AccountId: 011433970860
ContactId: d3af67ea-b83d-43b7-8019-3229b4125370
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 774619 ms
Total Talk Time (AGENT): 248417 ms
Total Talk Time (CUSTOMER): 280388 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/d3af67ea-b83d-43b7-8019-3229b4125370_20250624T18:31_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, uh, my name is, uh, [PII], and, uh, I'm calling because, uh, because, uh, I need some, uh, dental service.
[AGENT][NEUTRAL] OK. Um, do you, you have a dental policy or?
[CUSTOMER][NEUTRAL] Oh, no, no, I, I, well, um, I got, uh, uh, insurance with, uh, uh, uh, Universal Trucking, uh, benefits association.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Are you checking on your gentleman?
[CUSTOMER][NEUTRAL] And uh look at it and uh.
[CUSTOMER][NEUTRAL] Say what now?
[AGENT][NEUTRAL] Are you, are you wanting to check on your dental benefits or um how can I help you?
[CUSTOMER][NEUTRAL] Well, I mean, uh, thing is I'm trying to find out, I mean, uh, the deal.
[CUSTOMER][NEUTRAL] Insurance, uh, so that I, I can use it because, um, you know, um, uh, this girl in, in here, uh, she just tried to use it and, uh, she said, uh, that she called, uh, someone, so, you know, um.
[CUSTOMER][NEUTRAL] I'm trying to use my dental insurance, so yeah, and uh thing is is I can reach him.
[AGENT][NEUTRAL] OK, um, I can look up your policy by your last name or your social.
[CUSTOMER][NEUTRAL] OK. It's uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then Mr. [PII], can you verify your date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And then can you verify your address and email address?
[CUSTOMER][NEUTRAL] It's uh [PII].
[CUSTOMER][NEUTRAL] Uh, do you need the street, I mean, uh, the address?
[AGENT][NEUTRAL] Yes, and then your email address.
[CUSTOMER][NEUTRAL] It's uh [PII] uh.
[CUSTOMER][NEUTRAL] OK, it's uh [PII], and uh my email address is uh [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, it's uh [PII].
[AGENT][NEUTRAL] OK, thank you. OK, so I show your policy, your dental policy is effective [PII]. And so what were you needing on the policy?
[CUSTOMER][NEUTRAL] Say what now?
[AGENT][NEUTRAL] I, I have your policy effective [PII], your dental policy. It's active in our system. Were you needing on the policy?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I need to know, I mean, uh, well I need to get some work done.
[AGENT][NEUTRAL] OK, do you need me to send you your card or what information do you need?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I need the card and I need the policy number because I mean I'm here now and uh I thought that um uh this card here, you know, uh the one that I have, you know.
[CUSTOMER][NEUTRAL] I would do it, you know.
[AGENT][NEUTRAL] So did, did the dental
[CUSTOMER][NEUTRAL] But OK
[AGENT][NEUTRAL] Did the dentist call and verify your benefits? Let me see if they did. I, we make notes on our system, so.
[AGENT][NEUTRAL] Did you show them your card?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And they and they said what?
[CUSTOMER][NEUTRAL] That um I need my dental I mean um I mean my dental insurance card.
[AGENT][NEUTRAL] OK, so you don't have a dental insurance card?
[CUSTOMER][NEUTRAL] No, ma'am. See, because look at here, uh, I mean, I thought, hey, what I think is, is I, I thought, uh, uh, this car here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I mean, we'll cover it.
[AGENT][NEUTRAL] Which card do you have?
[CUSTOMER][NEUTRAL] It's a uh universal trucking uh benefit.
[CUSTOMER][NEUTRAL] I mean, uh, benefits, benefits, uh, benefits, uh, benefits association card with, uh, it's called on the top, uh, American Public Life.
[AGENT][NEUTRAL] Yes, so it says American Public Life, and then it has insured [PII], coverage individual policy search, group number, effective date and group voluntary dental. Does that, is that what it shows?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, yeah, that's
[CUSTOMER][NEUTRAL] Yeah ma'am, but uh I mean it does not say.
[AGENT][NEUTRAL] That's true.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] That's your ID card. We don't show anybody.
[CUSTOMER][NEUTRAL] So what now?
[AGENT][NEUTRAL] That's your ID card for your dental. We don't show anybody's called to verify that you have this coverage. So can the dentist call us to verify.
[CUSTOMER][NEUTRAL] OK, look here.
[CUSTOMER][NEUTRAL] OK, look at, uh, would you like to talk to the girl now?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, hold on a second, hold on 1 2nd.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yeah, see here.
[AGENT][NEUTRAL] Hi, um, yes.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hold on a second, hold on a second.
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Hold on one second now, uh, one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] There you go.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hi, um, this is [PII].
[CUSTOMER][NEUTRAL] This is [PII] speaking.
[AGENT][NEUTRAL] Yes, this is [PII] with American Public Life. Uh, we're the TPA for his dental insurance. Um, it, it, he said he presented his card, but I, I don't show anybody's call to verify benefits or any of that, so I'm not sure what's, what's, um, happening.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I called the number and it said I plan and then, um, to call the insurance provider. That was the only number that I see, so I'm not for sure.
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] The [PII]?
[CUSTOMER][NEUTRAL] Let me see if we have to get to see.
[CUSTOMER][NEUTRAL] The one on the front, right?
[AGENT][NEUTRAL] Yes, cause we, we document all of our calls. I don't show anybody who's called American Public Life for his policy. Do you want me to send you a fax back of his benefits?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Please, yes ma'am. I don't think we're in network, but uh I can put it on file so we can file it.
[AGENT][NEUTRAL] OK, we, there's no network, uh, there's not a network required on this policy, so he can see any dentist he likes.
[CUSTOMER][NEUTRAL] OK, but I'm saying like I require me, I don't know if you have to pay out of pocket or how does that work because we're, like I said, we still have to go by those fees.
[AGENT][NEUTRAL] OK, yeah, I typically.
[CUSTOMER][NEUTRAL] But I understand. Um, would you?
[AGENT][NEUTRAL] Yeah, I can send a fax back. What's your fax?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yes, but you know, Miss [PII], I don't even think I papers haven't even been coming through, so you can just give me a, he's for today, it's just a limited exam and X-rays, um, I guess he has something going on that he wants to is to look at. Um, so I can just get like co-insurances and maximum for him.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, sure. Um let me get that pulled up real quick.
[AGENT][NEUTRAL] Um, so not a guarantee of payment. That's OK.
[CUSTOMER][POSITIVE] OK, I'm sorry about that. And then I would have had to call, call you back.
[AGENT][NEUTRAL] Um, not a guarantee of payment basic outline of the policy, so he's effective and active [PII].
[AGENT][NEUTRAL] Um, his calendar year maximum is 1500.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, examine pro fees, that's gonna pay 100%.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] No deductible.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, FMX, if he needs an FMX, basic, basic restorative, those all pay 80% after a $50 calendar year deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So he don't have a deductible for exams and profy, but if you do FM make any basic restorative then uh he has to pay a $50 deductible.
[AGENT][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] And then, um, major endopperio and um oral surgery is gonna pay at 40% after that same deductible.
[CUSTOMER][POSITIVE] Got you OK.
[CUSTOMER][NEUTRAL] And you said 40%?
[AGENT][POSITIVE] Yes, I can also email um the fax back too instead of faxing if that's easier for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes. OK.
[CUSTOMER][POSITIVE] Yes, that'll be fine, but this is good as well.
[AGENT][NEUTRAL] OK, uh, that'll have our, uh, claims mailing address too so you'll have that information and then our fax and then our EDI numbers so our payer ID.
[CUSTOMER][NEUTRAL] And like something different.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, what's your email, [PII]?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that was [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, [PII], I'll get this uh sent over right now. Just give me a couple of minutes and then it'll give an outline of all of the coverage and codes that are covered as well.
[CUSTOMER][POSITIVE] OK, Miss [PII]. Thank you so much for your help.
[AGENT][POSITIVE] OK, thank you for uh calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] You too. Do you want to talk back to Mr. [PII] or Mr. [PII], you need to talk back to Miss [PII]? OK, he wants to talk back to you, Missy.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][POSITIVE] OK, great.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] OK, Mr. [PII], I'm gonna, I'm gonna send her over your information and she's verified that you're covered, so you should be good to go, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, yes, ma'am. And, uh, look here, uh, do I need, OK, now, do I need a certain, I mean a certain card too, I mean a different card or what?
[AGENT][NEUTRAL] No, no, that, that card's good. Um, that's the card that you should present to the dentist. I think there's just a mix up, so I'm gonna send the information they need, so you, you should be fine to proceed, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you man.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] Thanks bye bye.