AccountId: 011433970860
ContactId: 1be1e8ef-8a1c-47bb-a379-ce4665e2c857
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 361750 ms
Total Talk Time (AGENT): 190070 ms
Total Talk Time (CUSTOMER): 77041 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/1be1e8ef-8a1c-47bb-a379-ce4665e2c857_20250103T21:57_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, my name is [PII].
[CUSTOMER][NEUTRAL] And I was calling to to say, do I have to register?
[AGENT][NEUTRAL] Mm, OK, I can check and see, um, it is not required for you to register, but if you would like to do it, um, you can. Um, what is your policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] OK, let me find it.
[CUSTOMER][NEUTRAL] OK, it is 002.
[CUSTOMER][NEUTRAL] It's 02573464.
[AGENT][NEUTRAL] OK, may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And may I have your date of birth for security?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. In order to get registered, we're gonna need an email address, um.
[AGENT][NEUTRAL] Do you have an email address that you would like to use?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's the address on file just to make sure that it matches the system.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Given Street, apartment B.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] OK, so I went ahead and updated the system with your email. Um, so you can register if you would like to do so. Um, this is to submit claims or check claim status, get your benefits or get a temporary card, you can do all that through the website.
[AGENT][NEUTRAL] But it's optional.
[CUSTOMER][NEUTRAL] Oh OK I thought I had to register, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Mm, no, you don't.
[CUSTOMER][NEUTRAL] So the cars that we have.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the cards that I got in the mail.
[CUSTOMER][NEUTRAL] Uh, with my booklet
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I can use those like when I go to the doctor.
[CUSTOMER][NEUTRAL] The dentist and
[AGENT][NEUTRAL] Um, no, this one is just for medical. This is your secondary supplemental plan to the major medical. Um, if you go over to, to the booklet, um, on benefits, you will see what is covered under the policy, um, which it doesn't cover dentist or pharmacy or vision, and this is just for medical, uh, like for urgent care, diagnostic centers, surgical centers, um, inpatient stay in the hospital.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, do you need me to go over the benefits?
[CUSTOMER][NEUTRAL] Yes, um, I have one question.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I go to pain management.
[CUSTOMER][NEUTRAL] Um, so that that covers me for going to pain management.
[AGENT][NEUTRAL] Is this an office visit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, this one doesn't cover office visit. Um, it has a physician rider benefits that it will cover the $25 for the co-payment for the visit, um, up to 4 visits, but it doesn't cover the treatment itself. It's just gonna cover that $25.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, this is not a guarantee of payment, just a verification of coverage. That's also on the pamphlet under the benefit information if you need to look at it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm let me see what pages.
[CUSTOMER][NEUTRAL] Yes ma'am, I was just checking with um because I have an appointment and.
[CUSTOMER][NEUTRAL] I think next month.
[AGENT][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] Yeah, um, yeah, this one, only pays $25 for an office visit. Um, if it's um related to any other outpatient facilities like an urgent care, diagnostic center, surgical center, then you have up to $500 per year that you can use for that. And then if you're hospitalized 18 hours or more, either an observation or admission, then it's $1000 per year that we cover.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes ma'am, that's better than paying $200 a visit.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, yeah.
[AGENT][NEUTRAL] I understand, but yeah, we cover $25 so you can present the card at the time of service if you need to present the card so they can go ahead and bill us for that amount, or you can send us a uh claim for reimbursement, whichever is easier for you.
[CUSTOMER][NEUTRAL] OK. Oh, so you did the reimbursement also?
[AGENT][NEUTRAL] Yes, either we can reimburse you or either we'll pay the provider of service. So, uh, whoever is sending the claim will go ahead and pay too.
[CUSTOMER][POSITIVE] Oh, OK, I got you I got you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. Is there anything else I may help you with today? Any other questions or concerns?
[CUSTOMER][NEUTRAL] Um, no, that'll be all.
[AGENT][POSITIVE] All right, well thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] You too, have a pleasant sweet.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Alright bye bye.