AccountId: 011433970860
ContactId: 28af370e-11a9-4dfa-870e-c54a6b8fc048
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 398399 ms
Total Talk Time (AGENT): 155550 ms
Total Talk Time (CUSTOMER): 203575 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/28af370e-11a9-4dfa-870e-c54a6b8fc048_20250513T16:59_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling.
[CUSTOMER][NEUTRAL] Hello, um, I got a couple of questions, um.
[CUSTOMER][NEUTRAL] Hello, are you there? Up to 40.
[AGENT][NEUTRAL] Yes, I'm here. OK.
[CUSTOMER][NEUTRAL] OK. Um, yes, my, so my bro my brother passed away on the [PII] and
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][POSITIVE] Yes, I, I thank you so, uh, but and.
[CUSTOMER][NEUTRAL] I was trying to figure out how if I, if like for my, my days of missed work and all that, does, does it cover that or how does this work? And I know I'm paying on it. I just don't know what I'm paying for. It's funny saying that but that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, what's your name and policy number, please?
[CUSTOMER][NEUTRAL] It's just
[CUSTOMER][NEUTRAL] OK. Um my name is [PII]
[CUSTOMER][NEUTRAL] And the policy would be 025.
[CUSTOMER][NEUTRAL] 96814.
[AGENT][POSITIVE] OK, thank you so much. uh, give me one moment, Mr. [PII].
[CUSTOMER][NEUTRAL] I just don't know if you're, you know, person to tell me, you know, about my benefits or what I discovered or how that works and I just, yeah, um, um.
[CUSTOMER][NEUTRAL] I just kind of signed in.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And verify your date of birth, mailing address and the email address for me, please.
[CUSTOMER][NEUTRAL] [PII]. My mailing address would be [PII].
[CUSTOMER][NEUTRAL] And then my uh email is my name [PII].
[CUSTOMER][NEUTRAL] Number [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much and uh do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and I do show a different address in our system. Looks like a.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah, but I, I, I moved. I'm so, yeah, and it's just I moved to this last couple of months. I just.
[AGENT][NEUTRAL] OK, and what's the, um, current address again? I'm sorry.
[CUSTOMER][NEUTRAL] Uh, OK. The old address was [PII]. The current address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And still [PII].
[CUSTOMER][POSITIVE] Yes, I'm sorry about that. Yeah, everything else is the same zip code there.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] And the
[AGENT][NEUTRAL] OK, thank you. Well, I'm showing the type of policy you have as a secondary supplemental plan, uh, is not like a
[AGENT][NEUTRAL] Disability policy. What the policy does, it helps with your primary insurance deductible, co-pay or co-insurance for services performed in an outpatient facility or if you're confined as inpatient in the hospital.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I was just reading about it. I just didn't know if they, you know, if they covered it or what.
[AGENT][NEUTRAL] Uh no, sir. It's just um secondary supplemental medical policy.
[CUSTOMER][POSITIVE] Just in case if, if, if, if I don't have enough or my insurance doesn't have enough for it or however it works, this kicks in right away.
[AGENT][NEUTRAL] Well, what it does, it, um, picks up what your primary insurance applies towards deductible co-pay or co-insurance. Say for instance, if you go to the ER and um after primary process that claim, they apply $200 towards your deductible, that's what we pick up and pay as your secondary up to your max benefit with our company.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK. So how about like, I went to the doctor's the other day, well, I mean, a, a, a well being checkup. I haven't been to a doctor's in years. So I'm just getting started to do all this stuff. That's why I'm trying to figure out what's covering it, what I, what, what I have and all that, but um.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] If there if there had had to been a copay, I could have just gave them my card and then that would take, that would take care of the co-pay that something like that, is that what you're saying?
[AGENT][NEUTRAL] Uh, not for an office visit, only for outpatient or in hospitals. Um, you do have a writer that covers procedures in office if they are sickness or an injury as outpatient, but outpatient typically entails ER, urgent care, ambulatory surgery center, MRI or imaging center.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] But not for an office visit. Like it wouldn't cover office visit co-pays.
[CUSTOMER][NEUTRAL] Mhm. So.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, OK. And so I, I do have to go for an uh uh uh uh an X-ray, I guess, or an MRI. So how does that work? Do I just, so,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The only time when do I, when, when do I use this secondary thing when uh uh that's the only thing I just wanna understand so that way I know.
[AGENT][NEUTRAL] Well, when you give your primary insurance information, also give them our information as secondary, that way they can call verify benefits and eligibility, and we can let them know where to submit claims.
[CUSTOMER][NEUTRAL] Where
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, sir. So,
[CUSTOMER][NEUTRAL] OK, then, then, all right.
[AGENT][NEUTRAL] Alright, was there, go, I'm sorry.
[CUSTOMER][NEUTRAL] So then yeah it.
[CUSTOMER][NEGATIVE] There's no help, there's no help, um, so then, in other words, there, there, and, and if, if, what kind of insurance did I need for it to help me out for my brother's, uh, death?
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] None of our policies cover anything like that. Like if you had a disability policy with us, uh, that only covers for services if you are unable to work due to a sickness or an injury.
[CUSTOMER][NEUTRAL] Or how does that work?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, OK, OK, then, I just, I just, I just want to understand it more and I, and now I do know you explained it. You explained to me very well. So, OK, man, I appreciate your time. I'm just gonna, just, you know, just, just, uh, yeah, so now I know.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, I
[CUSTOMER][NEUTRAL] Now I know what what it is and what, what it's for.
[AGENT][NEUTRAL] Uh, yes, sir. And if you like, we do have an online service center to where you can set up an account to view your policies as well.
[CUSTOMER][NEUTRAL] OK. Yeah, I, I think, I think my wife's getting all that for me, like doing that, so.
[AGENT][NEUTRAL] OK. Yes, sir.
[CUSTOMER][POSITIVE] That, yeah, but, um, yes ma'am, I this is what I needed and this is what I, what I wanted so just I appreciate your time um.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Again, thank you. I, you, you, you answered my question.
[AGENT][NEUTRAL] Are you
[AGENT][POSITIVE] Well, good deal. Well thank you for calling APL and you have a great rest of your day, Mr. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm bye.