AccountId: 011433970860
ContactId: f89c7edf-d1ae-4d9e-8847-5c90767f0fee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 253399 ms
Total Talk Time (AGENT): 114742 ms
Total Talk Time (CUSTOMER): 103708 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/f89c7edf-d1ae-4d9e-8847-5c90767f0fee_20250602T12:32_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. This is [PII] in customer service. I have Ms. [PII] on the line.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, policy number is 23.
[CUSTOMER][NEUTRAL] 09
[CUSTOMER][NEUTRAL] 886.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And she's calling regarding the status of her claim.
[AGENT][POSITIVE] OK, [PII], happy to help. Do we have a callback number?
[CUSTOMER][NEUTRAL] Mhm. Yes, the um same one in the system ending in [PII] is the callback.
[AGENT][POSITIVE] Got it. Alright, you can go ahead and send her over. Thank you, [PII].
[CUSTOMER][NEUTRAL] Thank you. Um, um, she was having issues with um accessing the online service center and I told her that we are working on the issue, um, because apparently it's not taking the information of the customers. So, um, she will be, um, she will be, um, uh, updated about that later.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] OK, alright, awesome thank you so much.
[CUSTOMER][POSITIVE] Thank you. You have a good one.
[AGENT][NEUTRAL] You too.
[AGENT][NEUTRAL] Hi, this is [PII] over in customer care. Am I speaking with [PII]?
[CUSTOMER][POSITIVE] Yes you are.
[AGENT][NEUTRAL] Good morning, [PII]. I understand that you needed to check on a claim. Is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And was this a dental claim or a medical claim?
[CUSTOMER][NEUTRAL] Yeah, it was a dental claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I just got a text message that it had been processed and so when I tried to log in I couldn't log into the system.
[AGENT][NEGATIVE] Yeah, so we, um, launched a new online service center and um some of our customers are having a hard time getting.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Getting logged in, let me see what this claim says here.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so the recent claim that I see submitted on [PII], um, looks like it is showing denied. Um, it shows you're limited to one X-ray per 5 years on your plan. And so,
[CUSTOMER][NEUTRAL] Really?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] If you had another X-ray within that time frame, it looks like, you know, unfortunately,
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEGATIVE] OK, well, that's unfortunate, um, because I went to a new dentist in a different state.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And so, um, so how much am I gonna have to pay the.
[CUSTOMER][NEUTRAL] Dentist office.
[AGENT][NEUTRAL] That would be a question for them. Um, we generally, we don't advise on your responsibility. Um, they can make adjustments and things on their side, so you would want to contact them, uh, for the final what you would owe out of pocket.
[CUSTOMER][NEUTRAL] OK, I'm surprised that they didn't check my eligibility when I gave them my insurance information.
[AGENT][NEUTRAL] Yeah, because most of them will do that honestly, [PII], they'll ask us like for history and then we'll tell them last date of service, um, because the limit 1 per 5 is pretty standard, just kind of like any sort of cleaning or you know it's pretty standard on those plans.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, I've had I've had dental for years and then until I had this one, I've been able to get uh two cleanings a year and X-rays annually. So, um, OK, I will contact them. Uh, was the cleaning was the, did they put through the cleaning?
[AGENT][NEUTRAL] Yeah, so it looks like, I don't see anything else that has showed denied. It was just the X-ray. Um, that was it. Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK then I will uh I will get in touch with them all right, thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye