AccountId: 011433970860
ContactId: 33c3a468-9dd7-4a76-9dc9-03874558c3d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 429750 ms
Total Talk Time (AGENT): 126038 ms
Total Talk Time (CUSTOMER): 220554 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/33c3a468-9dd7-4a76-9dc9-03874558c3d1_20250122T20:49_UTC.wav
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[AGENT][NEUTRAL] APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, Ms. [PII], um, I have a question about
[CUSTOMER][NEUTRAL] Um, if I use the
[CUSTOMER][NEUTRAL] Uh, a different provider from the
[CUSTOMER][NEUTRAL] Your provider, how much would I have to pay or how much it cost for us to.
[AGENT][NEUTRAL] OK, what is your name?
[CUSTOMER][NEUTRAL] Pay.
[CUSTOMER][NEUTRAL] My name is [PII] and the card is under my husband. My husband, he's the one.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Mhm spell your first name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you have the policy number, Shavera?
[CUSTOMER][NEUTRAL] Uh, yes, hold on please.
[CUSTOMER][NEUTRAL] The policy is
[CUSTOMER][NEUTRAL] Where is that?
[CUSTOMER][NEUTRAL] OK. 025.
[CUSTOMER][NEUTRAL] 80
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] 744. Is that the right one?
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I got.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Thank you for that information. How can I help you?
[CUSTOMER][NEUTRAL] OK. Um, I have a referral for an OBGYN doctor, but when I called them, they told me that, um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The card
[CUSTOMER][NEUTRAL] That I have is not um.
[CUSTOMER][NEUTRAL] They never heard of it or were they not accept, but they told me to give you a call to see if you are affiliate with them.
[AGENT][NEUTRAL] OK, so are you trying to, so the policy number you gave me is for the dental policy. Your medical policy, the card number ends in 10741.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Instead of 44 it's 401.
[CUSTOMER][NEUTRAL] 07.
[CUSTOMER][NEUTRAL] Oh, OK, I see now.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Do you need the rest of the number?
[AGENT][NEUTRAL] Mm, I have it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said it's for um your OBGYN visit?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And so the only thing that's covered in a specialist office or PCP office is if it's a surgery.
[CUSTOMER][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] If it is surgery, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] In in office surgery. Otherwise, it's not covered.
[AGENT][NEUTRAL] Under this policy?
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Which is um a limited hospital indemnity policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So like, another question. So if he, like, if he needs to go see his uh specialist like um.
[CUSTOMER][NEUTRAL] You know, uh,
[CUSTOMER][NEUTRAL] A regular doctor. Right now, he has a regular doctor but it's not in the state. But he look in one here in [PII]. So,
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can he go anywhere in the state or it has to be specific one that you?
[AGENT][NEUTRAL] Yeah, he can go he can go anywhere, but the, the, the office visit isn't covered. It's only covered in an office if there is a surgical procedure done.
[CUSTOMER][NEUTRAL] Have a plan.
[AGENT][NEUTRAL] In the office.
[CUSTOMER][NEUTRAL] Right, OK.
[CUSTOMER][NEUTRAL] OK, but he can go see any like um family doctor here.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, then what is the difference? I'm sorry, go ahead, you go ahead and finish.
[AGENT][NEUTRAL] But it what
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, go ahead.
[CUSTOMER][NEUTRAL] OK. So, I still, I'm sorry, very slow. I still don't understand like, um, so I can't go to see my provider with my OBGYN unless like a surgery needed and it's not gonna cover if I don't have a surgery.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Uh, yeah, yeah, under this particular policy, yes, that is correct.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, but everything else is covered, right? Like, uh, family doctor visit, like with my kids and me and my husband, everything else is fine, right?
[AGENT][NEUTRAL] On only if there's only if it's a surgery in the office. Otherwise, it's not covered.
[CUSTOMER][NEUTRAL] Hm it's, it's only for surgery.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You know, that could be um ear wax removal.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Um, it could be uh a minor surgery in the office and then in the hospital, it covers if there's a surgical um procedure done in a hospital setting. And then there's an in-hospital benefit. If you're admitted to the hospital, um, there's a benefit for that as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So, like, see, I, I have to see my doctor like once every 6 to 7 months.
[CUSTOMER][NEGATIVE] And every time I go, they give me like a, you know, just the blood work and then uh
[CUSTOMER][NEUTRAL] I'll prescribe my medicine cause I have a thyroid condition. So that wouldn't cover like if I go see my.
[AGENT][NEUTRAL] Correct. It's only when there's a, a surgical procedure performed in the office.
[AGENT][NEGATIVE] So if you went just for like a regular office visit, it's not covered.
[CUSTOMER][NEUTRAL] Oh, so, OK. All right, I, I'll give him a call then cause I didn't know. I don't think he knows this either. I think he thought this is like for the uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Him to go see the doctor cause he's a diabetic and he goes see his doctor every 23 months.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] I don't think he realized that this card is not eligible for that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't think he'd get that either, so he probably have to call and cancel.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, he'll have to cancel through his group since it's a group policy.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, yeah, I will I'll call him and let him know.
[AGENT][NEUTRAL] OK. OK. All right. Well, did you have any other questions?
[CUSTOMER][POSITIVE] All right, thank you, ma'am.
[CUSTOMER][NEUTRAL] No, no, I don't. That's all I need to know.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Alright, well thank you for calling APO Miss [PII]. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.