AccountId: 011433970860
ContactId: 01b08578-42c3-440e-b07b-a80c8759c573
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 561119 ms
Total Talk Time (AGENT): 305336 ms
Total Talk Time (CUSTOMER): 123771 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/01b08578-42c3-440e-b07b-a80c8759c573_20250403T13:33_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], I'm calling um about some questions regarding my insurance policy. So I just wanna know if the policy covers eye vision and like doctor's appointment and physicals and stuff like that.
[AGENT][NEUTRAL] OK, so does it cover vision and primary care?
[AGENT][NEUTRAL] OK, I can definitely look into your policy and let you know of your coverage. Um, in terms of vision, American Public Life doesn't provide vision insurance at all, so I, we're not your provider for that, but I can definitely check your um office coverage for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] 18442
[AGENT][NEUTRAL] Do you have the APL ID card or do you have like paperwork?
[CUSTOMER][NEUTRAL] I have paper we, we don't know what the cards are.
[AGENT][NEUTRAL] OK, on the that number does it say it, that might be your group number. Can you repeat that number again? I can try that way.
[CUSTOMER][NEUTRAL] Oh yeah, I definitely think it's my group number. I'm in the policy with my mom is 18442.
[AGENT][NEUTRAL] And what's your mom's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, hold on one second.
[AGENT][NEUTRAL] Here we go. I just found her. Hold on one second.
[AGENT][NEUTRAL] All right, so it just popped up. And [PII], can you verify your date of birth and the mailing address on file?
[CUSTOMER][NEUTRAL] [PII] and the mailing address should be [PII].
[AGENT][NEUTRAL] Thank you and all the information provided is a verification of benefits, not a guarantee of payment. So with us, you all have uh dental, medical, and then a critical illness policy, um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So hold on for your dental, did you need, I'm sorry, for your medical, did you need your policy number?
[AGENT][NEUTRAL] Or I can also email.
[CUSTOMER][NEUTRAL] Please, give me one second.
[AGENT][NEUTRAL] If you'd like
[CUSTOMER][NEUTRAL] You can email it and tell me it starts to 5 of the 5.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So clear.
[CUSTOMER][NEUTRAL] OK, you can go ahead and tell me the insurance policy number.
[AGENT][NEUTRAL] So it's 258
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 7943.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then, um, so you have you all received your cards? Well,
[AGENT][NEUTRAL] Because I can like email you a copy. OK.
[CUSTOMER][NEUTRAL] We have is that.
[CUSTOMER][NEGATIVE] Yes, please, cause we lost it like literally.
[AGENT][NEUTRAL] OK, yeah, I can send you an email copy. Hold on one moment. And then, so do you need the physical card sent to your home as well? Because you could do both if you need it. OK.
[CUSTOMER][POSITIVE] Please, that would be great.
[AGENT][NEUTRAL] Sure. So hold on one moment. I'm pulling up the benefits so I can look at the um in-office coverage and then I've already sent the request for the physical cards to be mailed to y'all. And then um once I finished looking for the benefits, I'll get the digital card.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hold on 1 2nd.
[AGENT][NEUTRAL] OK, so the benefits just popped up and I'm waiting for the in office. Hold on one second.
[AGENT][NEUTRAL] OK, so for the physician's office, the policy would pay up to $75 per day with a max of 6 days per calendar year.
[CUSTOMER][NEUTRAL] And this was for the, which one again?
[AGENT][NEUTRAL] This is medical.
[CUSTOMER][NEUTRAL] OK, medical.
[CUSTOMER][NEUTRAL] Up to 75.
[AGENT][NEUTRAL] Mhm, per day, with a max of 6 days um per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And medical, what all falls under medical that includes like doctor appointments, checkups, physicals, TB tests, those kind of things.
[AGENT][NEUTRAL] So, for this policy, this is a hospital indemnity policy. A hospital indemnity policy is like a limited medical benefit policy. So your coverage is, so it's like a list of coverage. If it's not on this list, it wouldn't be covered. So your policy covers like hospital admission, it will pay up to $1000 per day, um, one day per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Confinement, um, that's any time in the hospital after admission, um, 18 consecutive hours or more. It'll pay $600 a day that you're in there, um, with a max of 30 days per year. Intensive care.
[AGENT][NEUTRAL] Uh, rehabilitation of any kind, and then it goes into the outpatient benefits, which is like the emergency room, urgent care facilities, um, the physician office benefits, so it's not like a major medical insurance policy.
[AGENT][NEUTRAL] So no matter if
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Like continue.
[AGENT][NEUTRAL] Um, so like, I was just gonna say, so for the physician's office, if no matter the amount of the bill, the max that this policy would pay is $75.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And straight up no eye vision and no TB test.
[AGENT][NEUTRAL] Well, APL as a whole, like our company just doesn't provide vision, not to say that you don't have it, it's just not with us. So they would, um, your mom may have to call HR to see like who they, they can see what she selected and tell her who that, you know, that provider is and they probably have a number for them too.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Yeah, cause she wanted me to call and ask if our coverage would cover a physical test and the TB test that we need to take.
[CUSTOMER][NEUTRAL] And the answer is no, right?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] The answer is not no, because it would pay up to the 75, but it's just not 100% covered. If you all
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] There are other policies. I, I would um tell your mom to reach out to um Universal Truck and I can give you the employee line number to see like if there's other options that have more like doctor office visit coverage or because there are some that do like wellness and that's where like your mammograms, pap smear, you know, like your yearly stuff. So there are there are policies with those options depending on
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Because our policies are through your employer, so depending on the employer, the options may change, but she can see if there's another policy has more like what y'all are looking for.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And um did you want me to give you that phone number?
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Um, I think she has it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But you could give it to me just in case.
[AGENT][NEUTRAL] OK. Hold on one second. Let me get it for you.
[AGENT][NEUTRAL] OK, so it's [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][NEUTRAL] You're welcome, and I'm getting ready to email you the, did you need your dental too or just medical?
[CUSTOMER][NEUTRAL] Um, you could just send them to the medical.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, you could just send both once I'm done.
[AGENT][NEUTRAL] OK. So I'll send you both the medical and dental ID cards to the email address on file. And um was there anything else I can help you with today?
[CUSTOMER][POSITIVE] Um, no, that'll be all. Thank you so much.
[AGENT][POSITIVE] You're very welcome, [PII]. Well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you. Bye-bye.