AccountId: 011433970860
ContactId: f20f5034-776c-4361-b213-b88435c942b8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 294359 ms
Total Talk Time (AGENT): 160809 ms
Total Talk Time (CUSTOMER): 111668 ms
Interruptions: 3
Overall Sentiment: AGENT=1.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/f20f5034-776c-4361-b213-b88435c942b8_20250207T20:00_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, I have a question for you. So I'm new to APL with, um, because my last company or my company last to somebody else. Does this include like Periodontist coverage as well, or?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because it's a little bit
[AGENT][POSITIVE] I can definitely get that pulled up and we will take a look, sure we can take a look and see if that covers those uh benefits. What was your name? I'm sorry.
[CUSTOMER][NEUTRAL] Confusing online.
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII], last name [PII]
[AGENT][NEUTRAL] OK, and [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Do you have your uh policy number?
[CUSTOMER][NEUTRAL] I do it's 02565106.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, I'm just gonna verify some information really quick. [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you and happy almost birthday. Uh, can I get your uh mailing address?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII].
[AGENT][POSITIVE] Perfect. Uh, last thing I need is the email address that we've got on file for you. Looks like it, uh, [PII].
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Yep, [PII].
[AGENT][NEUTRAL] OK, perfect. Thank you for that. All right. So this is a secondary medical policy. Uh, typically, they do not have any um dental orthodontic treatment, uh, coverage. Give me just a moment, let me just check, just for good measure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, it doesn't hurt to look into it, you know.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK. So, yes, under uh the exclusions on your policy, it does state uh dental or vision services, including treatments, surgery, extractions, or X-rays.
[CUSTOMER][NEUTRAL] OK, perfect. What about periodontics though? I'm doing a gum graft which is a little bit.
[CUSTOMER][NEUTRAL] Different than what was listed.
[AGENT][NEUTRAL] I don't think so. I do believe that would fall under the with dental, um.
[CUSTOMER][NEUTRAL] Yeah, I figured as much.
[AGENT][NEUTRAL] Was this, yeah.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] The only exceptions it states um is if it was resulting from an accident or uh due to a congenital disease or anomaly of a covered newborn child.
[CUSTOMER][NEUTRAL] Oh, OK, yeah, no, definitely not any of those, OK, and then one more question for you, so the supplemental I had before I was able to just give my doctor's office the card and then they billed you guys directly and then you paid them directly. Is that still applicable to you guys?
[AGENT][NEUTRAL] OK. Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Absolutely um so it does of course every provider's office is different on you know some just don't like secondary or supplemental plans at all um or they may not have heard of APL so they're not sure what kind of plan this is if you ever come across that when you give them this information, um, they are more than welcome to give us a call we do talk to providers all the time so we can kind of explain that to them.
[CUSTOMER][POSITIVE] Oh thank God.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Perfect. OK, that helps so much. Awesome thank you so much for your help. I really appreciate you, yeah.
[AGENT][NEUTRAL] I will say as well, sure, just really quick I'm sorry just so that there's no uh confusion because I'm not quite sure what you had before um but as this is a secondary medical it is very dependent on your primary medical so it's not like a traditional gap insurance um this one if your major medical is not willing to pay on something this policy can't.
[CUSTOMER][NEUTRAL] Yeah, no, no, you're fine.
[AGENT][NEUTRAL] So it's not like you could use this instead of your major medical. OK, just wanted to make sure. I know there could be some confusion with that. OK. Just wanted to make sure.
[CUSTOMER][NEUTRAL] Yeah, I think that's how
[CUSTOMER][POSITIVE] Yeah, yeah, I think that's how it worked before.
[CUSTOMER][POSITIVE] Yeah, I think that's how it worked before that I had to go in network and when the insurance submitted and I had to get like pre-approval and then like it was like a whole process, yeah, um but it was easy.
[AGENT][POSITIVE] Primary EB all that fun stuff.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It took me a long time to figure it out but I was like I hope this this company is the same concept, so it sounds like you guys are.
[AGENT][POSITIVE] Yeah, definitely.
[AGENT][NEUTRAL] No it sounds like it, yes, did you have any other questions for me, [PII]?
[CUSTOMER][POSITIVE] I don't think so. Thank you so much for your help. I appreciate you.
[AGENT][POSITIVE] OK, yeah, of course, thanks for giving us a call. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] Uh, you too, honey bye bye.
[AGENT][NEUTRAL] Bye bye.