUSTOMER][NEUTRAL] Yeah, but I'm, I'm part of a school. I was part of the school system, but you have to be part of the school system. So if my school system doesn't, uh, thing, uh, then, then you can, you can't write a policy, right?
[AGENT][NEUTRAL] Oh, correct. We only going through groups, so unless you, uh, your uh employer is, uh, have a group, well, signed up as a group with us and then they offer that dental policy or a different dental policy. That's the only reason, only why.
[CUSTOMER][NEUTRAL] For me.
[CUSTOMER][NEUTRAL] Pa
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, well, and the reason why you all still take my policy is because it's [PII] old, huh?
[AGENT][NEUTRAL] Um, I guess so. Uh, they just hadn't.
[AGENT][NEUTRAL] Change anything. They just, um, I guess, allow you to still keep this dental policy cause a lot of our other policies they were individuals, um.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] No longer valid.
[CUSTOMER][NEUTRAL] That, that, that, uh, just, oh, so y'all don't have, uh, individual policies at all.
[AGENT][NEUTRAL] Uh, no, sir. We don't offer any individual policies any longer unless you've already had a policy with us like y'all, and which y'all are able to keep it.
[CUSTOMER][NEUTRAL] You just
[CUSTOMER][NEUTRAL] OK, so that's you have to keep the one you have. I couldn't, I couldn't upgrade it.
[AGENT][NEUTRAL] Um, I can transfer to customer service and they can verify that.
[CUSTOMER][POSITIVE] OK, transfer me to customer service. Thank you very much.
[AGENT][NEUTRAL] Uh, yes, sir. Hold on one moment for me, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Good morning. This is [PII].
[AGENT][NEUTRAL] Uh, morning, Ms. [PII]. How are you doing? [PII].
[CUSTOMER][POSITIVE] I'm good. How are you?
[AGENT][NEUTRAL] I am here.
[AGENT][NEUTRAL] On this. I keep want to say a different day, but it's Monday.
[AGENT][NEUTRAL] But um,
[CUSTOMER][NEUTRAL] Monday
[AGENT][NEUTRAL] Yeah. I have an insured on the phone. He has an, um, dental policy with us and he's want to know if he can up his uh benefits or upgrade.
[CUSTOMER][NEUTRAL] OK. Um, he cannot, but just
[AGENT][NEUTRAL] And I didn't know if we did that with a.
[AGENT][NEGATIVE] Oh, he's not gonna be pleased. Oh well.
[CUSTOMER][NEUTRAL] What is that?
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] What is the policy number?
[AGENT][NEUTRAL] 615-237.
[CUSTOMER][NEUTRAL] Oh, no, yeah, I was gonna say possibly at open enrollment or something with the group but no.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] It is what it is. I mean, you know, but I can speak with you.
[AGENT][NEUTRAL] Yeah, it is what it is.
[AGENT][POSITIVE] All right, sweetie. I appreciate you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And I verified all this information.
[CUSTOMER][NEUTRAL] OK, yes.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Uh, uh, thank you. Hold on one second. Oh, he hung up. OK, he'll be fine. He'll call back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] He was fussing that we didn't cover fluoride, but it's like uh it's under the age of [PII]. Well, that doesn't seem fair with sir. It's been in the policy since she had it since [PII].
[CUSTOMER][NEUTRAL] OK, but would
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Fair or not, that's what it is. And you know, dental policies are never any good no matter what. I mean not ATL talking about dental.
[AGENT][NEUTRAL] Bless
[AGENT][NEUTRAL] That's what it is.
[CUSTOMER][NEUTRAL] Like any dental.
[AGENT][POSITIVE] Well I don't, yeah, well, I haven't had any other dental, um, that I can remember besides probably what my parents had me under, but under this one, I like ours, the D4 policies. I do like ours.
[AGENT][POSITIVE] Because it works, you know, we go and get our teeth cleaned every 6 months.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, that's true, that's true. And that's what um my husband always had me on his dental, and it's like I took out ours as secondary, you know, because his is not great. So I'm like, dental is always low. I mean, you know, as far as paying benefits.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] I mean, it's not gonna be 100%. I mean, it's gonna pay it all, but some insurers, they, they put in their brain that it's gonna pay it all. It's like, uh no. And then we get these uh simple dental, select dental policies, it's even worse in my opinion, because they're not paying us. It's only gonna pay what's in the fee schedule.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Why
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Uh-huh. Yes.
[AGENT][NEUTRAL] You might as well just go with your group.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Bless his heart, but it's.
[CUSTOMER][POSITIVE] So I'm glad he hung up though.
[AGENT][NEUTRAL] Yeah, cause he was getting a little fussy. I could tell he was starting to get a little fussy and I was like, well, sir?
[AGENT][NEUTRAL] Sorry, but that's just the way your policy works. You wanna upgrade, it's not gonna make a big difference. Uh, Schedule A to D. I mean, it's not, it's still not a lot, so.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I don't know what he believed what happened, but it's, it's still a lot.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] But they don't know that the grass is not greener on the other side. So, but he did have it for a long time, so especially for him and his wife, they're in their [PII]. I'm just thinking, well, sir.
[CUSTOMER][POSITIVE] Oh goodness.
[AGENT][NEUTRAL] You probably get on Medicaid or Medicare.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I don't know if they cover dental with Medicare, do they? Or they only for medical. I never really thought of it.
[CUSTOMER][POSITIVE] Pro yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I hadn't neither, but it seems like they cover everything needed. I don't know, they may not. I don't even know.
[AGENT][NEUTRAL] For senior citizens, I would think.
[CUSTOMER][NEUTRAL] I would think so too.
[AGENT][POSITIVE] So they probably have it better than what we offer, you know what I mean?
[CUSTOMER][NEUTRAL] Huh.
[CUSTOMER][NEUTRAL] Uh, yes, yeah.
[AGENT][POSITIVE] But they holding on strong to these policies. I appreciate it.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][POSITIVE] Right. You got that right, yes.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] And you know, I have talked to people who are in their [PII], late [PII] and want to cancel their policy because they hadn't used it for so many years and I'm like, [PII], um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I need to keep that in mind.
[AGENT][NEUTRAL] And they forget. Um, a lot of people don't know they have policies and they forget and you get a lot of people, family members calling it's like, hey, show my so and so has this policy. I just want to know uh if it's active and what it covers like, um, it's a dental.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's not a life plan because they hear APL American Public. I'm so happy they changed it from American Public Life to APL because people so y'all just do uh life insurance? No.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][POSITIVE] You're right.
[CUSTOMER][NEGATIVE] Cause they think like you say, when I hear that laugh, they think this person has a life insurance policy and it's like that dental or cancer or something. Yes, and they're so disappointed. I mean, you know.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] And you
[AGENT][NEGATIVE] Right, and then you can hear in their voice too, oh, so this nightlife, no, so there's no benefits for if they pass, no.
[AGENT][NEUTRAL] Just for, they had dental services. And um and I get it, but Aetna, I didn't know theirs was an uh Aetna Public Life or Aetna Life or some, something like that. So I wonder if they just like, you know, what these people keep asking, Are we a life? Let me just tell them it's just Aetna.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Or just Cigna.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] These calls
[CUSTOMER][NEUTRAL] Just American public.
[AGENT][NEUTRAL] APL.
[AGENT][NEUTRAL] Well, it says like.
[CUSTOMER][POSITIVE] Yeah, I like that too because that cuts down.
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] It says life. Well, it's that's just the name of the company. We all need to change your name. No, we don't.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] We get it. Those other people get it.
[CUSTOMER][NEUTRAL] You need to understand.
[AGENT][NEUTRAL] Ah
[CUSTOMER][NEUTRAL] And it's like maybe not life insurance, it's public life, like, you know.
[AGENT][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] Just like living day to day life.
[AGENT][NEUTRAL] Right, but.
[CUSTOMER][NEUTRAL] Not life insurance.
[CUSTOMER][NEUTRAL] Oh, yeah.
[AGENT][POSITIVE] But uh that'll be OK. All right, uh, sweetie, I appreciate it. I'm sure he'll call back.
[CUSTOMER][NEUTRAL] You're welcome. Probably so, but yeah.
[AGENT][NEUTRAL] Let me put a note in the system real quick, yeah.
[AGENT][POSITIVE] All right, well I appreciate you. Have a great one.
[CUSTOMER][POSITIVE] All right. You too, you too.
[AGENT][NEUTRAL] Um, back.
[CUSTOMER][NEUTRAL] OK. Bye.