AccountId: 011433970860
ContactId: c3703bda-1fe0-468b-a4c1-43d1a48d91bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192039 ms
Total Talk Time (AGENT): 98858 ms
Total Talk Time (CUSTOMER): 62772 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/c3703bda-1fe0-468b-a4c1-43d1a48d91bd_20250317T14:21_UTC.wav
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[AGENT][POSITIVE] Thank you for contacting APO. My name is [PII]. How may I help you?
[CUSTOMER][NEGATIVE] Yes ma'am, um, I have been needing to have some dental work done and you know I go to the same provider that I've used for many years, and y'all are denying um a crown, y'all are denying everything that we sent in. I don't understand why.
[AGENT][NEUTRAL] Well, let's look at it. Uh, let's look at your policy and I'm sorry, I didn't catch your name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], thank you. What is your policy number, please?
[CUSTOMER][NEUTRAL] Uh, let me see if it's on this, um, card right here covered policy number 01802778.
[AGENT][NEUTRAL] Thank you. And if I could just verify your date of birth and the phone number, please.
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[CUSTOMER][NEUTRAL] And what was the other thing you needed?
[AGENT][NEUTRAL] Um, just a phone number, please.
[CUSTOMER][NEUTRAL] Area code [PII].
[AGENT][POSITIVE] I do appreciate that. Thank you. So let's see what we have here.
[AGENT][NEUTRAL] OK. So I also showed that you have a group accident with the policy with us as well. Is that correct?
[CUSTOMER][NEUTRAL] I do my husband's work, so I'm assuming so I don't know what that is.
[AGENT][NEUTRAL] Oh, of course.
[AGENT][NEUTRAL] Sure, let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so, um,
[AGENT][NEUTRAL] What I show that, let me, let me tell you the policies that we have. The policy number that you gave me, the one ending in 2778, that was a uh secondary or gap insurance, uh, that was meant to pick up the deductible, co-payment or co-insurance for major medicals such as hospital inpatient hospital, and that lapsed as of [PII].
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Now, the policies that are, yes, ma'am.
[CUSTOMER][NEUTRAL] And that
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] Uh, the policies that you have that are active with us, there's a group cancer and there's a group accident policy. Uh, that, those are, uh, active and those have been active since, uh, let's see.
[CUSTOMER][NEUTRAL] I see that you have.
[AGENT][NEUTRAL] Uh, I can find that.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So you're saying we do not have dental insurance with you anymore?
[AGENT][NEUTRAL] Uh, I don't show that you ever had dental insurance with us. Uh, you had a secondary or gap insurance with us through, uh, your husband's policy, um, but that lapsed as of [PII]. So I've got group cancer and I've got, um, group accident, but there's, there is no, uh, there's not a dental policy. Now, he probably has one through his employers, but I don't doubt that he has one through his employers, but it's not with us.
[AGENT][NEUTRAL] So this is, this is a a gap insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK alright thank you.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] OK, there's nothing else to help with. Thanks for contacting AP. Have a good day.