AccountId: 011433970860
ContactId: d9e6eb53-2934-4360-8e98-8d7aa885c88f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 633820 ms
Total Talk Time (AGENT): 319581 ms
Total Talk Time (CUSTOMER): 176970 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/d9e6eb53-2934-4360-8e98-8d7aa885c88f_20250211T13:39_UTC.wav
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[AGENT][POSITIVE] Morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEGATIVE] Yeah, I'm on the website trying to make a new login and it can give me an error.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you. Do you happen to have your policy number available?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Um, yeah, it's 02451054.
[AGENT][NEUTRAL] Thank you. And do you mind verifying your name and date of birth and current mailing address?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you, Mr. [PII] and your um email and phone number, please, sir.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And phone number is [PII].
[AGENT][NEUTRAL] Thank you, Mr. [PII]. And I'm sorry, what was your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, thank you. Just checking your information. Do you have an account created?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] No, I'm trying to make an account and it says, uh, I get an error.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, I can help you with that.
[AGENT][NEUTRAL] And are you using the um.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] One of the questions it ask, ask if you're an individual or
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Employer you can choose that you're an individual with an APL policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I chose the individual.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're using that SB 912 is your email?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. So let's verify your social. Are you using the social and not the medical ID?
[CUSTOMER][NEUTRAL] Yeah, I'm using the social.
[AGENT][NEUTRAL] OK, can we verify that social, please, sir?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK, that is correct.
[AGENT][NEUTRAL] OK, give me just one second. I'm gonna try to.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you went in as a new user?
[CUSTOMER][NEUTRAL] Yeah, there it, yep.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You choose I'm an individual. And last name is [PII]
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And then your zip code is the [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] No, it's uh, it should be [PII].
[AGENT][NEUTRAL] [PII]. All right. Let me get that corrected. That's probably the problem.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And that's for [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Let's see if that fixed everything.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You want to try it now?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, I'll try now.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][POSITIVE] OK, it worked.
[AGENT][NEGATIVE] Oh right, it was just that one little piece of information that it didn't agree with.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] That's my pleasure. Now, you'll be able to click on your policy numbers. You have a medical policy and dental policy with APL. If you want to view your benefits, you can click on the policy number and it will download your policy certificate and you can view the benefits covered. You can also print cards from that portal and check claim status.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you. So I can see my coverage on the portal you said?
[AGENT][NEUTRAL] You certainly can. You would just click on the policy number for that policy. You have a hospital indemnity, which is your medical, and then you have the dental, which of course is your dental.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, so I would choose a dental office or dentist in the, in the coverage, right? And just go to the office.
[AGENT][NEUTRAL] Yes, so
[AGENT][NEUTRAL] Now, for the dental, it does participate in the Carrington PPO network, but it is not required to go to an in-network provider.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So just to let you know.
[CUSTOMER][NEUTRAL] Any, you say Eli?
[AGENT][NEUTRAL] Yeah, you can go to any provider. Now if you go to an in-network provider there could be a um they have a contracted amount they can charge so they can't go over that.
[CUSTOMER][NEUTRAL] So, what was that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, got you. OK.
[AGENT][NEUTRAL] We do honor claims from out of network providers as well.
[CUSTOMER][POSITIVE] OK, got it, thank you.
[AGENT][NEUTRAL] And that's the same for medical. Medical participates in multi-plan, and those are those network providers are on your card, and there's also a number to call if you want to locate a provider in your area.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Right, cause I'm trying to go to a dentist today because of toothache.
[AGENT][NEGATIVE] Oh, that's miserable.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, so I'm trying to get it over with.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see if I can, just a general dentist.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, I saw that they have one close by to my house. It's um.
[CUSTOMER][NEUTRAL] It's the office for uh let me see.
[CUSTOMER][NEUTRAL] That's in the, in the coverage. Um.
[CUSTOMER][NEUTRAL] It's uh Jamaica Hos Medical Center, East New York.
[AGENT][NEUTRAL] Let's take a look.
[AGENT][NEUTRAL] Now on our general um website, there is a section and you don't have to be signed in for this one, but there's a section that has um
[AGENT][NEUTRAL] Find a provider.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you can just put in your zip code and it will tell you dental providers in your area.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Now, just to be, just to be sure on your dental policy, it's not, does not cover major procedures. Just want you to be aware of that.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So what does it uh cover usually? Those uh
[AGENT][NEUTRAL] Mhm. It covers your preventive services at 100%. That's like your
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] X-rays, your exams, your cleanings, those are covered at 100%, and then your basic procedures which are fillings, your more extensive X-rays, and then there is a simple extraction if an extraction is needed, and that is um covered at
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 80%.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there like root canals too, uh, in case if there is.
[AGENT][NEUTRAL] Root canals are considered, yeah, root canals are considered um major procedures, so those would not be covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] It's my pleasure and I'm getting, what was the name of that dentist that you said?
[AGENT][NEUTRAL] That you were looking at?
[CUSTOMER][NEUTRAL] Um, yeah, yeah, let me check it, um.
[AGENT][NEUTRAL] So I can check it for you.
[CUSTOMER][NEUTRAL] Uh, it's the
[CUSTOMER][NEUTRAL] Um, Jamaica Hospital Medical Center [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Look at it at [PII].
[AGENT][NEUTRAL] Jamaican Hospital Medical Center.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, sir, they are a participating provider. Well, let me give you the doctors there are, there's a [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I'm not sure I'm gonna say these names right. There's an [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And uh [PII], hm, I'm not even gonna try that last name, but it starts with an [PII]
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] So, but the Jamaica Hospital Medical Center does have participating providers for dental coverage.
[CUSTOMER][NEUTRAL] OK, thank you. So I'll just go and just provide the information, right?
[AGENT][POSITIVE] Alright, yes sir, make sure to show them your card. They can call us, we'll be happy to verify your policy is active and verify benefits on the plan.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] It's my pleasure and I certainly hope you get some relief for that toothache. toothaches hurt worse than anything, I think.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] But is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Alright thank you so much.
[CUSTOMER][POSITIVE] No, that's it. You're very helpful.
[AGENT][POSITIVE] It's been my pleasure. Thank you for calling APL Mr. [PII], and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You too. Have a good day.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.