AccountId: 011433970860
ContactId: 32e67876-74eb-4701-947c-0916c7ffa540
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 541479 ms
Total Talk Time (AGENT): 97259 ms
Total Talk Time (CUSTOMER): 164401 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/32e67876-74eb-4701-947c-0916c7ffa540_20250225T14:33_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, hi, um, my name is [PII], and I was calling, um, my husband, uh, actually we, he took out this insurance a few years ago, and we're not sure like what all coverages he have, so he wanted me to see if he had uh critical care I think it's called.
[CUSTOMER][NEUTRAL] Um, coverage or something like that.
[AGENT][NEUTRAL] OK, Ms. [PII], what's that policy number, please?
[CUSTOMER][NEUTRAL] Um, I don't know, is that the number that's on the APL card?
[AGENT][NEUTRAL] Yes, ma'am. It should say policy or policy slash cert number or in-hospital outpatient benefit cert number.
[CUSTOMER][NEUTRAL] OK, I have to see. I see like a group number and.
[CUSTOMER][NEUTRAL] Um, affiliate number maybe?
[AGENT][NEUTRAL] No, ma'am. Uh, it should say policy number or policy er number.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Alright, I don't see all I see is group name group number.
[AGENT][NEUTRAL] It starts with a 01 or 02.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, let me look on the back of it.
[CUSTOMER][NEUTRAL] I see a member number, is that the one? Start with a 0.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] Uh, should write 01 or 02?
[CUSTOMER][NEUTRAL] Well, I don't
[CUSTOMER][NEUTRAL] Oh, I see something that says 01 start with 01, but it, it says member number.
[AGENT][NEUTRAL] What's that number? Let me look that up.
[CUSTOMER][NEUTRAL] It's 014. [PII], come tell me what to say. I can't see it. I don't have my glasses on.
[CUSTOMER][NEUTRAL] What that number say where it says member number 014 it says 01415880.
[CUSTOMER][NEUTRAL] Did you hear him?
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And I apologize, ma'am. Your name is again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], and verify your date of birth and the mailing address, please.
[CUSTOMER][NEUTRAL] [PII] and the mailing address is [PII].
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] Well, with this policy, a limited medical, uh, as far as benefits, you will have to contact with TPA and I can transfer you if you like, and they can verify what the benefits are.
[CUSTOMER][NEUTRAL] OK, and can
[CUSTOMER][NEUTRAL] OK, and can you also give me their number just in case I have to call back?
[AGENT][NEUTRAL] Uh, yes, ma'am. Let me know when you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, it's 866.
[AGENT][NEUTRAL] 9759458, option 3.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh, option 3 and you said this one is what now limited medical?
[AGENT][NEUTRAL] Uh, from what I say, it's a limited medical plan, but Web TPA will be able to verify what benefits are covered under the plan.
[CUSTOMER][POSITIVE] OK, alright, thank you.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to We TPA, the administrator for the limited benefit health insurance.
[CUSTOMER][NEUTRAL] Due to severe winter weather, you may experience longer wait times. If this is not an urgent matter, please call back at a later date. Thank you for your patience.
[CUSTOMER][NEUTRAL] Please note, your call may be monitored or recorded for quality assurance. The information provided during this call is only a description of benefits and is not a guarantee of payment. Benefits are based upon eligibility at the time services are rendered and all plan provisions.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you for calling customer service. My name is [PII]. How may we assist you today?
[AGENT][NEUTRAL] Hey, Ms. [PII]. I have an insured, oh, I'm calling from ATL. My name is [PII] and I have an insured on the phone inquired about benefits.
[CUSTOMER][NEUTRAL] OK, so what's the ID number please?
[AGENT][NEUTRAL] Uh, 01.
[AGENT][NEUTRAL] 415,880.
[CUSTOMER][NEUTRAL] OK, is that from [PII]?
[AGENT][NEUTRAL] Uh, [PII], it's for Ms. [PII]. She's the one that's on the line.
[CUSTOMER][NEUTRAL] Oh OK, birthday [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you for all your help. You can put her over.
[AGENT][POSITIVE] All right. Thank you, Ms. [PII]. Give me one moment.
[CUSTOMER][POSITIVE] You're welcome thank you.
[AGENT][NEUTRAL] Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I have Ms. [PII] on the line who'll be able to assist you further, OK?
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You are welcome. Y'all have a great day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you.