AccountId: 011433970860
ContactId: 3e9c0bda-cef8-4dff-9775-08ee62deb22d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 351519 ms
Total Talk Time (AGENT): 190220 ms
Total Talk Time (CUSTOMER): 168771 ms
Interruptions: 3
Overall Sentiment: AGENT=1.2, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/3e9c0bda-cef8-4dff-9775-08ee62deb22d_20250103T14:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. I just need some coverage information. We have an insurance with you guys, my husband and I.
[CUSTOMER][NEUTRAL] And do you want his group number or any information that would help you with his identity or our identity?
[AGENT][NEUTRAL] OK, so you're, do you have some ques you're covered on this policy and you have some questions on your coverage?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, Ms. [PII]. What is a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And your policy number, please?
[CUSTOMER][NEUTRAL] It is 01673440.
[AGENT][NEUTRAL] OK, thank you. So give me a moment to get the information pulled up. Once I do, Ms. [PII], I will have to verify several things with you first for security, and then also any information provided today would be a verification of benefits, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So first off, if you'll please verify Mr. [PII]'s name, first name and date of birth and then your date of birth.
[CUSTOMER][NEUTRAL] [PII], and my birthday is [PII].
[AGENT][POSITIVE] OK, thank you and the home mailing address for you all please?
[CUSTOMER][NEUTRAL] We just moved, so I'm not sure which one you have. It, it's [PII].
[AGENT][NEUTRAL] And is there
[CUSTOMER][NEUTRAL] Do you have that one or the old one?
[AGENT][NEUTRAL] OK, and is there a unit number that goes with that address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you. Mr. [PII]'s phone number, please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, I don't know it. Hold on one second. Let me look.
[AGENT][NEUTRAL] OK. Uh.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But, do you know your number, your phone number? Your phone number, yeah, [PII].
[CUSTOMER][NEUTRAL] [PII]. Yeah, your phone number? My ple.
[AGENT][NEUTRAL] Uh-huh. Yes, go ahead with that number.
[CUSTOMER][NEUTRAL] OK, OK, [PII].
[AGENT][NEUTRAL] No, sir, the other number. Uh, I'm sorry, there was an.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I'll start over [PII].
[AGENT][NEUTRAL] What is that number? Yes, sir.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then the email that we have on file, which it appears to be for Ms. [PII].
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, so it's [PII]. I'm, I'm not sure which one you have. [PII] or [PII], yeah, OK.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so now since Mr. [PII] is there with you, is the [PII], is that the correct address or is that?
[CUSTOMER][POSITIVE] Yes it is, yes, that's the new one.
[AGENT][NEUTRAL] That's the new address. OK. All right. So how can I help them? That's all the information I need to verify. So how can I help you today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, so he had last year in July, he had, he was in the hospital and then on [PII], he had surgery.
[CUSTOMER][NEUTRAL] So, but he's still getting now uh follow up care with doctors because of the surgery. So my question is, is the, are the co-pays still covered by you guys?
[CUSTOMER][NEUTRAL] Because it's like an extension of last year or is it a [PII]?
[CUSTOMER][NEGATIVE] You guys don't cover the copays.
[AGENT][NEUTRAL] OK, so the claims that are filed for dates of services for this calendar year would fall under this year's plan. So for example, if he went to the doctor today.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] That would be this year, this calendar year. Uh-huh.
[CUSTOMER][NEUTRAL] That would be this year.
[CUSTOMER][NEUTRAL] Alrighty, so that's my question. I just thought it all fell under, you know, the same procedure and follow up, but that was my question.
[AGENT][NEUTRAL] No. Yes, ma'am. Now, on this plan, office visits themselves are not covered benefits.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, but office treatment and anything, but yes, ma'am. It's a calendar year policy, so it rolled over [PII].
[CUSTOMER][POSITIVE] Correct, correct, um.
[CUSTOMER][NEUTRAL] All right. And uh we're actually now at the emergency room.
[CUSTOMER][NEUTRAL] If should I, should I make a, um, like I don't know, do they make a claim or do I make a claim for this?
[AGENT][NEUTRAL] Well, you would just have to discuss that with him. Um, make sure to provide them your APL ID card along with your primary insurance card. You can ask them if they will follow your supplemental. Most of the most of the time, they will, Ms. [PII]. But if for any reason they don't, then you can and you could call us back at that point and we could um explain how to do all of that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alrighty, thank you, that's what I needed to know.
[AGENT][NEUTRAL] OK. Well, OK, Ms. [PII]. Well, is there anything else that I can help you all with at the moment since you said you all are currently at the hospital?
[CUSTOMER][POSITIVE] No, that's it. Just wanted to find out about this whole coverage thing. Thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, you're certainly welcome. And just one quick thing I am gonna send an email, um, about our portal and since your email is the one that is on file for you all, it will come to, to, to that email address and it's it's not.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'll, I'll keep an eye for it.
[AGENT][NEUTRAL] OK, then. Well, is there anything else I can help with?
[CUSTOMER][POSITIVE] No, that's it thank you so much.
[AGENT][POSITIVE] OK, you're welcome and thank you again for calling APL. Yes ma'am. Bye bye.
[CUSTOMER][POSITIVE] Have a good one bye.
[CUSTOMER][NEUTRAL] Bye