AccountId: 011433970860
ContactId: 1142096a-083e-4037-a62f-d1a8e15f85c5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 262929 ms
Total Talk Time (AGENT): 106836 ms
Total Talk Time (CUSTOMER): 137784 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/1142096a-083e-4037-a62f-d1a8e15f85c5_20250224T22:19_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, I, um, have a question. I, um, have a health insurance through United Healthcare, and then I also have, um, a secondary, uh, insurance which is APO.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, and I just wanted to understand how does it work because I, uh, have a medication that I take once a month, um, through, uh, specialty pharmacy.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the um
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Have it through Optum, um, Optum RX, and, uh, through as I'm going to check out right to get it um delivered because usually it gets delivered to my house, it's asking me to pay 150 bucks right at the end upon checkout.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I find that strange because in the past I haven't, I haven't needed to pay, um, and then I was just wondering if I have this supplemental plan like should shouldn't.
[CUSTOMER][NEUTRAL] Shouldn't that also kick in or no, or how does it work?
[AGENT][POSITIVE] Well, I'll be happy to check that for you. Do you have your APL policy cert number?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, I have here it says I have a group number. Is that is that fine?
[AGENT][NEUTRAL] At the bottom of the card, do you see an outpatient hospital benefits certificate number?
[CUSTOMER][NEUTRAL] Yeah, you want the in the hospital or the outpatient?
[AGENT][NEUTRAL] Outpatient, please, sir.
[CUSTOMER][NEUTRAL] OK, 0259.
[CUSTOMER][NEUTRAL] 2992 ML 8.
[AGENT][NEUTRAL] Thank you. And what is your name and date of birth, please, sir?
[CUSTOMER][NEUTRAL] Yeah, [PII]. My date of birth is [PII].
[AGENT][NEUTRAL] All right, thank you, sir. And do you mind verifying your current mailing address, email, and phone number?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] An email and phone number?
[CUSTOMER][NEUTRAL] My email is [PII]. My phone number is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, thank you, sir.
[AGENT][POSITIVE] And it'll be my pleasure to assist you. Now, the prescriptions are not covered under your GAP policy. We pay for medical services, not medications.
[CUSTOMER][NEUTRAL] Oh, so medication doesn't, uh, doesn't apply. I got it, got it, OK.
[AGENT][NEGATIVE] Not under the gap policy, no, sir. And I know these medicines are just getting outrageous.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, they are, um, OK, so but if I do go to like the hospital or I get any medical care, it does, uh, kick in, right?
[AGENT][NEUTRAL] That's right. It would be like for inpatient hospitalization or outpatient hospital like surgery, diagnostic testing, emergency room, um, urgent care.
[AGENT][NEUTRAL] Physical therapy that is covered under your secondary gap policy and we do have a website. It should be listed on your card at Apub or [PII]. If you ever want to view your policy benefits, just create that account on our portal and click on your policy number and you can view the benefits that's covered under your plan.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] And how about um just like a regular like doctor's appointment, does that also apply or not?
[AGENT][NEUTRAL] It would not. Our assistants are not covered, nor our services in a doctor's office, so it have to be in an outpatient facility like a hospital or urgent care facility or emergency room.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Uh, I see, I see, I see. OK, alrighty, well thank you very much for all your help.
[AGENT][POSITIVE] It's been my pleasure to assist you, Mr. [PII]. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's it thank you very much.
[AGENT][POSITIVE] Thank you for calling APL. Have a wonderful afternoon.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye-bye.