AccountId: 011433970860
ContactId: df43eab8-a055-4b65-9608-e02f91c4b81b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 827659 ms
Total Talk Time (AGENT): 373408 ms
Total Talk Time (CUSTOMER): 344516 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/df43eab8-a055-4b65-9608-e02f91c4b81b_20250226T17:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi. Um, I, my name is [PII]. I just signed up for this insurance through my, um, my employer recently. And so I got the cards in the mail and I just was hoping I could ask you a couple of questions.
[AGENT][NEUTRAL] Yes, Ms. [PII], I can help you with questions. Uh, can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] And that is not my phone number, so please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Put it into the system. I'm borrowing my mom's phone because uh I actually don't have a phone right now. Mine crashed and I'm not getting one until this weekend, so.
[AGENT][NEUTRAL] Oh yes ma'am, I understand. OK, and Miss [PII], what is your policy number?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] It is 02596151.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] All right, Ms. [PII], um, can you please give me your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then can you also verify
[AGENT][NEUTRAL] Your address and your email address for me for security reasons.
[CUSTOMER][NEUTRAL] Sure, it's [PII], and I think the email that I gave for this is [PII].
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] I have like a couple different.
[AGENT][POSITIVE] That's the correct one. OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So what are the questions that you have about your policy, Ms. [PII]?
[CUSTOMER][NEUTRAL] Well, um, I'm, this is my dental insurance, correct?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. And um so I just.
[CUSTOMER][NEUTRAL] I need to go to the dentist for a cleaning because I haven't been in like over a year because I was without insurance and I.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, need, I don't even know if I'll go back to the same place I went before, but how do I figure out what dentists are covered in this plan? And just to make sure.
[AGENT][NEUTRAL] Yes. OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Is a dental 100% covered?
[AGENT][NEUTRAL] Let me look at your benefits real quick, um, and I'm also gonna give you a website to go to so you can search for a provider in your area.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you go to [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's [PII] and in the top right hand corner um where the little magnifying glasses um type the word provider in there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm gonna actually get while we're on the phone, just give me one second. OK, so in public.
[AGENT][NEUTRAL] And then the
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and then go to at the top where it says search the site.
[AGENT][NEUTRAL] Yes, you're gonna right you're gonna say provider you're gonna put provider in there and then the next page that it brings you to you're gonna click on provider resources.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then you'll just type in, um, you'll just follow the prompts from there. It looks for a provider in your area by zip code.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so like you can't type in your dentist's name and see if they are in the list, or?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so it says search for, so I assume I click on that.
[CUSTOMER][NEUTRAL] Right, OK.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Oh, it does have a thing where you can put your name, the name in.
[AGENT][POSITIVE] Oh, OK. Awesome, awesome. I thought it just did it by zip code, but that's, that's great. They are updating it, so that's a good thing.
[CUSTOMER][NEUTRAL] OK, and I suppose like all
[AGENT][NEUTRAL] And to answer.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I could also call the dentist and to ask them if they take this insurance, right?
[AGENT][NEUTRAL] Well, if they're on that provider list, then they already take the insurance.
[CUSTOMER][NEUTRAL] OK, but like, what, um, OK, good. I think I see the one that I used to go to came up. Now, if I did have to ask a dentist's office if they take this insurance, is it just called APL? Is that what it is? Or like?
[AGENT][NEUTRAL] Yes, ma'am. It's APL.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if they need to verify your benefits with us, you can give them the same number that you called and they can call us and we have a fax back that we can send to them that breaks down your policy with all your benefits and the fee schedule.
[CUSTOMER][NEUTRAL] OK, and what does Car Carrington Solutions simplified mean? that's on the front of the card also.
[AGENT][NEUTRAL] Right. Carrington is also um uh is the network.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is for your dental insurance.
[CUSTOMER][NEUTRAL] So is it called APL?
[CUSTOMER][NEUTRAL] And Carrington or is it called?
[AGENT][NEUTRAL] Yeah, it's both. We work hand in hand with Carrington. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so would I tell them that name then?
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] Yes, tell them it's through Carrington also. And like I said, if they call and verify your benefits, we have a really good um facts that we can send them that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Has all your benefit breakdown and fee schedule on it for them. Uh, and it, it goes by procedure codes, so.
[AGENT][NEUTRAL] Don't know what that means it's, it's really good, um, and then looking at your benefits, you asked the question if your preventative is covered 100%, and this is just to verify your benefits, it's not a guarantee of payment.
[AGENT][NEUTRAL] You have a calendar year maximum of $500.
[AGENT][NEUTRAL] And you also have a calendar year deductible of $50.
[AGENT][NEUTRAL] So once that $50 is paid, your preventative is 100%.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and when you say preventative, that's like when you get your teeth cleaning.
[AGENT][NEUTRAL] Cleaning. Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that like, does that include the X-rays because sometimes they have to do X-rays.
[AGENT][NEUTRAL] Um, your X-rays are, um,
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Like usually once a year you get the bite wings.
[AGENT][NEUTRAL] You get
[AGENT][NEUTRAL] Right. The bite wings are once a year. Yes, ma'am. You're correct on that. Um, your full mouth X-rays, pangramics, the one that goes all the way around, you get once every 5 years.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Your radiographs are covered 80%.
[CUSTOMER][NEUTRAL] I don't know what that is, but.
[AGENT][NEUTRAL] And your
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] I've never had that at the dentist.
[AGENT][NEUTRAL] Right, I understand, um.
[AGENT][NEUTRAL] If they ever have to do that, it's covered 80%.
[CUSTOMER][NEUTRAL] Well, when they do
[CUSTOMER][NEUTRAL] They, they do the bite wings once a year, are they, is that?
[CUSTOMER][NEUTRAL] Covered as part of preventative or is that, do I have to pay extra for that?
[AGENT][NEUTRAL] That is um preventative.
[CUSTOMER][NEUTRAL] OK, so like that's within the $500 if it, as long as it doesn't go over the $500.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Right, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, but I can go, like I can get two cleanings in a year, like, and if they go over $500 then I would just have to pay the extra.
[AGENT][POSITIVE] Correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think I called when I was without insurance just to see like how much it would cost to get a cleaning and I wanna say it was like $180 so hopefully it'll be.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Yeah, but it.
[CUSTOMER][NEUTRAL] My mom's in the back.
[CUSTOMER][NEUTRAL] If I have to pay the 50, which I, yeah, I assumed I would if it's a deductible.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yeah, it's $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, so that's for the preventative now like if I had a cavity or something, what does it cover for that?
[AGENT][NEUTRAL] Let me look and see. That's gonna be considered basic.
[AGENT][NEUTRAL] It all depends on the um.
[AGENT][NEUTRAL] Procedure code, the CDT code that they sent to us, but your basic expenses are 80% of the allowable amount.
[CUSTOMER][NEUTRAL] OK. So like if it costs $100 then I would have to pay $20 of it?
[AGENT][POSITIVE] Correct, yes ma'am, we pay 80.
[CUSTOMER][NEUTRAL] Is there a deductible on that also or?
[AGENT][NEUTRAL] No, you just have that one-time annual deductible of $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so as long as it's considered a basic code.
[CUSTOMER][NEUTRAL] Then it would be 80%.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So I guess like I, if I found out I had to get like a root canal, I would just have to call you to see beforehand to see how much it would.
[CUSTOMER][NEUTRAL] Cost or something like that, but I don't knock on wood. Hopefully that won't happen because I've only ever had to have cat like fillings, like in my life so far.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] But, OK.
[AGENT][NEUTRAL] Now you don't have, you don't have major.
[AGENT][NEUTRAL] Restorative on this policy, it's only basic.
[CUSTOMER][NEUTRAL] OK, so if it was major restorative I just have to pay out of pocket for for it.
[AGENT][POSITIVE] Correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] I don't know what major restorative means, but I'm assuming that means like a root canal or.
[CUSTOMER][NEUTRAL] Something like that.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It would be the big stuff, all the um root canal, crowns, things like that.
[CUSTOMER][NEUTRAL] OK and then um.
[CUSTOMER][NEUTRAL] Like, besides the cavity what is considered basic?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] I can look on this, uh.
[AGENT][NEUTRAL] Of course your films.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] Your films that they take, the film that they take, the um X-rays and things like that are considered.
[CUSTOMER][NEUTRAL] Sorry, what did you say?
[AGENT][NEUTRAL] Some of them are considered basic and some of them are pre preventative, um.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Do you know which ones are considered preventative?
[AGENT][NEUTRAL] Yes, the bite wings, single film, 2 films or 4 films, vertical bye wings, 7 to 8 films.
[AGENT][NEUTRAL] Those are considered
[CUSTOMER][NEUTRAL] So the panel, whatever.
[CUSTOMER][NEUTRAL] The pan pano one, is that not considered basic?
[AGENT][NEUTRAL] Uh, let me look and see.
[CUSTOMER][NEUTRAL] Or pre preventative or.
[AGENT][NEUTRAL] Once every that's basic.
[CUSTOMER][NEUTRAL] So that one I would have to pay 20% of?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK. I, I don't think I need that anytime soon, thankfully, so.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So your basic, um, your basic expenses would be like an extraction.
[AGENT][NEUTRAL] Uh, fillings, resin, composite.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Gold foil.
[AGENT][NEUTRAL] Uh, set it, if you have to be sedated for a feeling, that's basic restorative.
[AGENT][NEUTRAL] Pin retention.
[AGENT][NEUTRAL] So that's what's on, on your policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And like I said if if they want um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Full benefits for you, then we'll call our number and we'll fax it over to them that way they know what's covered and how much it is.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, well, um
[CUSTOMER][POSITIVE] Thank you for your help and I'll um go through here and try to find.
[CUSTOMER][NEUTRAL] A dentists to go to.
[AGENT][POSITIVE] Yes, ma'am. I wish you luck. It's always fun to go to the dentist to me. I always feel so good after I come back out.
[CUSTOMER][POSITIVE] Yeah, like I'm very excited to be able to go because I, oh.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I usually go twice a year.
[CUSTOMER][NEGATIVE] This thing screwed me up. So, all right, thank you.
[AGENT][POSITIVE] OK, you're very welcome, Ms. [PII]. You have a good day and thanks for calling APL.
[CUSTOMER][NEUTRAL] That's it.
[CUSTOMER][NEUTRAL] You too bye bye.