AccountId: 011433970860
ContactId: bded1202-97d4-458d-a7aa-efbe33c5ff35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 529000 ms
Total Talk Time (AGENT): 161816 ms
Total Talk Time (CUSTOMER): 249978 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/bded1202-97d4-458d-a7aa-efbe33c5ff35_20250624T16:05_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is uh [PII]. I'm calling about um a dental policy.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and let me give you that number.
[CUSTOMER][NEUTRAL] Uh, it's 0061.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 3733.
[AGENT][NEUTRAL] OK, thank you and Mr. [PII] verify your date of birth and the mailing address for me please.
[CUSTOMER][NEUTRAL] The mailing address is [PII], and my date of birth is [PII], but this is in my wife's name, I believe, and that's [PII].
[AGENT][POSITIVE] OK, thank you. And how may I assist you today, Mr. [PII]?
[CUSTOMER][NEUTRAL] I got a letter that says y'all are awaiting information from uh your employer association to confirm eligibility.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What, what do you see there on your screen? What's going on?
[AGENT][NEUTRAL] Oh, do you happen to have that claim number?
[CUSTOMER][NEUTRAL] Pardon?
[AGENT][NEUTRAL] Do you have the claim number from the EOB you received?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Claim number, yes, it's 361-319-6.
[AGENT][POSITIVE] OK, thank you so much. And uh do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, sir. Give me one moment.
[CUSTOMER][NEUTRAL] I mean, we've been with y'all since like '96.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Uh, yes, sir. The claim is just pending, um, till we receive eligibility information from the, your wife's group. Uh, once that it's been received and the claim will be complete.
[CUSTOMER][NEUTRAL] What group does she have to be with, uh.
[AGENT][NEUTRAL] Well, it's not a group, it's not an employer.
[CUSTOMER][NEUTRAL] I mean, when she had.
[AGENT][POSITIVE] Well policy
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] Um, talking to myself, I was looking at the information. I'm sorry, but um.
[AGENT][NEUTRAL] Because she's not with the employer groups individual, but.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] See today is [PII]. Give me one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I mean, it hadn't been a problem for 30 years. What's, what's up now, you know?
[AGENT][NEUTRAL] One
[AGENT][NEUTRAL] One moment, I'm sorry, just looking through here.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, let's see, it looks like the claim is pending until we receive payment.
[AGENT][NEUTRAL] And looks like it's set to be drafted on today so once that draft has been received and it reflects in the system, then they'll um release the claim to finish processing.
[CUSTOMER][NEUTRAL] OK, so y'all don't need any other information?
[AGENT][NEUTRAL] Uh, no, sir.
[CUSTOMER][NEUTRAL] So this claim will be um released you said sometime today.
[CUSTOMER][NEUTRAL] Did I hear you hear that right?
[AGENT][NEUTRAL] Once it shows that that bank draft has been uh taken out and been received, then they'll send a notification to the examiner to res uh.
[AGENT][NEUTRAL] To unpin the claim and completed.
[CUSTOMER][NEUTRAL] We have.
[CUSTOMER][NEUTRAL] Y'all take this, take the money straight out of my checking account every month.
[AGENT][NEUTRAL] Yes, sir. It's usually the [PII] on the, it's usually the [PII] of each month. So once premiums received, then it would.
[CUSTOMER][NEUTRAL] I don't know why you're waiting on some kind of.
[AGENT][NEUTRAL] Um, show that the data service was.
[AGENT][NEUTRAL] Eligible right now it's just showing May, so once they receive June, then they'll bump it up to where for this data service of [PII] that you're eligible for that date.
[AGENT][NEUTRAL] It's just pending the claim. It hadn't been denied, just pending.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the fact that this.
[CUSTOMER][NEUTRAL] Um, trying to see the date.
[CUSTOMER][NEUTRAL] That this, uh, it's gonna say [PII], I guess that's it.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Where did I go?
[CUSTOMER][NEUTRAL] I went on the, it says I'm the claim.
[CUSTOMER][NEUTRAL] The claimant, and I went to the dentist on the [PII], so they couldn't pay it because they haven't pulled the [PII].
[CUSTOMER][NEUTRAL] Uh, payment yet, is that's the problem?
[AGENT][NEUTRAL] Uh, yes, sir.
[CUSTOMER][NEUTRAL] Why, it seems like y'all ought to be ahead of me instead of behind.
[CUSTOMER][NEUTRAL] But anyway,
[CUSTOMER][NEUTRAL] That's not your choice. Um, all right, so, uh.
[CUSTOMER][NEUTRAL] Sometime today everything all get straight.
[AGENT][NEUTRAL] I'm thinking more or less tomorrow or definitely sometime this week. Yes, yes, sir.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Tomorrow, that's fine. Today or tomorrow.
[CUSTOMER][POSITIVE] OK. All right. All right. Thank you very much.
[AGENT][POSITIVE] Yes, sir. Thank you for calling APL. Have a great day, Mr. [PII].
[CUSTOMER][NEUTRAL] I mean, what, I got one more question.
[CUSTOMER][NEUTRAL] Uh, suppose we don't go back to the dentist for the next 3 months.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You'll be 33 payments ahead. Is this gonna happen again because I went on the first of the beats of September and you haven't got paid yet. I mean, you know, I'm just questioning, trying to figure out what's going on because this is the 2nd time this same thing has happened.
[CUSTOMER][NEUTRAL] In the last, well this year.
[AGENT][NEUTRAL] Well, I'm not sure as far as.
[AGENT][NEUTRAL] 3 months. Once if it's been received, then they'll be able to process the claim because it'll show that eligibility was.
[CUSTOMER][NEUTRAL] You know why, why is it?
[CUSTOMER][NEUTRAL] Why is it based on the same month is what, what I'm asking if I, I mean, I'm gonna, you gonna take this payment and then there's gonna be say a July and August, and.
[CUSTOMER][NEUTRAL] 2, that's 2 craters and then say I go to the dentist in September, is this gonna recur?
[CUSTOMER][NEUTRAL] Because you haven't got September's bill, I mean, a premium.
[AGENT][NEUTRAL] Uh, if it's probably after the [PII], it could happen that way. Your wife can contact our customer service department to change the draft date to where
[AGENT][NEUTRAL] It'd be around the [PII] or the [PII] of each month.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] Instead of later.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] I mean, my health insurance doesn't work that way. I pay them every month and, you know, that, then, uh, it's taken care of. It didn't bec[PII] you hadn't paid this month yet.
[CUSTOMER][NEUTRAL] You see where I'm coming from. I don't, I'm not following why it's suddenly started doing this this year. I mean, like I said, we've been that's what 29 years we've been with the APL and it's only started this business this year.
[CUSTOMER][NEUTRAL] This is the 2nd time.
[CUSTOMER][NEGATIVE] I need to talk to somebody in customer service.
[AGENT][NEUTRAL] Or your wife can, and she is the policyholder.
[CUSTOMER][NEUTRAL] You saying
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Oh, OK. All right, well, thank you for what you told me anyway. Appreciate it.
[AGENT][NEUTRAL] Uh yeah.
[AGENT][NEUTRAL] Yes,