AccountId: 011433970860
ContactId: 01efefcc-6008-4eba-a317-4961b2e42cc4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291529 ms
Total Talk Time (AGENT): 116049 ms
Total Talk Time (CUSTOMER): 107981 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/01efefcc-6008-4eba-a317-4961b2e42cc4_20250227T21:27_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. How are you?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm good. Um, I'm seeing here the supplemental insurance is under my husband's name because it's through his job. I wanted to know what benefits we have if we have dental with that.
[CUSTOMER][NEUTRAL] I can give you the payer ID number or the group number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, spell your name for me.
[CUSTOMER][NEUTRAL] Sure. It's um [PII]. Last name is [PII] and first name [PII]. Oh [PII]
[AGENT][NEUTRAL] OK, I need your first name. [PII], OK.
[AGENT][NEUTRAL] OK, [PII], and what's, uh, your policy number?
[CUSTOMER][NEUTRAL] The group number is 15493.
[AGENT][NEUTRAL] Do you have a copy of your ID card?
[CUSTOMER][POSITIVE] Yes, I have it with me.
[AGENT][NEUTRAL] OK, so I'm asking for the policy er number that's on the card that begins with a 0.
[CUSTOMER][NEUTRAL] OK, hold on a second.
[AGENT][NEUTRAL] It's kind of near the bottom, I think it should be an outpatient inpatient.
[CUSTOMER][NEUTRAL] Oh, OK, yes, I'm sorry. I have a hospital benefit number and outpatient.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give me the number before the elm, which should be the same for each.
[CUSTOMER][NEUTRAL] OK, so it's 02464761.
[AGENT][POSITIVE] Thank you. And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], what's your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that information. And how can I help you today?
[CUSTOMER][NEUTRAL] I wanted to know my benefits is to see, does it cover um dental?
[AGENT][NEUTRAL] Um, I'll check for you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I'm showing that you have the medical policy only and I need to give you the updated policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, that number is 250.
[CUSTOMER][NEUTRAL] 250
[AGENT][NEUTRAL] 1811.
[CUSTOMER][NEUTRAL] Walmart, OK.
[AGENT][NEGATIVE] Mhm. So it doesn't cover like your annual dental cleanings and things of that nature. It's not covered.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Right, it was, it was more for like implants. I have to do 3 implants, so it's more for that. So this is only like medical, like hospital and outpatient, right?
[AGENT][NEUTRAL] Yeah, it's.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, OK, thank you so much. I appreciate your help.
[AGENT][POSITIVE] Oh, you're welcome, [PII], and any other questions I can help out with today?
[CUSTOMER][NEUTRAL] Not at the moment. I'm well, what, what does it cover exactly because I didn't even know we had this till last year, my husband, yeah, through his insurance.
[AGENT][NEUTRAL] OK. OK. And so there's an in-hospital benefit, so that's if you were admitted. And then there's outpatient, which is emergency room, if you have to have service in a hospital, a diagnostic facility, a freestanding facility, and then, uh, let's see.
[AGENT][NEUTRAL] There is an office visit writer, so like if you went to your primary primary care or a specialist.
[AGENT][NEUTRAL] It doesn't cover the copay, but if they do treatment, covered treatment in the office, those items can be considered in an office setting.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then for emergency room, the co-pay, that doesn't cover it.
[AGENT][NEUTRAL] It does. Emergency room is outpatient.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So yes, that is
[CUSTOMER][NEUTRAL] Outpatient, so if we have like we, we get um we got a copay that it says $350 well then do I have to put it through you?
[CUSTOMER][NEUTRAL] Or do they do that?
[AGENT][NEUTRAL] So it will, yeah, it'll be, yeah, you're, they are generally resubmitted to the primary insurance carrier first and then send it to APL to pay a secondary.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Oh, OK, OK, perfect. OK, I appreciate your help with this. I was just trying to understand it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I understand. Any other questions, [PII]?
[CUSTOMER][POSITIVE] No, not at the moment. Thank you so much for your help.
[AGENT][POSITIVE] All right. You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.