AccountId: 011433970860
ContactId: db2da40c-9fe8-48f2-82f2-958a49c1a40a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 802340 ms
Total Talk Time (AGENT): 170365 ms
Total Talk Time (CUSTOMER): 338569 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/db2da40c-9fe8-48f2-82f2-958a49c1a40a_20250618T17:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, I have a question. Well, first of all, I'm, I'm unable to get into my account.
[CUSTOMER][NEUTRAL] Um, and that wasn't originally the point of my call, um, but as I was trying to get in there to, to, uh, see some information, I noticed that I can't get into my account at all, um, I do have a, um, a claim that was denied, and I'm wondering like what is missing or what my coverage is. It was, it was just for um like uh a twice yearly dental, you know, cleaning.
[CUSTOMER][NEUTRAL] Uh, check up, and I don't know what I, I assume that was under the, the benefits that I was covered for, but I'm not able to get in and and.
[AGENT][NEUTRAL] OK, do you have your
[AGENT][NEUTRAL] Do you have your policy number?
[CUSTOMER][NEUTRAL] Yeah, it is uh 02606100.
[AGENT][NEUTRAL] OK. Can I have your first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, my first name is [PII]
[CUSTOMER][NEUTRAL] Birth date is [PII].
[AGENT][NEUTRAL] OK, thank you, Mr. [PII]. And do you have a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] OK, and then just need a verification of your address and email address.
[CUSTOMER][NEUTRAL] Yeah, address is [PII].
[CUSTOMER][NEUTRAL] And my email address, uh, I'm not sure which one it is, uh, it's either [PII] or [PII].
[AGENT][NEUTRAL] OK, looks like we've got the rider.
[CUSTOMER][NEUTRAL] OK, that's the one I was trying to log in with, so I'm not sure what's going on there.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] OK, so you said there was a date of service. What date of service did you go to the dentist?
[CUSTOMER][NEUTRAL] Um, it was [PII].
[AGENT][NEUTRAL] Well, I don't show any claims on file, so it looks like we haven't received it from your dentist.
[CUSTOMER][NEUTRAL] Huh.
[CUSTOMER][NEUTRAL] Oh, I, no, I mean
[CUSTOMER][NEUTRAL] Because I paid it out of pocket.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And then I filed a claim and I received.
[CUSTOMER][NEUTRAL] An APL um.
[CUSTOMER][NEUTRAL] Form that says um.
[CUSTOMER][NEUTRAL] Benefits payable under the certificate was outlined on the scheduled benefits um this is not a covered loss under the plan, so I don't know if like.
[CUSTOMER][NEUTRAL] It just says benefit name not found so I don't know if if they gave a number that is not covered, but.
[CUSTOMER][NEUTRAL] Um, under my, on my dental, like the bill that I paid, it just says, uh, oral hygiene, cancer screen, uh, prophy AD, um, which is all just a general checkup.
[AGENT][NEUTRAL] Oh, OK, let me check. Maybe it got filed under another policy number.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Did, did you have a, you said you received a letter from us, is that right?
[CUSTOMER][NEUTRAL] Um, American Public Life Insurance Company.
[AGENT][NEUTRAL] Did it have a claim number on it?
[CUSTOMER][NEUTRAL] Is that you?
[CUSTOMER][NEUTRAL] Yes, one second, um.
[CUSTOMER][NEUTRAL] Claim number, yes, that is uh 360.
[CUSTOMER][NEUTRAL] 3971
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, it looks like.
[AGENT][NEUTRAL] It was filed under hospital indemnity policy.
[AGENT][NEUTRAL] Not your dental policy, OK.
[CUSTOMER][NEUTRAL] Huh.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Well, the web, yeah, the, uh, claims filing website was.
[CUSTOMER][NEUTRAL] Bouncing around a bit but yeah I know the drop down I had it under dental and.
[CUSTOMER][NEUTRAL] So I don't know, I did have a ton of trouble filing it, so that explains that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, what I'll do, let me see, let me pull it up real quick and just make sure I
[AGENT][POSITIVE] Have everything I need.
[AGENT][NEUTRAL] OK, it looks like you had completed a wellness claim form.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Uh, the wellness claim forms are related to medical. So for this, um,
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] We would need, do you, do you have, did your dentist give you a printout of the services that were rendered?
[AGENT][NEUTRAL] Because that's what we need.
[CUSTOMER][NEUTRAL] Yes, I have a.
[CUSTOMER][NEUTRAL] Yeah and I yeah I think that's what I included with the when I uploaded it initially or when I made the claim online.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] We just have the wellness claim form um that you had filled out and then you had checked routine dental exam.
[AGENT][NEUTRAL] Um, let me sure I'm not missing it.
[CUSTOMER][NEUTRAL] Yeah, I, I
[CUSTOMER][NEUTRAL] I went through the whole thing, OK, um, one second, let me try to log in again here.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so have you, have you created a new account because we have changed our website, so if you haven't logged in in the last two weeks and created a new brand new account with a new password and everything, you'll have to recreate your account.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, OK, that's obviously the problem that I'm having, OK.
[CUSTOMER][NEUTRAL] Let me see here, no, I haven't done that, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so let's see.
[AGENT][NEUTRAL] So you'll go to create your OSC account.
[CUSTOMER][NEUTRAL] Is this really OK yeah.
[AGENT][NEUTRAL] And then you're, you're the insured.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, um,
[CUSTOMER][NEUTRAL] 66 um.
[AGENT][NEUTRAL] And then you should only have to enter the last, last name, email, and date of birth.
[CUSTOMER][NEUTRAL] And can I
[CUSTOMER][NEUTRAL] Um, yeah, and I'm using the, you want me to use the writer email just because that's the one on file, OK.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] This says verification is this? OK, one second here.
[AGENT][NEUTRAL] Yeah, it'll send a code to your email. It might take just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah. OK.
[CUSTOMER][NEUTRAL] OK, there we go.
[CUSTOMER][POSITIVE] Uh, OK, perfect. So let me log in quickly.
[AGENT][NEUTRAL] Uh, it's, it'll do it's a two-factor verification code, so it will do it again.
[CUSTOMER][NEUTRAL] And I need another.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Send another one, yeah.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oops.
[CUSTOMER][NEUTRAL] A pop up window keeps getting buried, OK.
[CUSTOMER][NEUTRAL] All right, there we go.
[CUSTOMER][NEUTRAL] OK, let me get through all the OK here we go alright so.
[CUSTOMER][NEUTRAL] Well, let's see.
[CUSTOMER][NEUTRAL] OK, um, so now I just do start my claim thing.
[AGENT][NEUTRAL] Yes, start your claim and it'll be a traditional claim.
[CUSTOMER][NEUTRAL] Oh, this is traditional, not preventative.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then which coverage policy type applies to this?
[AGENT][NEUTRAL] Um, so it'll be your dental.
[AGENT][NEUTRAL] Um, so that
[CUSTOMER][NEUTRAL] Right, I'm
[AGENT][NEUTRAL] Uh, does it have like a dropdown of your plans or?
[CUSTOMER][NEUTRAL] It's this I'll tell you what it shows me it says uh 2606096-HI 4005 WPXB um.
[AGENT][NEUTRAL] OK, it's the
[CUSTOMER][NEUTRAL] 260609
[AGENT][NEUTRAL] It's 2,606,100.
[AGENT][NEUTRAL] It's the D4 FFSB, that's dental.
[CUSTOMER][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, dental's not, it doesn't say dental on here just uh has the numbers and letters.
[CUSTOMER][NEUTRAL] OK, let me get my.
[AGENT][NEUTRAL] And then just to confirm that the dentist did give you like a print out that has the actual codes like it'll say like D 0120 and then the charge.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] OK, OK, perfect.
[CUSTOMER][NEUTRAL] Yeah I've got that services rendered thing that is um I always make sure to get that now it's uh.
[AGENT][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Yeah, OK, let's see here.
[CUSTOMER][NEUTRAL] OK, so I uploaded that and then I just submit.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Financing, OK.
[CUSTOMER][NEUTRAL] Yeah that that one's got um I mean it has both the codes and the cost and the date paid and everything on it so.
[AGENT][NEUTRAL] OK, perfect, yeah, that's what we need and then we'll be able to get that into processing usually takes about um up to 7 working days. Sometimes we're a bit quicker than that, so, so.
[CUSTOMER][NEUTRAL] OK, no, no, it's no rush. I just, this was on my list of things because I got the exact same thing with my vision, um, and that one's through, I don't think you guys have my vision. I think it's through Metlife, so um.
[CUSTOMER][NEGATIVE] Yeah, and I was just wondering like did I completely misread all of my policies and none of this stuff is covered so.
[AGENT][POSITIVE] Right, yeah, I understand. Sorry about the confusion.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] No, no, it's OK and yeah it's good because I do recall that the website was being wonky and that they that it was gonna be you know redesigned so um that's good that I got this all filled out too.
[AGENT][NEUTRAL] OK. Well, is there anything else I can help with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I believe that's it. Thanks for your help.
[AGENT][POSITIVE] OK, well, thank you for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You thank you.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Bye bye.