AccountId: 011433970860
ContactId: 32cd4f17-424f-457a-87d1-0a05ebd3acdd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 288489 ms
Total Talk Time (AGENT): 149330 ms
Total Talk Time (CUSTOMER): 115087 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/32cd4f17-424f-457a-87d1-0a05ebd3acdd_20250310T15:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Um, I'm curious to know, uh, what all, uh, my plan, uh, coverage allows for me to, um, do, so I just wanted to inquire.
[AGENT][POSITIVE] OK, yeah, I'm happy to take a look at the policy coverage. Do you have your policy number?
[CUSTOMER][NEUTRAL] Um, I have the like my employee ID or
[AGENT][NEUTRAL] Um, do you have a card by chance?
[CUSTOMER][NEUTRAL] OK, let me put my email. OK, let's see.
[AGENT][NEUTRAL] Cause if you have a card, usually it's like a member's certificate number.
[CUSTOMER][NEUTRAL] Yes, OK. Policy certificate, yeah. So it's 02567164.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Alright, thank you, let me pull that up here.
[AGENT][NEUTRAL] And then if I can get.
[AGENT][NEUTRAL] Your first name and last name and date of birth.
[CUSTOMER][NEUTRAL] Yup, uh, [PII], and it is [PII].
[AGENT][NEUTRAL] Thank you. And then [PII] last piece I'll need is your address and email address, please.
[CUSTOMER][NEUTRAL] My address is [PII] and my email is [PII].
[AGENT][POSITIVE] Alright, thank you so much for that. OK.
[AGENT][NEUTRAL] So, um, you have what we call like a limited benefit medical plan. So what that means basically is it's a hospital indemnity plan. This plan pays a set amount, uh, depending upon what you're being seen or treated for. So, for example, um, if you needed to go to a doctor's office, like primary care physician,
[AGENT][NEUTRAL] Um, any sort of doctor's office visit, this plan allows up to 5 visits in a calendar year, and the benefit amount towards that is $75 so it's gonna pay $75 towards the office visit, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It, it also has benefits for like diagnostic testing or wellness. So if you, let's say, go to your doctor and um just have your yearly like wellness, well woman's exam, um, the benefit is $75 so the plan would pay $75 just to have the wellness visit.
[AGENT][NEUTRAL] Um, any diagnostic testing, it pays up to $250 towards that. Um, it also covers, of course, like if you had any surgery or anesthesia, there's benefits for that also.
[CUSTOMER][NEUTRAL] OK, but this plan wouldn't be something that I could use for like any like therapy sessions or anything like that?
[AGENT][NEUTRAL] So therapy would be considered like an outpatient um office visit. So you could use it for that. Uh, the plan's only gonna, the plan is gonna pay towards the 5 visits. It wouldn't pay towards anything over that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Got it. Got it. And what is that outpatient? Is that still a 75?
[AGENT][NEUTRAL] Mhm. It's a $75 yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, and then after that it would just be fun for um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Gotcha. Um, all right. Well, that was very helpful. Um, I think those were all of my questions. Um, and then I guess this, when I, um, use this, I have to use the, I would use like if I had to select an insurance provider, it's 90 degree benefits even though I have like benefits and a card. It's all kind of wrapped up into the same thing.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Right, exactly, yeah, exactly, yeah.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][POSITIVE] OK. All righty. Well, thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Hope you have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.