AccountId: 011433970860
ContactId: 07a35526-8c00-4de5-9fdd-3753f53734f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 589669 ms
Total Talk Time (AGENT): 323203 ms
Total Talk Time (CUSTOMER): 213116 ms
Interruptions: 6
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/07a35526-8c00-4de5-9fdd-3753f53734f5_20250603T19:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Like you. Can you hear me OK?
[AGENT][NEGATIVE] Um, a little. It does sound a bit muffled.
[CUSTOMER][NEUTRAL] Can you hear me better now?
[AGENT][POSITIVE] Oh much better, yes, thank you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, I'm calling um because I have insurance with you guys, but I didn't receive the card and um my uh providers, he needs the um the member ID number. I'm not sure how I can get that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah, I can get you that member ID and then I can also have an ID card sent to you um what was your name?
[CUSTOMER][NEUTRAL] [PII], last name [PII].
[AGENT][NEUTRAL] OK, and then before we go any further, uh, [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] 954683
[CUSTOMER][NEUTRAL] 1245
[AGENT][NEUTRAL] OK thank you alright um let's see, let me try searching just using your name give me just a moment.
[AGENT][NEUTRAL] OK. I believe I found you. Um, [PII], what was your date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Awesome, OK, uh, give me just a moment. I'm just gonna verify some other information really quick. Uh, can I get your mailing address please?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I have a different address here for you looks like it's in uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] The [PII] Yeah, I, I don't, I haven't lived there since. Yes.
[AGENT][NEUTRAL] Yes, yes, it does that need to be updated?
[AGENT][NEUTRAL] OK, OK, no worries, give me just a moment. What was, would you mind repeating that current address for me?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK thank you
[CUSTOMER][NEUTRAL] Hey [PII], give me like 5 minutes. I'll call you right back.
[CUSTOMER][POSITIVE] OK, sorry about that.
[AGENT][NEUTRAL] Oh, that's OK.
[AGENT][NEUTRAL] Alright, um, I'll try to go quick, I promise. Alrighty, uh, and then let's see, I can go ahead and send you this ID card through email. uh, what was a good email address for you?
[CUSTOMER][NEUTRAL] It's um you could send it to
[CUSTOMER][POSITIVE] Uh, you could actually do it to my work one cause I'm in there now. It's [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] And then it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, uh, I will go ahead and send that to you now, um, and then I can also go ahead and give you your member ID if you'd like to write it down.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and that is 02.
[AGENT][NEUTRAL] 63.
[AGENT][NEUTRAL] 66.
[AGENT][NEUTRAL] 59.
[CUSTOMER][NEUTRAL] And it was effective when?
[AGENT][NEUTRAL] Effective date was [PII], so just the Sunday.
[CUSTOMER][NEUTRAL] And can you tell me what the benefits are, cause no one.
[CUSTOMER][NEUTRAL] Ever explained it
[AGENT][NEUTRAL] Oh sure, yes, OK, so in short this is a secondary medical policy, so it is designed to help with co-pay, deductible and co-insurance after your major medical pays. Uh, it is very dependent on your major medical, so, uh, if they're not willing to pay this policy can't.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, that's.
[AGENT][POSITIVE] Um, if they do, of course it helps with all of the leftovers. Give me just a minute. I'm going to send this email to you right quick and then I can go over those benefits, uh, specifically with you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] but it's.
[AGENT][POSITIVE] And then if you would like I can also send a copy of your uh actual policy to you as well um it is really easy to read, not just a bunch of jargon I promise um and it does go in depth as to what is and is not covered dollar amounts, frequencies, things like that.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Yeah, so I tried to go online and like register an account, but the information when it asks for like my last name and it'll ask for my email address and date of birth, but then it tells me an error.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right, so the information you enter does have to match what we have in our system and as we did not have an email address for you in our system, um, that's going to be a really big kicker right there uh could also be that the um address we had for you is obviously not your current address so of course I am getting that changed. I did add this email uh so with that information you should be able to create an account.
[CUSTOMER][NEUTRAL] It's now here.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEGATIVE] And um did not answer.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. And then am I able to update the email at any time?
[AGENT][NEUTRAL] Yeah, um, you can, um, you can give us a call if you want to change that, um, because again the inform it does have to match what we have but it's, you know, if you wanted to say can we use a different email just let us know and I can get that changed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, definitely. OK, uh, did you want me to go ahead and send you a copy of your policy as well to this email address?
[CUSTOMER][NEUTRAL] Um, yes, please.
[AGENT][NEUTRAL] Sure, OK, let me go ahead and do that now as well.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] OK, you gave me the 18 and you want to.
[AGENT][NEUTRAL] OK, and then just so um you've kind of got an idea of how this policy works not just of course with your major medical you essentially have two separate um buckets uh for one is going to be for inpatient benefits one's going to be for outpatient benefits so.
[CUSTOMER][NEUTRAL] So I know you like to do 77.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Inpatient, best way to think of that is if you ever have to be hospitalized for longer than about a day, that would be considered inpatient. Anything that's, you know, any kind of procedure or treatment that's done before a day, you know, any kind of surgery or anything like that, that would be considered outpatient.
[AGENT][NEUTRAL] Does that make sense?
[CUSTOMER][NEUTRAL] OK. So, I'm sorry, say that one more time. So any surgery that I have?
[AGENT][POSITIVE] You're OK.
[CUSTOMER][NEUTRAL] It's going to be.
[CUSTOMER][NEUTRAL] If I, if they discharge me right after.
[AGENT][NEUTRAL] As long as it's
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] That would be considered outpatient.
[CUSTOMER][NEUTRAL] OK, but if I end up.
[CUSTOMER][NEUTRAL] But if I end up um
[CUSTOMER][NEUTRAL] I, if I end up having surgery and they have to end up admitting me or keeping me overnight, then it's, it's basically two claims that I'm submitting. OK.
[AGENT][NEUTRAL] Keeping you for a day or two.
[AGENT][NEUTRAL] Well, no, so in that case it would be considered uh in hospital or inpatient, so if it's anything longer than about a day that's in inpatient, um, so of course those benefits, so it's uh on a per calendar year basis, so it pays up to $3000 per calendar year and again that's going towards co-pay, deductible and co-insurance after your major medical pays.
[AGENT][NEUTRAL] And of course that's not as commonly used as the outpatient benefits. Let me find those give me just a moment.
[AGENT][NEUTRAL] OK, so outpatient benefits going to be the same, it's going to be $3000 max, uh, per calendar year.
[CUSTOMER][NEUTRAL] So did that change or something because it used to be 6000.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Like, uh, on the company's policy, so, um, and that's one of the reasons why I ended up getting it too. So all the previous years that the company has had this, um, this, the secondary or supplement plan, um, it's always been 6000 so I'm trying to understand where the change came in.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm not sure unless they elected to have a different kind of policy um but that is what it states in our system and what your policy states is 3000 each. That might be the confusion I guess uh because total benefit amount would be 6000 but essentially it's $3000 for inpatient, 3000 for outpatient.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, and there's no, so there's no combined 6000.
[AGENT][NEUTRAL] No, it is not combined. That's correct.
[CUSTOMER][NEUTRAL] It's either or. OK.
[AGENT][NEUTRAL] Right, 3000 for outpatient, 3000 for inpatient, yes.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Alrighty you should be getting those emails here pretty soon um did you have any other questions for me at the moment?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] OK, alright, well thanks for giving us a call, [PII]. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you. You as well.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.