AccountId: 011433970860
ContactId: 30f17dac-2394-4323-b087-44c9bdfd7493
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 759809 ms
Total Talk Time (AGENT): 360347 ms
Total Talk Time (CUSTOMER): 205359 ms
Interruptions: 3
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/30f17dac-2394-4323-b087-44c9bdfd7493_20250117T19:23_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, uh, let me see if you can help me. I have a quick question. I have United Healthcare and I also have the gap insurance, and I, I need to go to urgent care.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And I know that my United Healthcare now, I have to pay the 20%.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Of whatever they might charge me. Now, with the gap insurance, does it cover that or no?
[AGENT][NEUTRAL] OK, so you're wanting to see if you have benefits for urgent care on your supplemental coverage with APL. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes ma'am. Well, I can help you with that. I can look up for you. And who am I speaking with?
[CUSTOMER][NEUTRAL] Um, [PII]
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. And Miss [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Excuse me, uh-huh.
[CUSTOMER][NEUTRAL] [PII], no that's fine, [PII].
[AGENT][NEUTRAL] Thank you. And your policy number, please, with APL?
[CUSTOMER][NEUTRAL] Is that the one that's in the bottom where it says in or out?
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh. The first part of that number is your policy number if you'll notice there's the same.
[CUSTOMER][NEUTRAL] Or, OK.
[CUSTOMER][NEUTRAL] OK, it's 02446325 ML 7.
[AGENT][NEUTRAL] OK. Thank you. So give me a moment, um, I need to get your information pulled up and then I will have to verify several things with you first for security. So just a moment, please.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so first off, um, Ms. [PII], if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Give me just a moment. Something has happened to one of my screens. I'm sorry, one moment, please.
[CUSTOMER][NEUTRAL] No, that's fine.
[CUSTOMER][POSITIVE] Emotional support.
[CUSTOMER][NEUTRAL] Were they before.
[AGENT][NEUTRAL] OK, give, give me just one moment, Ms. Honey. I'm having, I'm having a, a technical issue. I'm so sorry.
[CUSTOMER][POSITIVE] Sure, no problem.
[CUSTOMER][POSITIVE] No, no problem.
[CUSTOMER][NEUTRAL] like do you have time.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][NEUTRAL] And.
[AGENT][POSITIVE] May I place you on a brief hold? I'm so sorry. Thank you, thank you.
[CUSTOMER][POSITIVE] Sure. No. No, no problem. You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How, how can I help you?
[AGENT][NEUTRAL] [PII], it's [PII]. I need, I've got an insured on the line that I'm trying to help and I've never had this come up. I need you to please look at a policy because on CUDAT it's telling me that no member, uh, that it doesn't exist, that she doesn't exist. The policy is 2446325 Malaros Hasame.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] And now it's not gonna let me off that screen, is it?
[AGENT][NEUTRAL] You have to take out the customer number and you have to, you have to wipe everything out and then just go up and type in whatever screen you wanna go to. So you're getting the same thing. Have you ever had this happen?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I not.
[CUSTOMER][NEUTRAL] No, I haven't um.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] It's not a new policy.
[CUSTOMER][NEUTRAL] Anything in notes.
[CUSTOMER][NEUTRAL] Nobody's changed anything since [PII].
[AGENT][NEUTRAL] Yeah, that's
[AGENT][NEUTRAL] Mm mm, that fall. Mhm.
[CUSTOMER][NEUTRAL] So that's, yeah.
[CUSTOMER][NEUTRAL] I wonder if it was something with the file that might have knocked all that out. I've had that happen before.
[AGENT][NEUTRAL] And what do y'all do to fix that? I mean, do I just need to submit a hub ticket once I try and help her? I mean, I can't change her information if it's not right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right. Um,
[CUSTOMER][NEUTRAL] I've never, there's nothing that I um customer service can do to to change that, um.
[CUSTOMER][NEUTRAL] Who would that go to?
[CUSTOMER][NEUTRAL] Supervisor I guess.
[CUSTOMER][NEUTRAL] [PII] or [PII]?
[CUSTOMER][NEUTRAL] Because there's nothing we can do.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Might be IT.
[CUSTOMER][NEUTRAL] Cause I don't know
[CUSTOMER][NEGATIVE] Yeah it's not gonna let us do anything in it.
[AGENT][NEUTRAL] I can't add an email. I mean, I can't, OK, yeah, um.
[AGENT][NEUTRAL] Yeah, because, OK.
[CUSTOMER][NEGATIVE] Yeah, because it's not gonna let me either.
[AGENT][NEUTRAL] Mm. OK. So you don't know what would cause that?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEGATIVE] I see. OK. All right. Thank you very much for looking at it. Oh, now, oh no, now it's just like all of her when I try, oh on CUI and Q, it just totally like made her non-existent.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I can still get her in C [PII] I N Q.
[AGENT][NEUTRAL] I can't. I tell.
[AGENT][NEUTRAL] I've had it with this thing.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, [PII]. Well, thank you for looking at it. I appreciate it.
[CUSTOMER][NEUTRAL] Alright sorry I wasn't able to help.
[AGENT][NEUTRAL] OK. No, you're fine. No, no, no, you're fine. Thank you.
[CUSTOMER][POSITIVE] All right, thanks. Bye.
[AGENT][NEUTRAL] All right. Bye-bye.
[AGENT][NEUTRAL] Ms. [PII], thank you so much for holding for me. I am sorry, but I am, I'm having some technical difficulties um in pulling up all of your information, especially like your demographics, but I'm going to, I want, I've located what I can. So if you could please verify your address also.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one that you gave me, so that is your best contact number, is that correct?
[CUSTOMER][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] OK, thank you. And then I will need to add an email address. I see we don't have one on file for you at this time. What is your email?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm just gonna repeat that back to you. So, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's correct.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, so again, any information that I do provide for you, Miss um [PII] is a verification of benefits and not a guarantee of payment. So on your outpatient benefits, yes, ma'am, urgent care is one of the places of service that we can review for.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] For potential benefits to be paid. So on your policy, the outpatient benefit maximum for you is $500 per covered person per calendar day for covered outpatient services with no outpatient deductible per covered person per calendar day. So if you're going to be, have you gone yet or are you planning on going to the?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, I was gonna, I was gonna go.
[AGENT][NEUTRAL] OK, so make sure.
[CUSTOMER][NEUTRAL] Because I have
[AGENT][POSITIVE] Oh, I didn't mean to interrupt you again. I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, no, no, because I, I, I have like uh like.
[CUSTOMER][NEUTRAL] I don't know what it is, uh, like an infection on my, on my chin. I mean, I thought it was a little pimple and I had like
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It just started growing and it's like halfway through my chin, and I was out of town. I was in [PII] and I just got in last night.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh, no. Yes, ma'am. It definitely sounds like you should be going to be seen. Um, definitely. So when you go, present them your give them your APL ID card along with your primary insurance. Most providers, Ms. [PII], will file both insurances for you because they will have to file with your primary first and then with APL because we have to have the EOB from your primary insurance.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] But if for any reason they will not follow your supplemental policy, you can do that if that need arises, you can call us back and we can give you all the information on how to go about doing that but I am going to.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, about, about claiming it, yeah.
[AGENT][NEUTRAL] Yes ma'am. I am gonna, mhm, if for some reason they were to tell you that they will not file your supplemental policy, you can file your own claim and you could call us back for us to give you all, you know, the information of how to go about doing that. Now I am going to email you a user guide for our portal, um, the [PII] is the.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Website for our portal and that's called the online service center.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] So when I'm gonna email you that and user guide in just a moment and the email that you will receive from me is going to come from care team.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] [PII] and I will put in the subject line for you APL so you can recognize that.
[CUSTOMER][NEUTRAL] OK, that's fine.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, and is
[CUSTOMER][POSITIVE] Oh, you've been a great help.
[AGENT][POSITIVE] Oh, well, thank you. Well, it's my pleasure and thank you for your patience and me getting all of your information pulled in. So, is there anything else at the moment that I could help you with?
[CUSTOMER][POSITIVE] No, no problem.
[CUSTOMER][NEUTRAL] Nope, that should be it.
[AGENT][POSITIVE] OK. Well then, thank you very much and I hope you get to feeling better and I hope you have a nice weekend also. Yes, ma'am.
[CUSTOMER][POSITIVE] Thank you. Thank you. Likewise. All righty. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.