AccountId: 011433970860
ContactId: 3a7b9b37-3f01-4f58-bf15-c046c4783ad4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 387549 ms
Total Talk Time (AGENT): 226204 ms
Total Talk Time (CUSTOMER): 123052 ms
Interruptions: 3
Overall Sentiment: AGENT=1.1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/3a7b9b37-3f01-4f58-bf15-c046c4783ad4_20250106T19:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, [PII]. How are you?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][NEUTRAL] I'm OK. Yes, my name is [PII], and I received my APL card, but I was wondering if you could explain to me, um, is it possible for me to like go to the doctor with this card?
[AGENT][NEUTRAL] Oh, we could take a look, um, oh we could see what kind of policy you have see if office visits are covered, um, [PII], really quick, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And do you have your policy number?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes, the policy number.
[CUSTOMER][NEUTRAL] It is 02580607.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and [PII] just gonna, oh sorry.
[CUSTOMER][NEUTRAL] I just wanna, I just.
[CUSTOMER][NEUTRAL] Yeah, I just wanna know what doctors I can go to with this card.
[AGENT][NEUTRAL] Sure, OK, I'm just gonna verify some information really quick, [PII], can I get your date of birth, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. The last thing I need is the email address that we've got on file for you looks like it is a [PII] account.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Alrighty, so this is your dental policy and you just want to see who was in uh network who you're able to go see which provider?
[CUSTOMER][NEUTRAL] Oh this is a dental network card.
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] OK, so what about, OK, I think I gave you the wrong.
[AGENT][NEUTRAL] OK, so this was supposed to be for medical?
[CUSTOMER][NEUTRAL] Thingy there cause I have a medical too.
[AGENT][NEUTRAL] I see. OK, no, I've got it here. Let's see.
[CUSTOMER][NEUTRAL] Yeah, I have a medical too.
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] All right, yeah, you've got the hospital indemnity.
[AGENT][NEUTRAL] And we were wanting to see, so an actual physician's office, um, were you wanting, or is it in regard to a sick oh go ahead.
[CUSTOMER][NEUTRAL] Well, no, I have, well, I have a prime, I have a primary care doctor. I was just wanting to know, can I use my card at that office?
[AGENT][NEUTRAL] OK, let's see, so this policy doesn't necessarily have a set network per se, so it's really as it's a limited indemnity medical plan is what it's called. So as long as the doctors are willing to take it, it really just depends on them. If they won't, you can still file a claim on your own. So regardless of whether they would file the claim for you or not, you would still be able to.
[CUSTOMER][NEUTRAL] OK, because it's called limited benefit hospital amenity.
[AGENT][NEUTRAL] Uh, yes, limited indemnity medical plan.
[CUSTOMER][NEUTRAL] OK, now as far as the dental.
[CUSTOMER][NEUTRAL] Um, goes, how would you say it's the same thing, it has no limits, um, per se as far as who I go to or.
[AGENT][NEUTRAL] Now you're right, so your dental, they put this plan participates in the Carrington PPO network, so you could call physicians where or I'm sorry, uh, dental providers um you can either ask if they accept APL or if they're a part of the Carrington PPO.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And if there's any confusion or they're not sure um you are more than welcome to give them this phone number same with uh medical for your medical if they're not sure or if there there seems to be some confusion they're more than welcome to give us a call as well they can call the same number we do talk to providers all the time so we can explain your plans um and hopefully clear up any confusion.
[CUSTOMER][NEUTRAL] OK. So, um,
[CUSTOMER][NEUTRAL] So even with the same thing with the emergency room if you can, if, if you need to go there.
[CUSTOMER][NEUTRAL] You can present this card.
[AGENT][NEUTRAL] Yes, um, just make sure that that's gonna be covered under this policy. All of these plans are very different for the hospital indemnity. Bear with me just a moment, let me make sure.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK. The emergency room, it states if it's regarding a sickness, then yes, that would be covered. Same with the physician's office, urgent care. So yeah, as long as it's regarding a sickness.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So does it have a co-pay?
[AGENT][NEUTRAL] No, no, as this again, since it's a limited indemnity medical plan, there's no copay, no deductible, it essentially pays a set dollar amount per procedure or office visit.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] If you'd like, uh, [PII], I can send you a copy of this policy. It does go in depth as to what is and is not covered, dollar amounts, frequencies, things like that. Um, it is very easy to read as well. It's not just a bunch of jargon, I promise. Did you want me to send this to you?
[CUSTOMER][NEUTRAL] So it would
[CUSTOMER][NEUTRAL] OK, you can you send it to my email?
[AGENT][NEUTRAL] Of course, uh, let's see just this Gmail account that we've got.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Pardon me?
[AGENT][NEUTRAL] The [PII] account?
[CUSTOMER][POSITIVE] Yes please thank you.
[AGENT][NEUTRAL] OK, yes, of course, um, did you want me to send you your dental one as well or just the medical?
[CUSTOMER][POSITIVE] Both of them if it's no problem. Yeah.
[AGENT][POSITIVE] Absolutely, yep I'll go ahead and get that sent to you right now yeah, did you have any other questions for me, [PII]?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this is coming through um pay per weekly through MAU.
[AGENT][NEUTRAL] Oh, let's see, for your provider or I'm sorry, your um, your group, let's see.
[CUSTOMER][NEUTRAL] Employer.
[AGENT][NEUTRAL] Yes, uh, management analysis and utilization.
[CUSTOMER][POSITIVE] OK perfect alright well thank you so much [PII].
[AGENT][NEUTRAL] Yeah, that's who we've got, of course, yeah, any time I know it can be a bit confusing so if you've got any questions feel free to give us a call right back.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Alright thank you you have a good day.
[AGENT][POSITIVE] Alright, yeah thanks for giving us a call you too bye bye.