AccountId: 011433970860
ContactId: eae6a816-c81f-4bd4-a29f-542acc85248a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 620809 ms
Total Talk Time (AGENT): 305914 ms
Total Talk Time (CUSTOMER): 252745 ms
Interruptions: 8
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/eae6a816-c81f-4bd4-a29f-542acc85248a_20250509T17:52_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, so it's [PII], how are you there?
[AGENT][POSITIVE] I'm good. How about you?
[CUSTOMER][NEUTRAL] I'm fine, thank you. This so, oh my goodness, I have a, a big customer on the phone who has questions about her benefits or they didn't pay anything on her claim, and she, I guess trying to decide if she wants to keep it or not.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] In a sense.
[AGENT][NEUTRAL] Oh, got you. OK. Um.
[CUSTOMER][NEUTRAL] So she wants to know why, you know, why she has it basically it's not how she worded it, but, you know.
[AGENT][NEUTRAL] Mm, yeah, I got you. I got you. OK, what is the policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, 261.
[CUSTOMER][NEUTRAL] 9215 and I know you just got off another call because y'all are getting them back to back apparently you know the way it looks.
[AGENT][NEUTRAL] Yes, we are, yeah, that's why I was like, uh, I'll just finishing with the note and I'm like, OK.
[CUSTOMER][POSITIVE] Oh bless up God.
[CUSTOMER][NEUTRAL] I know
[CUSTOMER][POSITIVE] Yeah, I, I, I try to give you a second to breathe when you answer the phone, but, you know, just catch your breath, you know, whatever, God bless you, you know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] It is fine. It's OK. It's all right. OK, let's see, um.
[AGENT][NEUTRAL] And uh did she say if it was the disability or the dental or she did not specify?
[CUSTOMER][NEUTRAL] Did she say it was what there? I'm sorry.
[AGENT][NEUTRAL] If it was the dental or the disability?
[CUSTOMER][NEUTRAL] It's the dental.
[AGENT][NEUTRAL] It was the dental? Oh, OK. Well, I don't see no claims. OK.
[CUSTOMER][NEUTRAL] And she said
[CUSTOMER][NEUTRAL] Oh well, she said it, they didn't pay anything. All I know, she said, you know, but if she doesn't want it, she, she told me, you know, first she was like she wanted to cancel, then she decided, well, first she won't ask about the benefits before she canceled. She's just gonna be sent straight to if she thought she doesn't want it straight to big. So I don't think she's gonna be able to can she may be able to cancel since it was, no, she just enrolled. Oh my [PII]. OK, she's pretty.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah. Mhm.
[CUSTOMER][NEUTRAL] I don't know how that works. It, it's between her benefits of the car.
[AGENT][POSITIVE] Yeah, well, yeah, usually, if we don't know, we don't do cancellations, so yeah, it will go to them. Uh, yeah. OK dokey, but all her information, perfect.
[CUSTOMER][NEUTRAL] Oh God help us.
[CUSTOMER][NEUTRAL] Yeah, we don't do that. Yeah, that's it. That's it we don't do that. uh, you, I did verify all of her information. Her call back number is the same as what's on file, so if, if you like, I can go ahead and give that to you.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, perfect.
[AGENT][POSITIVE] No, no, it's fine. I got it. Thank you so much. I'm ready for her. Have a good weekend. Happy Mother's Day.
[CUSTOMER][POSITIVE] OK, OK. Thank, thank you, dear. You too. Oh, you too, so so, so, [PII], I'm so tongue tied and crazy today. Thank you so. You too, honey. Bye dear.
[AGENT][NEUTRAL] You're.
[AGENT][POSITIVE] You're welcome. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Good afternoon. This is so in the care team department. Is this Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And how may I assist you today, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, I was actually trying to figure out how does the insurance work because I had a dental visit today and it was like I had no insurance at all.
[AGENT][NEUTRAL] OK. Um, well, I see that you have a, um, and this is not a guarantee of payment, just a verification of coverage, Ms. [PII] and Miss [PII], um, told me that she verified your information, so I'm not gonna verify you again. Um, but, um, you have one of our basic dental policies. Um, the basic dental policy is for your regular checkups, your regular cleanings, your back wings, your full mouth X-rays.
[AGENT][NEUTRAL] Your fillings and your simple extraction. That's what is covered under the basic dental policy. Um, when they said that it will not cover what what service was it render?
[CUSTOMER][NEUTRAL] OK, cause I had a
[CUSTOMER][NEGATIVE] I had a uh X-ray done today and it didn't cover the X-ray. I had to pay for that out of pocket as well.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Mm, did they run the benefit? Did they run the insurance or they called to get the information or?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, they have it on the paperwork. My primary insurance is American American Public Life.
[AGENT][NEUTRAL] And this is for the dental, correct?
[CUSTOMER][NEUTRAL] And they have the
[CUSTOMER][NEUTRAL] Uh-huh, this is mental.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We had an X-ray done along with an extraction.
[AGENT][NEUTRAL] Was it a simple extraction or was it a surgical extraction?
[CUSTOMER][NEUTRAL] Um, surgical.
[AGENT][NEUTRAL] OK. The sur surgical instructions are not gonna be covered, so that part of it will not be covered. Now, the X-ray, uh, if they, if they did an X-ray, then usually that's cover 80% based on your benefits, you have up to $500 per year with the $50 deductible.
[CUSTOMER][NEUTRAL] I'm aware.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I'm not um really sure um why you have to pay out of pocket, but what you can do is either have them to submit the claim or get the paperwork and send us the claim. Um what you need to get is um.
[AGENT][NEUTRAL] You, you can let them know that you need to submit your own claim to give you some paperwork with the quoting and the uh the information of what they did.
[CUSTOMER][NEUTRAL] I have that right here.
[AGENT][NEUTRAL] OK, so uh what you need to do is just go ahead and submit a claim, send us a claim and we can review and see if we can send you a refund.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, let me give you the instructions and you can do this either online if you register online through our website at [PII].
[AGENT][NEUTRAL] Or you can fax or mail the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and um I don't believe we have a claim for for dental. Let me check, let me double check. I don't think we do.
[AGENT][NEUTRAL] Usually even by the providers, but if in a case like this you can submit your claim.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, let's see. Oh, we do have 10, well, it's not required. OK, so let me see. So we need the most dentists, uh, assignment insurance.
[AGENT][NEUTRAL] OK, so what you need to ask them for is the ADA claim form.
[AGENT][NEUTRAL] Is that what they gave you?
[CUSTOMER][NEUTRAL] Uh AB.
[CUSTOMER][NEUTRAL] ADA claim form.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I do know.
[CUSTOMER][NEUTRAL] Claim. No, they actually just gave me the treatment plan with all the.
[CUSTOMER][NEUTRAL] The pricing and estimated insurance.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Um, I guess, yeah, I guess the insurance pay $4 on the $51.
[CUSTOMER][NEUTRAL] For the $55.
[CUSTOMER][NEUTRAL] Because
[AGENT][NEUTRAL] OK, so are they gonna send the the claim or?
[CUSTOMER][NEGATIVE] That's what it says it's negative sense.
[CUSTOMER][NEGATIVE] I'm not for sure.
[AGENT][NEUTRAL] So they they're charging you $54 for that service, Miss [PII].
[CUSTOMER][NEUTRAL] I'm not
[CUSTOMER][NEUTRAL] It was, it was $55 for the fee.
[AGENT][NEUTRAL] Oh, got you. And you, you have a $50 deductible. So yeah, it is only gonna pay after that $50 deductible.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It was
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, can you get me back to the um to the service, the service thing where I'm able to opt out?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so if you want to do any changes to your policy, you need to get in contact with benefits in a car. They're the ones that put this policy together for you. You have a disability and a dental with us. I can go ahead and get um benefits card for us in the line.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Is that OK? You're welcome. OK, let me give you their number. OK, let me give you their number just in case you need it for the future. OK, one moment.
[CUSTOMER][NEUTRAL] Uh-huh, that's fine.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that number is 1800.
[AGENT][NEUTRAL] 497.
[AGENT][NEUTRAL] 4856.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. OK, let me go ahead and transfer you, and you have a good day. Happy weekend, Miss [PII]. One moment while I transfer you.
[CUSTOMER][NEUTRAL] you
[AGENT][POSITIVE] Thank you for calling ABM.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to Benefits in a card.
[CUSTOMER][NEUTRAL] For English, press one.
[CUSTOMER][NEUTRAL] Pa espanol pres.
[CUSTOMER][NEUTRAL] For English, press one.
[CUSTOMER][NEUTRAL] Para espanol precios.
[CUSTOMER][NEUTRAL] Your call may be recorded for quality control purposes.
[CUSTOMER][POSITIVE] Thank you for calling Benefits in our car. My name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Um, yes ma'am, I was trying to get to where I'm able to opt out of the services.
[CUSTOMER][NEUTRAL] OK which staffing company are you with?
[CUSTOMER][NEUTRAL] Um, American Public Life.
[CUSTOMER][NEUTRAL] I do not believe so, ma'am. American Public Life is a company for insurance. I need the staffing company's name.
[CUSTOMER][NEUTRAL] Oh, I'm not Omegaforce. I'm sorry.
[CUSTOMER][NEUTRAL] That's OK. What are the last four of the social?
[CUSTOMER][NEUTRAL] [PII].