AccountId: 011433970860
ContactId: ef1febe2-d10c-4659-90d1-56dc5ce1f046
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 555359 ms
Total Talk Time (AGENT): 251503 ms
Total Talk Time (CUSTOMER): 171692 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/ef1febe2-d10c-4659-90d1-56dc5ce1f046_20250508T20:58_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I am calling for some member benefits.
[AGENT][NEUTRAL] OK, [PII], you're needing benefit information from member, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Yes, it is 02061497.
[AGENT][NEUTRAL] Thank you, one moment while I get the member's information pulled up please.
[AGENT][NEUTRAL] Is this on a dental policy that you're needing benefit information?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and so far our dental policies, [PII], we send fact facts with the members benefit information on there, um.
[CUSTOMER][NEGATIVE] I, I called before and requested a fax back and I've never received it. So that's why I was calling back and
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see. So first off, any in OK.
[CUSTOMER][NEUTRAL] Try to maybe get some information.
[AGENT][NEUTRAL] And I'll send you a fax back again, maybe it just didn't go through for some reason. So any information that's provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's uh [PII] and date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So I do show that he is the subscriber on this plan and.
[AGENT][NEUTRAL] It is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um just one moment.
[AGENT][NEUTRAL] OK, is the um,
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] And you spoke to some, OK.
[AGENT][NEUTRAL] Is what is your fax number?
[CUSTOMER][NEUTRAL] Um, I'm gonna try to give you this one, this number here [PII], see if that, that's a different fax number so maybe that will work.
[AGENT][NEUTRAL] OK, and again you said it was 214504.
[AGENT][NEUTRAL] I'm sorry, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, now is that tied to your phone line or is that completely separate?
[CUSTOMER][NEUTRAL] Yes, no, it's tagged to my phone line.
[AGENT][NEUTRAL] It's separate.
[AGENT][NEUTRAL] OK, so does it come to your email? Will it come while you're on the phone?
[CUSTOMER][NEUTRAL] It should be, it should.
[CUSTOMER][NEUTRAL] It shouldn't it may. That's why I'm hoping if it doesn't then I'll give you a different one.
[AGENT][NEUTRAL] OK, so I have just sent that to you because it's 8 pages.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But the policy, yes, ma'am, it is active, effective [PII].
[AGENT][NEUTRAL] And when did you most recently, because I don't see on this particular policy with us where anyone has recently called in.
[CUSTOMER][NEUTRAL] Yeah, I just called in. Mhm, um, maybe an hour ago.
[AGENT][NEUTRAL] Do you know who you spoke with?
[AGENT][NEUTRAL] Do you know who you spoke with?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I don't know. No, ma'am. I, I just, she said that I can send you a fax and gave her a number and said thank you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and nothing came through. Can I give you a different one?
[AGENT][NEUTRAL] You can. Just a moment.
[AGENT][NEUTRAL] And it's gonna take it a few minutes. I mean, it's, you know, it's, it'll, cause I haven't received a notification of delivery or failure.
[CUSTOMER][NEUTRAL] Oh, that is the, the, oh, OK, OK.
[AGENT][NEUTRAL] On it, yes. So it's, it's gonna, because it's, uh, ours is through our computer system. It's not like it's a machine that I'm faxing it from.
[CUSTOMER][NEUTRAL] Oh OK, yeah, I see, and that's what I'm receiving it from is in the system, so.
[AGENT][NEUTRAL] OK, so what's another fax number and I'll send it to that as well. But again, like I said, it hasn't had time on the first number for me to know whether it's gonna go or not.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] 469
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I'm just gonna repeat this one back to you as well. [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am. Yes, ma'am.
[AGENT][NEUTRAL] OK, so that one has just been sent off as well to you, so that other fax number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Well, hopefully it'll work this time.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Like I said, you'll need to give it probably 1010 or so minutes.
[AGENT][NEUTRAL] Um, to fully transmit to either one of those numbers.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I ask you just a couple of questions while I got you on the phone.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, on basic and preventative are those that are 100% with coinsurance.
[AGENT][NEUTRAL] Preventative is. Basic is 80% of UCR subject to the $50 calendar year deductible.
[CUSTOMER][NEUTRAL] Preventative.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Preventative is the only thing that's 100% of UCR coverage services.
[CUSTOMER][NEUTRAL] OK. And you said basic was what? I'm so sorry, 80.
[AGENT][NEUTRAL] 8%, mhm.
[CUSTOMER][NEUTRAL] Uh-huh. And what about um major?
[AGENT][NEUTRAL] 40% of UCR and that is also obviously subject to the deductible.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And any ortho coverage on this plan?
[AGENT][NEUTRAL] No, there is not.
[CUSTOMER][NEGATIVE] No. OK.
[AGENT][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Alright, well,
[CUSTOMER][NEUTRAL] May I get your name?
[AGENT][NEUTRAL] Yes, my name is
[CUSTOMER][NEUTRAL] And a reference number for our call?
[AGENT][NEUTRAL] Again, my name is [PII], and my name in today's date would be your call reference number. That's why I was wondering who you spoke to before because we give our names and.
[CUSTOMER][NEUTRAL] Oh, gotcha.
[AGENT][NEUTRAL] Today's date as the reference number.
[CUSTOMER][NEUTRAL] Yeah, and
[CUSTOMER][MIXED] I wasn't paying attention. I was just excited about getting the facts.
[AGENT][POSITIVE] I understand the simple things, the simple things that get us excited.
[CUSTOMER][POSITIVE] All right. Well, Miss [PII], I hope it comes through. If not, I'll be calling back. I appreciate your help. Thank you so much.
[AGENT][NEUTRAL] Yeah just give us a call back let.
[AGENT][NEUTRAL] I, I'm gonna document the two fax numbers um that I've sent it to and then just so that you're also aware, if you all end up filing a claim with us on this policy, [PII], once the claim has been processed by APL, we do have a portal in which you should be able to check claim status.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And the website for our portal is secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Again, the website is secured. [PII]. Oh well, you're welcome. OK, did you get it all? OK, so sometimes people need for me to repeat that one.
[CUSTOMER][POSITIVE] All right. Well, I appreciate it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, I got it.
[AGENT][NEUTRAL] OK. Well, is there anything at the moment, [PII], that I can help you with?
[CUSTOMER][NEUTRAL] No, I got it.
[CUSTOMER][POSITIVE] No, ma'am. Thank you, ma'am, for your help.
[AGENT][POSITIVE] Well, you're, oh, you're very welcome and thank you again for calling APL. I hope you have a very nice evening.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Bye bye.