AccountId: 011433970860
ContactId: f11580f1-5242-478a-a752-8fd7e335b1f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 698239 ms
Total Talk Time (AGENT): 259793 ms
Total Talk Time (CUSTOMER): 187595 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/f11580f1-5242-478a-a752-8fd7e335b1f8_20250523T17:20_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. Thank you. How may I help you? I'm sorry.
[CUSTOMER][POSITIVE] Oh yeah, uh thank you, [PII], um.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I just want to know the status of my dental work. uh, when I got X-rays and they sent in the.
[CUSTOMER][NEUTRAL] Uh, playing for them. I just wanna know when can I reschedule.
[AGENT][NEUTRAL] Wait, say that again, so you.
[CUSTOMER][NEUTRAL] And what's covered.
[AGENT][NEUTRAL] You're wanting, wait a minute. So you went to an appointment.
[CUSTOMER][NEUTRAL] I, I went in, I, I, I.
[CUSTOMER][NEUTRAL] Yes, uh, about a month and a half ago I guess, maybe 2 months ago, and, uh, they submitted it, they did the X-rays and now I need to come back and get my cleaning and some more work done. There was an estimate that they sent.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK, OK, OK, I got it now. And may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] My name is [PII] and my contact number is [PII].
[CUSTOMER][NEUTRAL] 980.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, and Mr. [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] Oh [PII], I'm driving, uh, Jesus, let me see.
[AGENT][NEUTRAL] Oh, it's OK. Um,
[AGENT][NEUTRAL] I can look it up with your social too, whichever is easier for you.
[CUSTOMER][NEUTRAL] Social.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 9397.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] OK, here we go. So I just found the policy. Hold on one moment, it's coming up now.
[AGENT][NEUTRAL] And I have it here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[CUSTOMER][NEUTRAL] Uh, email [PII] [PII].
[AGENT][NEUTRAL] And the mailing address.
[CUSTOMER][NEUTRAL] It should be [PII].
[AGENT][NEUTRAL] All right, and all the information provided is a verification of benefits, not a guarantee of payment and
[AGENT][NEUTRAL] So they said that they sent the estimate in. The reason I'm asking is because I don't see anything here, so I just want to make sure I'm understanding correctly.
[CUSTOMER][NEUTRAL] It should have come from General Works of Quincy, Florida. I've already got the X-rays done.
[CUSTOMER][NEUTRAL] I went for a cleaning. I already got the X-rays done and a crown.
[CUSTOMER][NEUTRAL] And I'm just waiting for her approval from the insurance company.
[AGENT][NEGATIVE] Right, but what I'm saying is we haven't received anything. So, like, where we go to look for your claims and documents that come in, literally the screen is blank, like they have not sent it to us, or if they did, I don't know where they're sending it to, but we don't, we, we don't have anything here for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What what would they send a fax or email or what, how would they do it?
[AGENT][NEUTRAL] Well, to be honest, um, pre-estimates and things like that aren't required, so unless they just want to do it, you don't have to do that. They can just do the work. Um, they called us the last time we spoke to anybody was back in February. They called and we sent the schedule of your like a a breakdown of your coverage. So they have, you know, what's covered on your policy and
[AGENT][NEUTRAL] was not, um, and then they would just file the claim after you get the services.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, is the, is a crown covered under my claim?
[AGENT][NEUTRAL] Um, let me pull up your benefits. Hold on one second. Let me see what policy you have.
[CUSTOMER][NEUTRAL] Under my coverage
[CUSTOMER][NEUTRAL] Cause I've been with you guys for a while.
[AGENT][NEUTRAL] Hold on one moment. I'm just pulling up your um your breakdown so I can see all the coverage.
[AGENT][NEUTRAL] You said crowns?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, you have major coverage. Um, let me see. Now,
[AGENT][NEUTRAL] So your major coverage has a 12-month waiting period. Um, let me look at this first one. Hold on one second.
[CUSTOMER][NEUTRAL] I've been with UTBA which is the agent I guess.
[CUSTOMER][NEUTRAL] APL for some time there was a billing issue where they was sending it to the wrong something and there was like a.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] I misunderstanding but I'm a truck driver so.
[CUSTOMER][NEUTRAL] By the time we got it fixed, everything is back in control, but I've been rolled with you guys since like [PII] or something like that.
[AGENT][NEUTRAL] The first policy you have with us is [PII]. Um, this policy that's active here now wasn't active until [PII].
[AGENT][NEUTRAL] And there's a 12-month waiting period. So you do have major services covered, but there's a 12-month waiting period. Um, let me do this. If you don't mind, I'm gonna place you on a brief hold. Let me just reach out to um customer service.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, but I'm, uh.
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] I'm pretty sure I have to go by the [PII] date, but I just want to make sure.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right, hold on one moment for me, OK?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Alright, thank you so much for holding. So yes, it's um when this, when the active policy became active, so [PII], um, and then the twelve-month waiting period will be this August, you can um use your your major expenses.
[CUSTOMER][NEUTRAL] OK, alright, so.
[CUSTOMER][POSITIVE] Alright, I guess I'll go that route. I still can get my cleaning done right away though, right?
[AGENT][NEUTRAL] Oh yeah, you can get your cleanings, um.
[AGENT][NEUTRAL] Once every 6 months.
[CUSTOMER][NEUTRAL] OK, they've already done the X-rays, so I need them to submit.
[CUSTOMER][NEUTRAL] The claim to you all.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then once we get the claim,
[CUSTOMER][NEUTRAL] OK, I need a phone.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] We'll go ahead and process it. Do you, well, I was gonna say, do you know if they have it, but yeah, we sent them the breakdown, so they have everything. But I mean if they need help, I can.
[CUSTOMER][NEUTRAL] Oh, what is it [PII] of Quincy?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I'm not sure. It just says the person who calls uh in the dental office. Do you have the location that you're going to now? Do you have their fax number?
[AGENT][NEUTRAL] Because I can fax it over to them so they'll have it just in case it's somebody different.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Let me see, it may be online, let me see.
[AGENT][NEUTRAL] Oh, I can look, what's the name of it?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][POSITIVE] Dental works, D E N T [PII] X.
[CUSTOMER][POSITIVE] But I'm thank you I'm driving.
[AGENT][POSITIVE] Oh, definitely, you don't have to do that and then
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is it on [PII]?
[CUSTOMER][NEUTRAL] Yes, that's it.
[AGENT][NEUTRAL] OK, here it is.
[AGENT][NEUTRAL] Let me see if I can find it um.
[AGENT][NEUTRAL] Hold on 1 2nd.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] We're open.
[AGENT][NEUTRAL] Yep, here it is. So I'll go ahead and fax them over um a copy of your dental breakdown and it has all the ways to file a claim on there and in the attention I'll put your name so they'll know it's for you.
[AGENT][NEUTRAL] Well, I'll just put [PII].
[CUSTOMER][POSITIVE] Alright thank you ma'am and uh put and put yeah uh [PII], it doesn't matter yeah please do.
[CUSTOMER][NEUTRAL] And uh maybe you know my date of birth or something like that so they'll know.
[AGENT][NEUTRAL] Well, I can't put all that on the attention because of HIPAA, but I'll um make sure they know it's for you.
[CUSTOMER][POSITIVE] I appreciate that.
[CUSTOMER][NEUTRAL] OK, that's part, that part, that part.
[AGENT][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] So when can I call them later on today?
[AGENT][NEUTRAL] Call them for to see if they received it.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh, we usually say to give a fax about an hour.
[AGENT][NEUTRAL] Um, just, you know, just for it to be sent.
[CUSTOMER][POSITIVE] OK good good I'll call I'll call later on this afternoon.
[CUSTOMER][POSITIVE] Yeah, I'll do that thank you ma'am.
[AGENT][POSITIVE] You're very welcome. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] No, that's it. I just gotta wait until [PII] to get the other work done.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Alright thanks.
[AGENT][POSITIVE] Alrighty, well, thank you so much for calling APL. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye.