AccountId: 011433970860
ContactId: d58a1cee-b163-4617-b914-fcfbaed69109
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 301350 ms
Total Talk Time (AGENT): 121472 ms
Total Talk Time (CUSTOMER): 136183 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/d58a1cee-b163-4617-b914-fcfbaed69109_20250305T15:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, uh, I would like to know if my coverage includes, um, I have to have a crown, um, a dental.
[CUSTOMER][NEUTRAL] The dentist told me I needed to have a cavity and uh an old crown needs to be removed.
[CUSTOMER][NEUTRAL] Um, because it's under the old crown and I was wondering if uh I can submit um.
[CUSTOMER][NEUTRAL] Um, my, my paperwork to you guys if, if you cover any of that.
[AGENT][NEUTRAL] OK, I can check your benefits for you. Um, can I please get your name and your policy number?
[CUSTOMER][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] My policy number is 221-6481.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] Group number 255 OK.
[AGENT][NEUTRAL] OK, Ms. [PII]. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you ma'am, and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] [PII], um, the, uh.
[CUSTOMER][NEUTRAL] Email is [PII].
[AGENT][NEUTRAL] And then one last verification, can you give me your phone number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, is that also a good number to call you back on if we get disconnected?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, thank you so much. Alright, so looking at this policy and this is just to verify your benefits it's not a guarantee of payment. This is a medical policy it's not a dental policy.
[CUSTOMER][NEUTRAL] This is
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, it's not a dental, OK.
[AGENT][NEUTRAL] Right. So this policy helps with deductible, co-pay and co-insurance for medical purposes. Um,
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, do, do you have available, um, a dental coverage for individuals or not?
[AGENT][NEUTRAL] You'll have to go through lawyer the Bell and Jesu prep school. You'll have to go through them um and see if they have any dental benefits available for you.
[CUSTOMER][NEUTRAL] No, no, I, what I'm, what I'm saying, I, they do, but uh what I'm saying is, do you can, if, if a person is interested in getting supplemental coverage for dental with you individually, not with work, is that possible?
[AGENT][NEUTRAL] No ma'am, because we don't do only go through the group.
[CUSTOMER][NEUTRAL] I see. OK, alright, and 11 more thing I, I, I would like you to check for me please if you could, uh, I had a, uh, a claim from a um.
[AGENT][POSITIVE] Yes, ma'am. I'm sorry.
[CUSTOMER][NEUTRAL] Uh, dermatologist, and I was wondering if it was already, if it was already paid.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and do you know when you reported the claim?
[CUSTOMER][NEUTRAL] Um, they reported it, but I'm not sure when.
[AGENT][NEUTRAL] I see one that was reported on [PII].
[CUSTOMER][POSITIVE] That sounds right, yeah.
[AGENT][NEUTRAL] Look at it real quick through Vital MD Group Holdings.
[CUSTOMER][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] OK, so looking at this claim, let me see.
[AGENT][NEGATIVE] It was not paid because office visits are not covered under your policy.
[CUSTOMER][NEUTRAL] But it wasn't for office visits. I, I paid for the office visit. It was for a procedure that they did.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] Did they do it in the office?
[CUSTOMER][POSITIVE] They did it in the office, yes.
[AGENT][NEUTRAL] Yes, ma'am. That, that's, that's why.
[CUSTOMER][NEUTRAL] But I paid
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's why.
[AGENT][NEUTRAL] Yes ma'am, because the office.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, the is still when you have things done at the office, it's not covered under your policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, I see.
[CUSTOMER][POSITIVE] OK, all right, thank you very much.
[CUSTOMER][POSITIVE] Have a good day.
[AGENT][POSITIVE] You're very welcome. Is there anything else, Ms. [PII], I can help you with?
[CUSTOMER][POSITIVE] No, that's it thank you bye bye.
[AGENT][POSITIVE] Alright well you have a great day and thank you for calling ma'am.
[CUSTOMER][NEUTRAL] OK, bye bye.