AccountId: 011433970860
ContactId: 11c4a9a1-a683-41e8-ad9d-c242a54f3db3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 491750 ms
Total Talk Time (AGENT): 199056 ms
Total Talk Time (CUSTOMER): 190868 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/11c4a9a1-a683-41e8-ad9d-c242a54f3db3_20250402T19:04_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] Hi, [PII], I'm trying to find myself a primary care doctor. I'm new to uh APL.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] So, uh, am I looking at, uh, [PII] website? Am I in the right place or?
[AGENT][NEUTRAL] It, um, the, well, let me pull up your policy so I can see what type of policy you have. Um, may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] So we
[CUSTOMER][NEUTRAL] Yeah, let's do that because I was on the phone with uh somebody else for about 3 or 4 minutes and we got disconnected so I'm calling back my phone number.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] Thank you for that. And your name and policy number?
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] Uh, policy number is 02595525.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] OK, my date of birth is [PII], that's [PII].
[AGENT][NEUTRAL] And your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. So,
[AGENT][NEUTRAL] Yes, you are going through multiplan. I just had to check the type of policy you have. So yes, um, because the hospital indemnity part of your policy, there's no network, but you have that PPO added which is through multi-plan. Um, so you can use their website. Are you on the website now?
[CUSTOMER][NEUTRAL] I'm looking at it, so on the multi-plan network it says limited benefit practitioner, PPO, etc.
[AGENT][NEUTRAL] Hold on, let me go to the website because I heard there were some changes, so let me see. Oh, it is.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so I would click on, you already clicked on find a provider?
[CUSTOMER][NEUTRAL] Uh, yes, and it says chooses a network and there's a whole list here PHCS other network multiplan network.
[AGENT][NEUTRAL] So under multi-plan, you'll do multi-plan PPO?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then that's where you can put like your zip code or the doctor's name or um facility name if you have it, if you have one in mind.
[CUSTOMER][NEUTRAL] I do not, uh, so my last doctor does not recognize this insurance, never heard of it, so I just need to find a new primary. So now I, I clicked on that.
[CUSTOMER][NEUTRAL] And I'm gonna hit select and search at the bottom, yeah.
[AGENT][NEUTRAL] Select and search.
[AGENT][NEUTRAL] Oh, mine doesn't look like that, but yes, if you see search under there by the zip code, that's where it is for me.
[CUSTOMER][NEUTRAL] OK, allow zip code.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then it'll pop up with the list in your area.
[CUSTOMER][NEUTRAL] Oh, search, it's error. Search string must contain between 2 and 50 characters. It says search by name, specialty, facility, NPI number. Oh wait, that sounds familiar. I think I had an MPI number.
[AGENT][NEUTRAL] The MPI is like the, the um doctor's ID number or in the other box, put the zip code and it'll populate. Um, I will put like primary care or family doctor for in the first line there.
[CUSTOMER][NEUTRAL] OK, uh, oh, here's my list family practice.
[CUSTOMER][NEUTRAL] Let me try primary. Let me type that in and see what happens.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Primary care.
[CUSTOMER][NEUTRAL] And there's my address.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK directory information.
[CUSTOMER][NEUTRAL] OK, here's a list.
[CUSTOMER][NEUTRAL] Of doctors.
[CUSTOMER][NEUTRAL] So, um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let's say I click on one of those names.
[CUSTOMER][NEUTRAL] Then what happens?
[AGENT][NEUTRAL] I mean, I don't know what happens when you click it, but these are all the doctors that are um in your network in your area. Let me see what happens when you click it. It might just show there.
[CUSTOMER][NEUTRAL] OK, here's a, here's uh.
[CUSTOMER][NEUTRAL] Oh my God, it's around the corner, [PII]. So if I click on that doctor's name.
[AGENT][NEUTRAL] I mean, nothing is gonna happen like if you click, so in terms of like.
[AGENT][NEUTRAL] If it's going to make like an appointment or anything, it's just gonna show you like the doctor's information if you click on their name.
[CUSTOMER][NEUTRAL] I see. OK, let me just bookmark this page.
[AGENT][NEUTRAL] And it'll let you change your, um, I guess we can call them filters or your preferences, like, you know, if you want a female doctor or a male doctor, it'll change it like that too and search for you if you want it to.
[CUSTOMER][NEUTRAL] Mm, uh, OK, so here he is [PII]. So now if I make an appointment and I go see this doctor and I show him this card, is there a co-pay? Is the whole thing covered? How does that work?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, so with your um hospital indemnity policy, there's no, um, well, with majority of our, our policies, there's no deductible because we're or copay because we're not a major insurance company, so it's not like Aetna or Blue Cross Blue Shield, um, so there should you shouldn't have to pay anything upfront. Everything with us is on the back end once the claim is filed, um, after the services are done.
[CUSTOMER][NEUTRAL] OK, so again, is it totally covered or is there a cost to me after the fact?
[AGENT][POSITIVE] Again, you shouldn't have to pay anything upfront because we don't have any, we are not charging you anything like there's no co-pay or deductible with this policy from the insurance company. So I for that I can't, there's no charge. Everything is handled on the back end once we receive the claim, that's when we pay out. So I can't tell you if it's covered completely or not until we process it, but there's no, we don't charge you a co-pay or deductible.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I understand. um, OK, so I think I'm all set here.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Alrighty. You're very welcome, [PII]. Well, thanks for calling APL. If you think of anything else or if they need to, um, you can also, once you find the doctor that you want to go to, once you give them your card, have them give us a call to verify benefits also.
[CUSTOMER][NEUTRAL] OK, and uh that phone number is uh wait don't tell me [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, that's right on top of the back of the card.
[CUSTOMER][POSITIVE] Um, OK, my friend, thank you very much for your help. I appreciate your time.
[AGENT][POSITIVE] You're very welcome. Well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too now thanks.
[AGENT][POSITIVE] Thank you. You're welcome. Bye bye.
[CUSTOMER][NEUTRAL] Bye