AccountId: 011433970860
ContactId: 0c7fad2f-c736-4ce4-9c91-90cb9780e1c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 386380 ms
Total Talk Time (AGENT): 204593 ms
Total Talk Time (CUSTOMER): 100831 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/0c7fad2f-c736-4ce4-9c91-90cb9780e1c4_20250418T16:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hello [PII]. I just wanted to verify something. Uh, my father just recently got the APL insurance from his work, and I was just calling to give, uh, we can make sure that they are active and good to be used, and I was trying to log into the website. It tells me here, but I couldn't get into that, so I just decided to call.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yeah, not a problem. Do you have your policy or certificate number? I can pull it up?
[CUSTOMER][NEUTRAL] Uh, the policy said, yes, uh, here it is. I see it.
[CUSTOMER][NEUTRAL] You ready?
[AGENT][NEUTRAL] Uh, go ahead.
[CUSTOMER][NEUTRAL] It's 02612434.
[AGENT][NEUTRAL] All right, let me just pull that up here. Give me just a moment.
[AGENT][NEUTRAL] And then can I get your first and last name, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And then [PII], I need to verify for security your date of birth and address, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And then what's your physical address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, thank you. So the policy right now is showing active coverage for just yourself. I don't show anybody else listed on here.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, yeah, I was just making sure that it's like good to use like right right off the bat, right. I cause I didn't know if I took it right now, they, they would take it or not.
[AGENT][POSITIVE] Yeah, I know, the effective date on here is [PII], so you can use it today. Um, yeah, it is active, so it's good to go.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] What all does it cover?
[AGENT][NEUTRAL] Well, it's a limited benefit plan, so it's gonna pay just a set amount depending upon what you're being seen for. Are you trying to go to like a doctor's office? Do you, can you give me kind of an idea?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes, uh, usually, when he goes to the doctor's office, he goes every 6 months. It's just for checkups since he has diabetes, and he always pays out of pocket.
[CUSTOMER][NEUTRAL] It's only like $50 for the visit.
[CUSTOMER][NEUTRAL] And then right now, he also needs to get blood work done and we're wondering how much uh that would cover it.
[AGENT][NEUTRAL] Well right now the plan only has coverage for you there's nobody else listed on here.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] But yeah, no, I'm just asking if it'll, if it'll cover that stuff.
[AGENT][NEUTRAL] OK, let's see. So,
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so it looks like this plan has a physician's office benefit of $50 per day for a maximum of 4 calendar days per year. So what that means is that the plan will pay a maximum of $50 per day for up to 4 physician office visits. Uh, it's not gonna cover more than that in a calendar year.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And then it would also cover outpatient prescription drugs. It looks like there's a $10 benefit per day, and there's a maximum of 15 days per calendar year per covered.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] So, it would provide benefits additionally for a physician's office and it does have prescription drug benefits on it.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Um, like I said, it is a limited benefit, [PII], so it is only gonna pay those set amounts. It's not a percentage or anything like that where you have a copay like with a major medical. So that's just the important thing to understand the difference between a major medical on this type of plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh yeah, OK, I got you. I understand.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] So those are kind of those benefits and if you'd like I can actually send you a copy of the policy certificate if you look at the schedule of benefits it breaks down exactly what is covered, what the amount is per day per year, so that's actually really helpful also if you don't have a copy of this.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] No, yeah, we, I don't have a copy of that. I would appreciate if I could get that.
[AGENT][NEUTRAL] Yeah, do you want me to send it to you in the [PII] postal mail or do you want it emailed?
[CUSTOMER][NEUTRAL] Uh, email is fine.
[AGENT][POSITIVE] OK, we don't have an email on file for you, [PII], so if you'd like, uh, go ahead and give me your email address and I'm happy to forward that on to you.
[CUSTOMER][NEUTRAL] Alrighty, 1 2nd.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Uh, the email will be throw far away.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII] [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, so I'm sending that over to you now, so that'll be helpful because if you go to, um, it's a rather large document. It is 38 pages, but the schedule of benefits is clear, um, it's pretty concise. It's page 21 on there and it is pretty, um, it's easy to understand as far as it'll tell you hospital admission and the benefits.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um, so it should be pretty easy for you to, to decipher.
[CUSTOMER][POSITIVE] Mm, OK. So yeah, that's all I have for today. Thank you very much.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye bye.