AccountId: 011433970860
ContactId: 292c58b1-e81d-4127-9527-6ce098577410
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 452470 ms
Total Talk Time (AGENT): 283195 ms
Total Talk Time (CUSTOMER): 151027 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/292c58b1-e81d-4127-9527-6ce098577410_20250228T18:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] on the customer service department. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi. My name is [PII]. And I have some um orders for uh like medical.
[CUSTOMER][NEUTRAL] I don't know, diagnostic or, um, and I'd like to know what is covered when my insurance um
[CUSTOMER][NEUTRAL] I have through KGO I think through you GA Insurance. I'm not sure how it works.
[AGENT][NEUTRAL] Yes, ma'am. I can definitely help you with that information, Ms. [PII], but before we proceed, is it possible to get a callback number, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Of course. [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And do you happen to have a policy number or any information on that gap policy, Ms. [PII]?
[CUSTOMER][NEUTRAL] I, all I have is the paperwork that they sent us from work. Um, but it doesn't say a policy number on there.
[AGENT][POSITIVE] I can pull up the group. Bear with me.
[CUSTOMER][NEUTRAL] No, we probably got, yeah.
[AGENT][NEUTRAL] It's OK. No, it's OK. I just wanted to make sure. All right, I do recall that of us having KGO, so I am familiar with the group. Bear with me.
[CUSTOMER][NEUTRAL] I apologize.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, I'm just gonna do a quick name search and it looks like I found you. Just to make sure this is in fact your policy, can you verify a couple things for me? Will you please verify your date of birth and your mailing address, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] 2, OK. Date of birth is [PII] and the address is [PII].
[AGENT][NEUTRAL] Thank you for that, Ms. [PII], and that is what we have on file and I'm also showing that we have an email account on file. Looks like it's your personal email. Can you verify that too for me, please?
[CUSTOMER][NEUTRAL] Um, does it start with a T or an M?
[AGENT][NEUTRAL] M
[CUSTOMER][NEUTRAL] OK, so then it's [PII].
[CUSTOMER][NEUTRAL] Um, mm, I don't know it by heart. Hold on a second. Uh.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][POSITIVE] get that for you right now.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that, Ms. [PII]. And that is what we have on file. So I am showing that you do have coverage. You've actually had it for quite some time. You are active and effective. Um, what I'm gonna do for you, do you, you don't have a card or anything, right, Ms. [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't think so. I don't know how I can get it. Do I go online and print it out? Do you email me one?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You can go online um and register to get that information, but I can go ahead and email you on and I'm also gonna order a physical one to be mailed to your home address, so you'll get that within 5 to 7 business days. Just keep an eye out for it, um.
[CUSTOMER][POSITIVE] I appreciate it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And also you said that you really wanted to just kind of find out what what coverage you had and you're possibly gonna submitting a claim maybe or you have a claim to submit in right? OK, so.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, uh, uh-huh.
[AGENT][NEUTRAL] What I'm gonna have to do, Ms. [PII] is let you speak to another representative regarding on what benefits you have and the details on how you can utilize the policy, and they'll also be able to assist you with the claim and how you can file that. Now you can file um online by registering and again once you register you'll have access to download your claims and view your claims and also see your policy certificate along with temporary cards.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So you will send me the image of the uh ID card and the link on how to register, correct?
[AGENT][NEUTRAL] Cars. Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am. I'm gonna send you all that information that way you can do that um and like I said, she'll probably mention it to you that you can do that um she'll give you the details on what we need so you can um submit the claim online.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, and then do I have to have the services done first, or can I give the card and they bill you directly?
[AGENT][NEUTRAL] It depends on how you wanna do it. So if you do give them the card and they choose to bill, some places they will bill us directly and some places won't. Um, and if you run a case where a provider doesn't file secondary insurance, that's OK. You can still file individually with us. Um, you just need to make sure you get an itemized bill, the procedure codes and charges that were conducted that day for your service. Um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] But again, you know, if they file for you, they will submit everything we need and then of course payment is paid out to the provider so keep that in mind as well whoever's filing is is the one that gets payment um so it just depends on how you'd like to do that but yes you do have the option to give it to them.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, sounds good.
[AGENT][NEUTRAL] Alright, Ms. [PII], you're gonna be getting an email in about 5 or 10 minutes from [PII]. It's gonna go to your Gmail email. Um, again, I am gonna be ordering physical cards for you, so those will be coming in the mail within 5 to 7 business days. Is there anything else I can help you with before I transfer you to our claims rep?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, that's it. Um, she would be the one to tell me if I give them what orders have been um requested by the doctor, whether they're going to be covered or not, right?
[AGENT][NEUTRAL] Yes ma'am, she will be able to provide you with the benefit details and also before I transfer you, let me go ahead and give you your policy number so you'll have that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh good, thank you.
[AGENT][NEUTRAL] And I am gonna provide everything to her so you won't have to repeat everything, but I just wanted to make sure you have your policy number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I appreciate it.
[AGENT][NEUTRAL] All right. So your policy number is 248.
[AGENT][NEUTRAL] 31
[AGENT][NEUTRAL] 07.
[CUSTOMER][NEUTRAL] OK, I'll repeat that back. 248-3107.
[AGENT][POSITIVE] Yes ma'am, that is correct.
[CUSTOMER][POSITIVE] OK. I appreciate your help. Thank you.
[AGENT][POSITIVE] No problem at all, Ms. [PII]. Thank you for calling APO. You have a wonderful day and hold please.
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Spring.
[CUSTOMER][NEUTRAL] Money.
[AGENT][NEUTRAL] Hey, I've got an insured on the back line that's wanting to see what her benefits are, her gap plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Her policy number is 2483107, and I'm sending her the information on how she can register on the online service center and temporary cards um along with physical cards, but just so you know, she didn't have that information and she's been verified.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] All right. Here she goes. Thank you.
[AGENT][NEUTRAL] Oh, you want a callback number?
[CUSTOMER][NEUTRAL] Is it the one on the screen, the [PII]?
[AGENT][NEUTRAL] [PII]. I can't see it no more. [PII], is that it? Yeah, that's it. All right, thank you.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye-bye.