AccountId: 011433970860
ContactId: f93b15e3-0fe2-4e70-8ce7-9a341ddb9d74
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 550460 ms
Total Talk Time (AGENT): 346426 ms
Total Talk Time (CUSTOMER): 134854 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/f93b15e3-0fe2-4e70-8ce7-9a341ddb9d74_20250318T19:39_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is. How may I help you?
[CUSTOMER][NEUTRAL] Yes, I'm calling to see if you all, um, like if I have to take my kids to the dentist, do you all pay for like out of network, um.
[CUSTOMER][NEUTRAL] Dental dentist.
[AGENT][POSITIVE] I can check that for you. It would be my pleasure to assist you. Do you have your policy number available?
[CUSTOMER][NEUTRAL] OK, yes, let me see.
[CUSTOMER][NEUTRAL] The policy um certification.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] That's the number is 02574708.
[AGENT][NEUTRAL] Thank you. And your name and date of birth and callback number please, ma'am.
[CUSTOMER][NEUTRAL] My name is [PII]. It's on [PII], which is my spouse. Um, my callback number is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And do you mind verifying your current mailing address?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, thank you. And y'all haven't been affected by any of those storms lately, have you?
[CUSTOMER][NEUTRAL] Um, no, we don't have any damage, but you know, it's places around that that yeah.
[AGENT][POSITIVE] Oh good.
[AGENT][NEUTRAL] Yeah, I know, uh, I'm outside of [PII], so I know things were kind of hopping up, have been hopping up there lately.
[CUSTOMER][NEUTRAL] Oh yeah, yeah.
[AGENT][NEGATIVE] It's been rough. It's been rough.
[CUSTOMER][NEUTRAL] It sure has. It sure has been. I'm hoping they fall behind us.
[AGENT][POSITIVE] Well, thank God we're.
[AGENT][MIXED] Oh yeah, me too, and hope, you know, just thankful that the good Lord protected all of us, so I'm praying for those that weren't protected, but yeah, it's been rough. Well, yeah.
[CUSTOMER][NEUTRAL] That's true.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I can help you, Miss [PII]. Now, this policy does not participate in a network.
[AGENT][NEUTRAL] So you can go to any dental provider.
[CUSTOMER][NEUTRAL] OK, so it doesn't matter. Oh, OK, go ahead, I'm sorry.
[AGENT][NEUTRAL] Now, if
[AGENT][NEUTRAL] I'm sorry, it doesn't matter where you go because we pay now they may ask.
[AGENT][NEUTRAL] Um, you know, if you call to schedule an appointment.
[AGENT][NEUTRAL] And you can tell them that the policy pays.
[AGENT][NEUTRAL] Per UCR and usual that stands for usual customary rates, so that's UCR.
[AGENT][NEGATIVE] So there's no network participation.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's because Mr. [PII] may be out on the road and he didn't, you know, he may need attention and there may not be a network provider in his area where he is.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] So this policy does not participate in a network, so he can get that attention needed without having to worry about that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and um like do it usually cover like uh like your regular dental cleanings or how is that set up?
[AGENT][NEUTRAL] Sure. So the policy pays 100% of the usual rate in your area for cleanings, and that's also for your checkups. So it would be for just your regular checkups, cleanings, um, fluoride.
[AGENT][NEUTRAL] Um, simple X-rays.
[AGENT][NEUTRAL] The visit, all that would be paid at 100% of whatever that usual rate is in your area, if you go in the West Point area.
[AGENT][NEUTRAL] So if that dental provider charges above what the usual rate is, then you may have to pay a small part of that, but it normally, especially in [PII], they thank goodness, charge around the normal amount.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, um, that's good to hear. Um, do, like, since I have you on the phone, you like, um, say for instance if somewhere down the road like my kids may need braces, how is that, uh, you know.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah, let me check
[CUSTOMER][NEUTRAL] How do you
[AGENT][NEUTRAL] So for orthodontics, that is not covered under this plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then for you.
[CUSTOMER][NEUTRAL] And you don't have a plan that covers it, do you?
[AGENT][NEUTRAL] We do not.
[AGENT][NEUTRAL] That is, you would need to check with the benefits department with universal trucking to see if they do in fact have a plan that might include braces or or orthodontics.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, for you and Mr. [PII], if you all happen to need a major procedure, I will advise that this policy does have a 12-month waiting period for major procedures. Major procedures are things like root canals, crowns, bridges, oral surgery, um, your periodontic gum treatment, or endoontic services.
[AGENT][NEUTRAL] Those would be covered after [PII], and those are covered at 40%. But your basic um fillings, there's a simple extraction, all of that is covered at 80%.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's, that's covered now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we do actually have a
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Website because you, I see that, let's see, have an active dental policy. If y'all ever want to create an account online.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We do have a portal that you can actually pull up your policy and it'll show you what else is covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] He would have to, he would have to set that up because the policy is in his name.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it the one that's on this card? It says uh [PII] and then it has a slash number sign and.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] Yes ma'am, that's it. You would just go to that website and create an account.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So when he logs in as a new user he's, it's going to ask some questions and he's going to choose the top answer. I'm an individual with an APL policy and then the next page he'll put in his information including his social and then the next page.
[AGENT][NEUTRAL] Um, once your information is entered, the next page it'll take you to would be to create a username and password.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And once that's created, when you're online, you just click on the policy number and it'll show you the benefits on your policy certificate.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] That's what I needed to know.
[AGENT][POSITIVE] Well, anything else you can think of? Cause I'll be happy to help you.
[CUSTOMER][NEUTRAL] Um, how many cleanings are allotted during a 12 month period?
[AGENT][POSITIVE] That's a good question.
[AGENT][POSITIVE] Let me get to that and I can answer that quick for you.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, it's per person on the policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Um, the benefits are.
[AGENT][NEUTRAL] And the calendar year max is $1500 per person. Now that is a verification of coverage on your policy, not a guarantee of payment. For your cleanings, it's once every 6 months.
[AGENT][NEUTRAL] So it has to be separated by 6 months.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then your exams, that's payable 2 times for 12 month period.
[AGENT][NEUTRAL] And then there's bite wings, those are the simple X-rays that are covered under your preventive at 100%, and that's
[AGENT][NEUTRAL] Payable one time per 12 month period.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then your more extensive X-rays like your, um, they call them a full mouth x-ray or a panoramic X-ray. Those are covered once every 5 years per person.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think that's about all I can think of at the moment.
[AGENT][POSITIVE] Oh, Ms. [PII], it's been a pleasure to assist you with your policy information.
[AGENT][NEUTRAL] And you just call us if you need anything else, OK?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK, I sure will. Thank you for your time.
[AGENT][POSITIVE] Mhm. Thank you, Ms. [PII]. You take care and have a wonderful afternoon.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] Bye, bye.