AccountId: 011433970860
ContactId: ebe51e45-19f8-4511-a5b2-1918b5d336d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 820929 ms
Total Talk Time (AGENT): 436840 ms
Total Talk Time (CUSTOMER): 210362 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/ebe51e45-19f8-4511-a5b2-1918b5d336d1_20250224T15:35_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I'm trying to find uh.
[CUSTOMER][NEUTRAL] Providers in my area that will take my dental card.
[AGENT][NEUTRAL] OK, so you're needing to find out who you would contact regarding finding a dental provider in your area, is that correct?
[CUSTOMER][NEUTRAL] Can you help me?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Yes, so I can help you with um that. But first I'll need to pull up your policy information and verify some things with you for security and then once I, once I see the type of plan you have, I'll be able to direct you as to who you would need to contact.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, so first off, who am I speaking with, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you, Mr. [PII]. What is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, and your policy number, please?
[CUSTOMER][NEUTRAL] 0, 025.
[CUSTOMER][NEUTRAL] 60613
[AGENT][NEUTRAL] OK, thank you. So give me a moment please, Mr. [PII], to get your information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so first off, Mr. [PII], any information that I provide will be a verification of benefits and not a guarantee of payment. If you could first please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And your home mailing address, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And your street number, did you say [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. The phone number that we have on file for you is the same as the one that you gave me so again that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you. And lastly your email address, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. All right, so first of all, Mr. [PII], have you ever said, I'm sorry, Mr. [PII], have you ever set up your profile in the APL online service center where you can have access to your ID cards and policy information as well as claims information online?
[CUSTOMER][NEUTRAL] No, I have not.
[AGENT][NEUTRAL] OK, well now I do have a user guide that I'm going to email you that will give you the instructions on how to go about setting that up.
[AGENT][NEUTRAL] Um, and I'll email you that when we get off of our call. That email will come to you from care team at [PII], Mr. [PII], and I will put APL online service center, uh, portal in your subject line for you so that that's easy to recognize, OK?
[AGENT][NEUTRAL] So on your coverage that you have, I see this is through Triton Logistics. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. So this this plan that you have, this dental plan, it's not a network plan, which means that you can select any provider to go to. There's not a list of doctors.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you may.
[CUSTOMER][NEUTRAL] Does that mean it's a benefit?
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] I mean, does it mean that there's uh some kind of discount with the plan going to the office or?
[AGENT][NEUTRAL] No, sir. This is, again, this is, yes, sir, again, this is not a network plan. This is not a PPO you're not in a network.
[AGENT][NEUTRAL] Your benefits. Correct. Mhm. You would just provide your, the dental provider that you choose to go to with your APL ID card and they will call us to verify any information, you know, that your policy is active and ask any other questions that they may need information regarding.
[CUSTOMER][NEUTRAL] So I can go anywhere.
[CUSTOMER][NEUTRAL] OK, and then, uh, how will they be able to assess my fee for the services?
[AGENT][NEUTRAL] They would have to provide us information on what is being done.
[AGENT][NEUTRAL] And then we would be able to, you know, we, we can't pay claims over phones, but we can send them benefit information showing them what is covered under your plan.
[CUSTOMER][NEUTRAL] Oh, so they'll have to accept.
[CUSTOMER][NEUTRAL] It in order to do it if they don't accept your card.
[CUSTOMER][NEUTRAL] Then
[CUSTOMER][NEUTRAL] Just like me walking in as a walking or anything like that.
[CUSTOMER][POSITIVE] That's about right.
[AGENT][NEUTRAL] Well, that would be between, well, most companies, most providers will accept your dental coverage. If for any reason they don't, then you could still file your claim. They would just need to provide you the claims information so that you could file the claim.
[CUSTOMER][NEUTRAL] OK, this means, would this mean, will this mean I have to uh.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Some way I have to pay up front and then.
[CUSTOMER][NEUTRAL] My, my dental benefits take care of me later on or?
[AGENT][NEUTRAL] If it's a covered service under your plan, we would not be able to determine that until we have received the claims information for review.
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] And as far as your, you know, working a payment arrangement out or ever how the provider chooses to handle that, we don't have any part of that, Mr. [PII].
[CUSTOMER][NEUTRAL] OK, I'm, I'm trying to understand you clearly now you you're saying.
[AGENT][NEUTRAL] OK, I'm saying that you're not in a network plan we can't, we can't force the provider to accept your coverage.
[CUSTOMER][NEUTRAL] 7.
[AGENT][NEUTRAL] But most providers will accept your information once you provide them with it, they will call us to verify any information that they need.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then file the claim for you.
[AGENT][NEUTRAL] Regarding, we do not determine any form of patient responsibility at all. That is, that is up to the provider.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] As to how they handle that.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Well, do my claim, do my, do my, uh my benefits include uh.
[CUSTOMER][NEUTRAL] Extractions or surgery or?
[AGENT][NEUTRAL] You have a 12-month wait.
[CUSTOMER][NEUTRAL] Are you able to
[AGENT][NEUTRAL] Well, and again, once you set up your profile, you will also have access to your benefit information, but on your plan, for certain services, your policy just went into effect on [PII]. So you do have a 12 month waiting period on certain services.
[AGENT][NEUTRAL] Before this policy would, you know, provide any benefits if approved.
[AGENT][NEUTRAL] So the categories for you would be that are under the twelve-month waiting period or major expenses, endoonic expenses, periodonic, prostatonic, and oral surgery.
[AGENT][NEGATIVE] So this plan does not provide any benefits. It would not provide any benefits for those categories until after [PII].
[CUSTOMER][NEUTRAL] The the.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Now, if you had to have a tooth pulled, if it's a simple extraction, you know, that's, that's a little different. I mean, that is something that's covered under your policy that does fall under your basic expenses. There is no waiting period on that. You would have to meet your $50 calendar year deductible. And then this plan pays 80%.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] Of the usable and customary charges, but again without having.
[CUSTOMER][NEUTRAL] Yeah, they are the dentist.
[CUSTOMER][NEUTRAL] Well, man, man.
[CUSTOMER][NEUTRAL] The dentists have already, the doctors have already, uh, I paid out of pocket for my consultation already.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And they can't do a simple extraction. They're going to have to do cutting to get that.
[CUSTOMER][NEGATIVE] That too fast.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] And uh so that that's what I'm trying to see if we where I'm at on that uh what's uh.
[AGENT][NEUTRAL] Yes, I said.
[CUSTOMER][NEUTRAL] I'm needing to get a
[AGENT][NEUTRAL] And again, those, that would be something that would fall under the, the categories that you have your twelve-month waiting period.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] Alrighty, I guess I can't use this card then I guess that's pretty much I can, I can get a, I can probably get a teeth cleaned with it, huh?
[AGENT][NEUTRAL] Absolutely. You know, your preventative expenses are covered at 100%. And then if you have to have any type of X-rays or anything that falls under your category of basic or basic restorative, those three categories, aside from preventative. The other categories fall under your um deductible, your $50 calendar, your deductible, and then they are covered at 80% of the UCR in your calendar, your maximum benefit.
[AGENT][NEUTRAL] On this plan, Mr. [PII] is $1500 per covered person.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now you say that then are you when you say 1000, that means I have to pay out 1001st.
[AGENT][NEUTRAL] 1000
[AGENT][NEUTRAL] No, so the maximum benefit that this plan would pay per calendar year for covered outpatient services is $1500 and you do have a $50 calendar year deductible that has to be met.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Well, I gotta get this surgery out of this. This won't they won't. I went to try to get it pulled, but they won't do it.
[CUSTOMER][NEUTRAL] We need to cut, so which means I don't have to take out, I guess that that's what you're saying pretty much saying.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] OK. Well, is there anything else that I can help you with, Mr. [PII]?
[CUSTOMER][NEGATIVE] Oh, no.
[AGENT][NEUTRAL] OK, well, you're very welcome and again, I will send this email that I was referring to a little bit ago um about our portal so that you can set up your profile and have access to your information online also, including your ID cards.
[CUSTOMER][NEUTRAL] OK. Are you, are you all, um.
[CUSTOMER][NEUTRAL] Independent contractor or just through that company?
[AGENT][NEUTRAL] We're not a contracted company, is, is that what you're asking?
[AGENT][NEUTRAL] Again, this is
[AGENT][NEUTRAL] Again, we're not part of a network. Mhm.
[CUSTOMER][NEUTRAL] Only if you're
[AGENT][NEUTRAL] This is a plan that you enrolled for through your employer. This is an offering that your employer.
[CUSTOMER][NEUTRAL] So if I don't work for the.
[AGENT][NEUTRAL] Provides through the Universal Trucking Benefits association as an option for enrollment for dental coverage.
[CUSTOMER][NEUTRAL] I am I, am I able to keep it at even after not in being employed with that company?
[AGENT][NEUTRAL] No, sir. You would not be able to continue that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] Yes, sir. All right. So is there anything else, Mr. [PII], I can help you with?
[CUSTOMER][POSITIVE] Oh, that'd be all, thank you.
[AGENT][POSITIVE] OK, well, you're very welcome and thank you again for calling APL. I hope you have a nice day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome.