AccountId: 011433970860
ContactId: c487d027-f479-4308-bb72-db6378e2634f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 557669 ms
Total Talk Time (AGENT): 218547 ms
Total Talk Time (CUSTOMER): 233455 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/c487d027-f479-4308-bb72-db6378e2634f_20250312T15:53_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Um, yes, this is [PII].
[CUSTOMER][NEUTRAL] I'm calling about my, my benefits, um.
[CUSTOMER][NEUTRAL] I went to the dentist this past, um, I don't know, October.
[CUSTOMER][NEUTRAL] And I just got a bill from my dental company saying that I have a, a, a balance of $151. Um,
[CUSTOMER][NEUTRAL] I just need to see cause I thought I increased my coverage and so I need to see what's going on with it.
[AGENT][NEUTRAL] OK, uh, Ms. [PII], do you have your policy number?
[CUSTOMER][NEUTRAL] Not only me, no.
[AGENT][NEUTRAL] OK, give me a moment.
[AGENT][NEUTRAL] And what's your social?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you so much. Give me one moment.
[AGENT][NEUTRAL] OK, and verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, let me type in this one.
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and Miss um [PII], do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, um, this one I'm on now, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you, ma'am, give me one moment.
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And let me look at your policy.
[CUSTOMER][NEUTRAL] Are you getting frustrated?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Wait just a minute sweetie. Oh wait just a minute.
[CUSTOMER][NEUTRAL] Just a minute.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] She's [PII] old.
[AGENT][NEUTRAL] Oh, is it grandbaby?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Um great grandbaby.
[AGENT][POSITIVE] Oh, great grand.
[CUSTOMER][POSITIVE] Great, great then. Mhm.
[AGENT][POSITIVE] Oh, sweet.
[CUSTOMER][POSITIVE] The very first great granddaughter.
[AGENT][NEGATIVE] Oh, I bet she's gonna be spoiled rotten.
[CUSTOMER][NEUTRAL] Oh gosh. It's up to Gigi, she is.
[AGENT][POSITIVE] Oh too sweet.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. You said you had upped your policy as far as benefits?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] it's OK.
[CUSTOMER][NEUTRAL] Well, I thought I did when I got something, uh, an email from y'all, and I clicked on it, so I thought I like increased it, but I'm not sure.
[AGENT][NEUTRAL] OK. And do you happen to have that, um, oh, I'm sorry.
[CUSTOMER][NEUTRAL] I thought I did, but
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Uh, do you happen to have that data service, um, for the claim?
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Oh, for the uh bill you receive?
[CUSTOMER][NEUTRAL] Let me see if it's
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um, I, it didn't have a, it just had the bill, but when I called them and talked to them about this, they said it was October.
[CUSTOMER][NEUTRAL] They said there was 2, there was, I went in April of this past year.
[AGENT][NEUTRAL] October.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I was back in October and she said that y'all hadn't, you only paid a little bit of each one of them. I don't know.
[AGENT][NEUTRAL] OK, give me one moment I'm just gonna look through your history give me one moment.
[CUSTOMER][NEUTRAL] And they did a, they did a uh.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, it's called a Perx Pro, which is um an X-ray of my jaw, of my
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, of my jaw.
[CUSTOMER][NEUTRAL] And I don't know.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] Well, we are gonna look it up. Give me one moment, Ms. [PII].
[CUSTOMER][NEUTRAL] OK, and I'm gonna run and get her bottle real quick.
[AGENT][NEUTRAL] OK. Oh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh my gosh.
[CUSTOMER][NEUTRAL] If you want to finish this?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] You don't, OK.
[CUSTOMER][POSITIVE] That's OK, good.
[AGENT][POSITIVE] I promise you give me baby fever. Baby is so sweet.
[AGENT][POSITIVE] They are truly a blessing.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] They are totally, I mean, sometimes you might get um
[CUSTOMER][NEGATIVE] Overwhelmed
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] And yeah, they might be fussy, but there's still God's blessing. It's God bless God.
[AGENT][POSITIVE] Absolutely
[CUSTOMER][NEUTRAL] Little angels.
[AGENT][POSITIVE] Yeah. Oh, it made me miss my baby, my son when he was a baby. He was so sweet. He rarely cried unless he was wet or hungry.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][POSITIVE] Yes, indeed.
[CUSTOMER][NEUTRAL] My uh
[CUSTOMER][NEUTRAL] My kids were like that. So, but uh.
[AGENT][NEUTRAL] No.
[CUSTOMER][MIXED] This one here gets a little fussy, but she sleeps good at night.
[AGENT][POSITIVE] Oh, that's good.
[CUSTOMER][NEUTRAL] You gonna get a little fussy now? You gonna get a little fussy there?
[CUSTOMER][NEGATIVE] I, I'm on the phone. You can't do that.
[CUSTOMER][NEUTRAL] Oh gosh, OK.
[AGENT][POSITIVE] Oh, I hear her. Oh my goodness.
[CUSTOMER][NEUTRAL] Yeah, that's.
[CUSTOMER][NEUTRAL] It's so.
[AGENT][NEUTRAL] Let's see, 354. OK, I see a claim for [PII] and it looks like it was for
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, an exam, a cleaning.
[AGENT][NEUTRAL] Bit wing and a PA or um individual um X-ray and we paid $55 and that was towards the cleaning and the exam. The one for the bite wing and the PA were processed as
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh, benefits were applied towards the deductible because they are.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, there is a $50 deductible.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And I wonder why she only said, I've got a $151 bill. Mm.
[AGENT][NEUTRAL] And then there's a data service of [PII].
[AGENT][NEUTRAL] And on this one.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, this one looks like for an exam and another PA, and we paid $25 for the exam, and the PA was uh was processed as benefits applied towards the deductible.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, so, um.
[AGENT][NEUTRAL] I'm not sure how you said 115 or 150 that they sent a bill for?
[CUSTOMER][NEUTRAL] 150
[CUSTOMER][NEUTRAL] A total of 151 between April of last year and October of last year between the two of them.
[CUSTOMER][NEUTRAL] I mean, am I, are they overcharging?
[AGENT][NEUTRAL] Uh, that I, I don't know, um, and with this policy, do you know if they are a Carrington provider or not?
[CUSTOMER][NEUTRAL] Um, I don't know.
[AGENT][NEUTRAL] Because usually if you go to a provider and they participate with Carrington, there's, they have a contract with them on how much they would charge for certain procedures.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But I don't show your policy benefits have changed, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that you, you believed you did when you received the letter from us?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Well, and I, I've had so much going on this last, this last year. Um, I'm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know. I thought I did.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] I thought, I thought I accepted it, but I might not have.
[AGENT][NEUTRAL] Yeah, because I don't, yes, ma'am, when life becomes busy, you just kind of focus on the most important thing, I guess. But if you like, I can transfer you to customer service and they can verify if you wanna um
[CUSTOMER][NEUTRAL] You know how that goes?
[AGENT][NEUTRAL] Up your benefits if it's possible.
[CUSTOMER][NEUTRAL] Well, I've, I've got her in my hands right now. I just, uh, I can call back later and check with them. But uh I just want to check to see, um,
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Anyway, OK, I appreciate your time.
[AGENT][POSITIVE] Uh, you're welcome, and then you have a great day and enjoy that great grand.
[CUSTOMER][POSITIVE] I am. You have a good one too. All right. Bye-bye.
[AGENT][POSITIVE] You too, ma'am. Thank you.
[AGENT][NEUTRAL] Bye.