AccountId: 011433970860
ContactId: d4bfb3bb-0bc7-4341-9dc1-9c078978255d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 886700 ms
Total Talk Time (AGENT): 459902 ms
Total Talk Time (CUSTOMER): 364865 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/d4bfb3bb-0bc7-4341-9dc1-9c078978255d_20250516T17:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] How you doing [PII]? I am, uh.
[AGENT][NEUTRAL] Hi.
[CUSTOMER][POSITIVE] I'm doing OK. I have.
[CUSTOMER][NEGATIVE] I'm going through some problems here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I got my APL card.
[CUSTOMER][NEUTRAL] In the middle, and on the right hand side it says [PII].
[CUSTOMER][NEUTRAL] And then I have a payer ID number. I have a policy certificate number, and a group number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] When I called, uh,
[CUSTOMER][NEUTRAL] Uh, APL before they told me to go to a website, which I did, and they would provide me with a network of doctors that accept.
[CUSTOMER][NEUTRAL] This insurance.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, uh,
[CUSTOMER][POSITIVE] I typed in my zip code [PII], and it gave me, and then it gave me the option of uh how many uh uh doctors I want in a certain vicinity.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I put 10 and then uh I called.
[CUSTOMER][NEUTRAL] That when I looked at the uh uh
[CUSTOMER][NEUTRAL] The 10 doctors that they uh
[CUSTOMER][NEUTRAL] Uh, provided me, it was the same number.
[CUSTOMER][NEUTRAL] It was the it was [PII]. So apparently there's 10 doctors in a place and they all have the same number. I called that number.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] They're not responding. So I expanded my church to 50 doctors.
[CUSTOMER][NEUTRAL] And I found one that had a [PII] number which is my area code.
[CUSTOMER][NEUTRAL] I called them
[CUSTOMER][NEUTRAL] And I said, listen, uh, uh, I went to the APL network, uh, and your number came up, it's a 301 number and they told me that they don't accept APL, but they do accept Carrington. Now Carrington is on the right hand side of of this card that I received from APL.
[CUSTOMER][NEUTRAL] And they're telling me they don't accept APL, but they do accept Carrington.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] So then she told me to call, you know, to call the number on the back of the card and that's what I'm doing and this is where I'm at right now.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, let's get this, let's get this fixed. Um, can I get your name?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] OK, and can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Right, and what's the policy number that you have? It, it would be the policy certificate number.
[CUSTOMER][NEUTRAL] OK, I have that. It's 02612980.
[AGENT][NEUTRAL] OK, let me check on that for you.
[CUSTOMER][NEUTRAL] And then I have like a group number and then on the upper right hand corner it has a payer ID number if if that helps.
[AGENT][NEUTRAL] The group number is just a number that is assigned specifically to your um your employer because you get this through your employer. um, so if you, we're gonna go through some verification process real quick. Uh, can you verify your date of birth?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and your mailing address and phone number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And what was the other?
[AGENT][NEUTRAL] Uh, phone number?
[CUSTOMER][NEUTRAL] Oh, it's [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] All right. This is a dental policy.
[AGENT][NEUTRAL] Um, so Carrington is the dental provider that we use.
[AGENT][NEUTRAL] So it is technically a Carrington Dental, um, you just, your, your group bought it through APL. So it would still be Carrington. Um, and you can also, if you're ever concerned when you go to that doctor, um, they can call us and verify eligibility and make sure that we take them, but I'm showing that your policy is active.
[CUSTOMER][NEUTRAL] I, I know, but why would they tell me, uh,
[CUSTOMER][NEUTRAL] They don't accept APL but they accept Carrington.
[AGENT][NEUTRAL] They're probably thinking.
[CUSTOMER][NEUTRAL] You know, they told me this and I I
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Uh, I mean, because they, I've called twice and uh.
[CUSTOMER][NEGATIVE] From different, uh, the same number and I got a, a representative in the same thing and they both told me the same thing. They told me we don't accept APL.
[CUSTOMER][NEUTRAL] But we do accept Carrington.
[CUSTOMER][NEGATIVE] You know, and so I wanna know I don't wanna go there and you know I want my insurance to be accepted. I'm not coming out the pocket, that's the reason why I got insurance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So, I mean, I just wanna know.
[CUSTOMER][NEUTRAL] You know, if they take it or they don't because I wanna find a provider who does take it.
[CUSTOMER][POSITIVE] Without no issues. I want to present my card and say, listen, you know, this is a network. They tell me you accept it.
[CUSTOMER][NEUTRAL] Can you provide services for me under this insurance?
[CUSTOMER][NEUTRAL] That's all I want.
[CUSTOMER][NEGATIVE] But now I'm calling on the providers under the website and when I call the providers they tell me they don't accept it so.
[CUSTOMER][NEUTRAL] But they do accept caring, so I need clarification.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] OK, and I'm, I'm working on that clarification for you as well.
[AGENT][NEUTRAL] And because if your card says Carrington, that's the dental network that we use, and you just happen to get it through APL so it's technically Carrington, but I wanna double check that. Um, APL whenever you're going through APL, that's just who your, your employer bought the insurance from because you might have multiple insurances or um you might have multiple plans through us.
[CUSTOMER][NEUTRAL] It does
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] To
[AGENT][NEUTRAL] Let me check. Yeah, because, so the APL you have a hospital indemnity plan.
[AGENT][NEUTRAL] As well.
[AGENT][NEUTRAL] Hospital indemnity plan would be.
[CUSTOMER][NEUTRAL] Yeah, yeah, I got dental, I got vision.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, I got dental, vision, and a multi-plan.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] You know, it wasn't the bottom of, you know how they have copper, uh, uh.
[CUSTOMER][NEUTRAL] You know, gold, silver, and platinum. I, I got like the silver plan. I got the one that was in the middle.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You know, I didn't go, I didn't get the bottom, but I got in the middle.
[CUSTOMER][NEUTRAL] Of the plan so that's what I have, and I got that card also.
[AGENT][NEUTRAL] So your card shows APL and Carrington because your dental, so your group.
[AGENT][NEUTRAL] When your employer goes through a broker to buy their insurance, they went through APL.
[AGENT][NEUTRAL] APL has dental plans, but it is through Carrington. So your hospital indemnity plan is an APL plan.
[AGENT][NEUTRAL] Your dental plan is a Carrington plan bought through APL. So when they're giving, when you're asking for it, it will be APL, and if you are really concerned, you can say, can you pre uh, can you do a pre-check and then have your dentist give your dentist or whoever you're using.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Your policy number and they can precheck before you come in so you can make the appointment and pre-check with us and they can do that but your dental is through Carrington but it just happened to be your employer bought it through APL because I am showing you have a dental plan.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I wanna double check and make sure um if you need that and.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Most dentist office will call us and we will give them a fax of everything that is uh every service that is rendered through us, so we do that. Carrington does not um because you bought the plan through us. So if you ask them to do a pre-certification or ask them, give them your policy number, and they can come through us and we can give them a fax of everything that you are covered by and how much we pay.
[AGENT][NEUTRAL] Beforehand because Carrington is only the network you bought it, your employer bought it through APL and I know that's that's super confusing um but it is right so when in doubt, give the the dentist office your uh policy number which is that certification number or policy certificate number. Ask them to pre-certify you. You are in our system.
[CUSTOMER][NEUTRAL] It is, it is, it is.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we can provide that dental office a fax of everything that you are covered and how much it pays.
[CUSTOMER][NEUTRAL] And it's
[CUSTOMER][POSITIVE] Awesome. Now, now do I say it's ATL or do I say it's Carrington?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You want to say it's through Carrington.
[CUSTOMER][NEUTRAL] When I call the dentist, OK, Carrington, OK.
[AGENT][NEUTRAL] Right, right, that is only the network.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So don't use APL just use Carrington.
[AGENT][NEUTRAL] Correct and again if you are concerned about it because I wouldn't want to get a scary bill either call them and ask them to pre-check.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, alright, I will do that.
[AGENT][NEUTRAL] So make the appointment and ask them to precheck and just just verify with them the day of your appointment as well, make sure that they prechecked.
[AGENT][NEUTRAL] Um, and make sure that they got a fax from us.
[CUSTOMER][NEUTRAL] And make sure that they confirm it, OK.
[CUSTOMER][POSITIVE] Alright, that's what I'm gonna do, thank you so much. I appreciate your help. No, I needed it.
[AGENT][NEUTRAL] OK. And then if they don't.
[AGENT][NEUTRAL] And then, um, also as a backup, if you get a bill and they do not file the claim for you, you are able to file a claim on your own behalf. Uh, do you have an online account set up with us?
[CUSTOMER][NEUTRAL] I needed it
[CUSTOMER][POSITIVE] I, I go to a website, yes, I do, I do, I do.
[AGENT][NEUTRAL] That's secured. Am public.
[CUSTOMER][NEUTRAL] Uh, I believe I have to provide a, you know, uh, uh.
[CUSTOMER][NEUTRAL] A username and password.
[CUSTOMER][NEUTRAL] To it, that's how I got the list. That's how I got the list of the, of the doctors.
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] And let me make sure that it's active just real fast, um.
[AGENT][NEUTRAL] Because through the online service center you can you can file your claim and check your claim status as well um and that's really helpful and should you ever not have your ID um it's showing that you don't have an account through the OSC it might have been a different account it might have been a different portal that they sent you to.
[CUSTOMER][NEUTRAL] No, uh, uh,
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] No, it was a [PII].
[CUSTOMER][NEUTRAL] [PII], I mean, it's right there. [PII]m.
[AGENT][NEUTRAL] OK, so this is a this is an online portal that you will register for. This is completely separate. So instead of going to that one, go to [PII].
[CUSTOMER][NEUTRAL] OK, hold on, I gotta write this.
[AGENT][NEUTRAL] Right, you can write it down or we can go through it together right now on the phone it's up to you.
[CUSTOMER][NEUTRAL] Just bear with me.
[CUSTOMER][NEUTRAL] OK, I'm ready. I got a pen.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, what uh site am I supposed to go to?
[AGENT][NEUTRAL] So go to [PII].
[CUSTOMER][NEUTRAL] The chair
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You will click a and I can send you uh I can send you um.
[CUSTOMER][NEUTRAL] And then what I
[AGENT][NEUTRAL] A help guide on this as well, um, the email that you.
[CUSTOMER][POSITIVE] Oh, I, I would appreciate that.
[AGENT][NEUTRAL] Sure the email that you will need to use for this secured site has to be the email that we have on file. Can I confirm that email with you?
[CUSTOMER][NEUTRAL] Yeah, it should be
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, that's the one that we have on file um because our system and this secured website talk to each other any time you wanna change um you will need to make sure that you um have everything on file with us as well if you're ever getting an error message it's probably because uh you changed something online but not through us just give us a call um I'll send you a user guide.
[AGENT][NEUTRAL] Really all you're going to do is go on there, click new user.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You're an individual.
[AGENT][NEUTRAL] And then it asks for your last name, your social security number, your zip code, the email that you just confirmed with me, and your birthday, and what this does, and you can do it on your phone as well. What this does is it has your ID cards there, you can file your claims online. Um, we also have the, the site that they gave you has all of the claim documents. So should your dental office not.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][POSITIVE] File the claim for you. This would be the way that you could file a claim online and check the status so it's all right there in your policy document, everything, all of your benefits will be right there on that site. So that's really helpful to have, um, and I will send you an email with that help guide as well. Uh, expect it in about 10-15 minutes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][POSITIVE] OK, thank you so much I really appreciate it.
[AGENT][POSITIVE] Mhm. Awesome.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Alright you have a great day. No, I'm just trying to get through this and make it happen, but I appreciate your help. Hopefully this works out.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] All right thank you so much and if you have any more issues just give us a call back OK?
[CUSTOMER][POSITIVE] No problem you take care have a great day.
[AGENT][NEUTRAL] All right. You too, bye.