AccountId: 011433970860
ContactId: d6bfd6a5-7d24-4e2b-93bb-fe262aa0d6c0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 422109 ms
Total Talk Time (AGENT): 233298 ms
Total Talk Time (CUSTOMER): 97800 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/d6bfd6a5-7d24-4e2b-93bb-fe262aa0d6c0_20250213T14:37_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] How you doing? My name is [PII]. I was calling to see, um, um, pretty much checking my policy details.
[AGENT][NEUTRAL] OK, sure, I can assist you with that. Um, may I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah it's [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's 134 0503.
[AGENT][POSITIVE] Mm thank you.
[AGENT][NEUTRAL] And for security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] [PII] [PII] [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Um, can, can you verify that policy number for me one more time?
[CUSTOMER][NEUTRAL] 1340503
[AGENT][NEUTRAL] Are you looking at the card?
[CUSTOMER][NEGATIVE] No, this is what I got from the UP I mean UTBA um personnel. I haven't even received the card or anything.
[AGENT][NEUTRAL] OK. Yeah, that number is is is not your number. One moment.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] You know, when I called the UTBA um number, that's what they gave me.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Oh, I'm so sorry, yeah.
[AGENT][NEUTRAL] That's maybe a different number, like probably one of the numbers is different, but yeah, it's, it's not pulling your information. Um, let me have the spelling of your last name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, OK. And the spelling of your first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, bear with me, let me see if I can find your correct policy number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm sorry, let me have your date of birth one more time.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Here it is. OK, thank you.
[AGENT][NEUTRAL] And this is for your dental, correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I found it. Um, let me give you the correct policy number, um, and it looks like again, yeah, it was just one number that is incorrect. Um, the first number is a number 2, 234-0503.
[CUSTOMER][NEUTRAL] 234-050-3
[AGENT][POSITIVE] Mhm, yes, mhm, correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So, um, you said you need, you have not received your card, so let me go ahead and request the card to be sent out to you and then you said you need a breakdown of your benefits, correct?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. And the address um that you provided to me was it [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, right, let me go ahead and order that card first.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then I can give you a breakdown.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, so I have ordered the card. Um, the card usually takes 5 to 7 business days for you to get it. It goes regular mail, OK? And see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you need like a breakdown um given to you by by phone or do you need this to be faxed over to you or emailed to you?
[CUSTOMER][NEUTRAL] No, you could just send me by phone. I'm just trying to figure out like if I wanna go in for a cleaning, what do I have to do? What do you guys cover? What do I pay stuff like that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, the amount that you pay is not determined by us, but I can tell you how the policy works, um, and this is not a guarantee of payment, just a verification of coverage, and that's just a disclaimer. Uh you have a calendar year maximum of $1500 with the $50 deductible.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] And deductible does not apply to preventatives.
[AGENT][NEUTRAL] The preventatives are your regular checkups, your regular cleanings, and your bite wings. Those are considered under preventative and those are covered 100%.
[AGENT][NEUTRAL] Um, and then we have radiograph FMX which is a full mal X-ray. Uh, that one is covered at 80%.
[AGENT][NEUTRAL] And then we have a basic and basic restorative, which is your fillings and your simple extractions. Um, those are covered at 80%.
[AGENT][NEUTRAL] And then we have major services, which is endedonic, periodonics, uh, surgery, um Crown, which is those are covered at 40%.
[CUSTOMER][NEUTRAL] OK, so the cleaning is covered at 100% and if I need a filling that's covered at 80%.
[AGENT][NEUTRAL] Correct. If it's a simple cleaning, it is covered 100% and then the filling is 80%, yes. If they need to do a deep cleaning, deep cleaning is considered a major service, so that will be covered at 40%.
[CUSTOMER][NEUTRAL] At 40%.
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, yeah, and I just treated, I, I got you. I, I understand. I just was trying to get that figured out.
[AGENT][NEUTRAL] Mhm. All right.
[AGENT][NEUTRAL] I understand. But yeah, if you need to go to a dentist or if you're trying to make an appointment, you can just provide them with the policy number so they can call us and we can go ahead and verify this information for them. And if we need to send them a schedule of benefits, we can go ahead and do that as well, so so.
[CUSTOMER][NEUTRAL] OK, so I just give them my policy number.
[AGENT][NEUTRAL] Yes, and the phone number that you're dialing is the same number for them, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] No, ma'am, that's it. I appreciate it.
[AGENT][POSITIVE] OK. You're welcome and thank you for calling EPO. Have a good day, Mr. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you.