AccountId: 011433970860
ContactId: d44210b7-507b-47b5-ba22-5eaa98edbe9a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 678349 ms
Total Talk Time (AGENT): 324970 ms
Total Talk Time (CUSTOMER): 250394 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=-1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/d44210b7-507b-47b5-ba22-5eaa98edbe9a_20250205T19:07_UTC.wav
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[AGENT][NEUTRAL] Afternoon, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh yes, hi, I need to know. I'm having a very, I'm trying to be calm and patient here. I'm having a very difficult time trying to find a dentist to do a root canal because of the insurance. It are you guys up under any anything else besides um APL? Like what do you go through?
[AGENT][NEUTRAL] OK, so you have a question regarding the type of coverage you have or locating a provider that could possibly be in your network of your plan as a network plan?
[CUSTOMER][NEGATIVE] Right, because everything that's listed under the under the providers for what I need, they don't do it.
[AGENT][NEUTRAL] OK, yes, ma'am. Well, I can try and help you with this, but first I'll need to pull up your dental um policy information and verify some things with you for security first and
[AGENT][NEUTRAL] So who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And Mr. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, and your policy number?
[CUSTOMER][NEUTRAL] I, I don't have a clue. We always give the social.
[AGENT][NEUTRAL] OK, so one moment.
[AGENT][NEUTRAL] OK. And is the, is the policy in your name, Mr. [PII]?
[CUSTOMER][NEUTRAL] That's in my husband's name.
[AGENT][NEUTRAL] What is his full social?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, so one moment while I try and locate the information. And again, once I do, I will have to verify several things with you first for security, so just one moment.
[AGENT][NEUTRAL] And any information is [PII] that I do provide for you will be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your husband's name and date of birth and then your date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII] and mine is [PII].
[AGENT][POSITIVE] Thank you. The whole mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And the phone number for Mr. uh [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. So on this plan that you all have with our company, Mr. [PII], there is no network. You're not in a network, you may choose to go to any provider.
[CUSTOMER][NEUTRAL] Ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] They will not, I, I have called 8 to 11 different dentists, 8 yesterday and a couple today.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] They will not accept American public life insurance.
[AGENT][NEUTRAL] OK. Again, I can't, uh-huh.
[CUSTOMER][NEUTRAL] So they were asking me.
[CUSTOMER][NEUTRAL] They were asking me something to the effect of, does it, does the American public life insurance go to, to anyone else? Does it go through anyone?
[AGENT][NEGATIVE] No, it does not.
[AGENT][NEUTRAL] No, ma'am. The policy that you have is with APL.
[CUSTOMER][NEUTRAL] And that's what I'm
[AGENT][NEUTRAL] I can give you your policy number since you said that you, you don't have an ID card. Is that correct?
[CUSTOMER][NEUTRAL] No, they just have to give the social.
[AGENT][NEUTRAL] OK, so I can give you your policy number.
[AGENT][NEUTRAL] For the coverage you have and you can see if the provider would be willing to call us to ask any additional questions that they, that they may have. I'll be happy to request that ID cards actually be mailed to you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, what's the policy number?
[AGENT][POSITIVE] I mean, we, we met for you.
[AGENT][POSITIVE] Um, but I'll be happy to be mailed.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] If you'd like to take down your policy number.
[CUSTOMER][NEUTRAL] I'm sorry, I didn't catch.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Would you like to take
[AGENT][NEUTRAL] OK, so your policy number is 1246519.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] And so the insurance that I have, I should be able to go to any.
[CUSTOMER][NEUTRAL] Dental office with the insurance.
[AGENT][NEUTRAL] That is correct because this is not a network plan.
[AGENT][NEUTRAL] There is not a specific network to use.
[CUSTOMER][NEUTRAL] Well, I don't know what
[CUSTOMER][NEGATIVE] Yeah, I don't know what's going on because yesterday I was so frustrated like they weren't listening to me, they weren't hearing me. This is the exact same thing that I was telling them, and they, they will not listen. I am at my wits end.
[AGENT][NEUTRAL] Oh, I'm very
[CUSTOMER][NEUTRAL] We're trying to explain this to them.
[AGENT][NEUTRAL] I am very sorry. Now, I do see, uh, Mr. [PII], I don't know what clinic she may have been with, but someone did call in earlier today.
[AGENT][NEUTRAL] Uh, let me look at this note. Give me just a second.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so someone had, there were
[AGENT][NEUTRAL] A couple of calls.
[AGENT][NEUTRAL] By providers yesterday and then there's been one today where they didn't receive the fax back of benefits that we had sent to them via fax so it was emailed and they did receive that.
[AGENT][NEUTRAL] She was with Aspen Dental. I can tell that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, but that's, that's just, they don't, that's where I went to have them check my tooth out in the first place, but they don't do the root canals. They said I need to see him in, in um [PII].
[AGENT][NEUTRAL] Oh, OK. Uh-huh.
[AGENT][NEUTRAL] An endodontist. Uh-huh.
[CUSTOMER][NEUTRAL] Yeah, and so they referred me out, so I called 3 of them. No, we don't accept that you're not in the network, blah blah blah blah blah. And so I, I went to your website, pulled up all the list of endodinas, and I'm telling you, ma'am, if.
[CUSTOMER][NEGATIVE] I, I've just never seen anything like it before. I'm like, you guys are on the list for my insurance company. They don't take it. Some of the businesses are closed.
[CUSTOMER][NEUTRAL] I'm out of network we don't take that insurance I.
[AGENT][NEUTRAL] Yes, ma'am. That's
[CUSTOMER][NEUTRAL] I don't know where to turn to.
[AGENT][NEUTRAL] And unfortunately, I'm sorry that that sounds like that's on, you know, the provider's end because you're not even in a network so that we can't, you can't say they for them to tell you that you're out of network, your plan is not a network plan.
[CUSTOMER][NEUTRAL] Well, I tried to explain that to them and no one's listening. So I, I, I.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] I don't know what to do, and I am frustrated.
[CUSTOMER][NEUTRAL] I, I, I don't know what to do.
[AGENT][NEUTRAL] I'm sure that you are and I can understand that.
[CUSTOMER][NEUTRAL] So if I'm not in the network, that means that they should take it, but, and then one of the dentist offices, no, I never heard of that insurance before. We don't take that. I've never heard of that one before.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEGATIVE] Oh, I don't know. I I don't know what to do, so I'm calling back. I've called you guys, I don't know, maybe 3 times. I, I don't know what to do.
[CUSTOMER][NEGATIVE] Because no one will do my root canal. They want me to come out of pocket and pay $1,729 and then $292 just to walk in for a visit consultation.
[CUSTOMER][NEGATIVE] And so the root canal they want me to come out of pocket when I'm paying freaking dental insurance faithfully every freaking month. What sense does that make?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure, and again, see, I mean we can't, we don't have any control over how the providers.
[AGENT][NEUTRAL] Choose to bill or what?
[AGENT][NEGATIVE] You know, that it's just not something that we're involved with, unfortunately for you, and I understand this is very frustrating. All I can tell you is that, you know, maybe if you can now provide them with your policy number and our phone number. Again, I can see, you know, but you said that [PII] is just where you went initially, that's not to the specialist, any of the specialist, um, but to have them, you know, reach out to us.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Is there a direct number maybe they can call and talk to you on?
[AGENT][NEUTRAL] And we could explain the.
[AGENT][NEUTRAL] No, ma'am. Unfortunately, there's not because we, it, it
[AGENT][NEUTRAL] We're one team and it's just the next available, you know, person that's available to take a call, um, but the [PII].
[AGENT][NEUTRAL] Is the phone number that they would need to call in on.
[CUSTOMER][NEUTRAL] Is that the number I'm calling you on now?
[AGENT][NEUTRAL] Um, I can't see, I mean.
[CUSTOMER][NEUTRAL] Hold on a second, I'm sorry, hold on.
[AGENT][NEUTRAL] Sure. No, you're fine.
[CUSTOMER][NEGATIVE] So they call that number and then what do they need? I, I, I don't, this is, this is absolutely absurd to me. I don't, I have never seen anything like this before in my life.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] They call that number and then what number do they need to dial into?
[AGENT][NEUTRAL] I it should bring them straight to our our team without having to go through any prompts.
[CUSTOMER][NEUTRAL] It it doesn't it makes you go through it. You have to go through prompts, yes.
[AGENT][NEUTRAL] For
[AGENT][NEUTRAL] Well then if they're calling regarding dental, then that's the one that they would need to select our customer service.
[AGENT][NEUTRAL] What prompt did you choose?
[CUSTOMER][NEUTRAL] I, I at this point I don't remember between all the calls yesterday I, I don't remember.
[CUSTOMER][NEUTRAL] Let me try to call again. I, I.
[CUSTOMER][NEGATIVE] I'm trying to call this is like bull. I don't understand. I, I, I feel like I need like more help, like I'm paying the insurance every single month. I feel like they need to help me. I, I'm I'm telling them that no one's accepting the insurance.
[AGENT][NEUTRAL] OK, and again, because you're not in a network.
[AGENT][NEUTRAL] Ms. [PII], I mean, we have no control over what a provider will or will not accept. All you can really do is provide them your policy information, our phone number. I've requested that your ID cards be mailed to you.
[AGENT][NEUTRAL] Now, uh, if Mr. [PII] can call in, we do need to add an email address on file for him so that we can, he can set up his profile online and y'all can have access to your ID cards online, but that is something we can only do with him since he is the primary subscriber on this policy.
[CUSTOMER][NEUTRAL] I, I can at this point I could care less. I, I handle all of this. He's a truck driver. He has time, didn't have time to even wash his butt.
[CUSTOMER][NEUTRAL] Let me try to call and figure this out.
[AGENT][NEUTRAL] Well, is there anything else that I can help you with?
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] OK. Well, you're very welcome. And if there are any other questions, Mr. [PII], please give us a call back and we'll be more than happy to try and help you.
[AGENT][POSITIVE] You're welcome.