AccountId: 011433970860
ContactId: 3eaba84d-3756-4f3f-b6bb-3f2f1886a929
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 671640 ms
Total Talk Time (AGENT): 204777 ms
Total Talk Time (CUSTOMER): 115317 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=-1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/3eaba84d-3756-4f3f-b6bb-3f2f1886a929_20250401T13:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII], and I received my medical cards in the mail yesterday. Thank you very much. I had a question. There's no co-pay listed on my cards, like when I see a doctor, um, and so forth. So I was wondering, how does this insurance work? And I apologize but I sound ignorant. I just, um, I, I just want to make sure that I understand this correctly.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] It's OK. It's just fine, Ms. [PII]. Yes, I can assist you with that information. Um, may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and let me have that policy number, certificate number.
[CUSTOMER][NEUTRAL] OK, let me put on my glasses quick.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, that policy search number is 026-07844.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] All right, thank you. For security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] You bet. My date of birth is [PII]. Email address is [PII]. Mailing address is [PII].
[AGENT][NEUTRAL] Perfect. Thank you, Ms. [PII]. All right, so I see that you have one of our limited hospital indemnity plans. Um, with the limited plans, there is no co-payment, co-insurance or deductibles, and this one pays a flat amount based on the service rendered. Um, for an example, and this is not a
[CUSTOMER][NEUTRAL] What does that mean exactly? Yeah.
[AGENT][NEUTRAL] OK. And this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. Um, but for example, if you go to your regular doctor, um, for an appointment or a specialist.
[AGENT][NEUTRAL] There is $100 that we pay up to 4 visits per year. So we'll pay $100 in whatever is remaining, either if you have another insurance, you will use other insurance or you will pay out of pocket.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, I see. OK, so basically I'm responsible for all of all costs other than $100.
[AGENT][NEUTRAL] If it's an office visit, because you have different benefits based on what service is rendered, that's just one of your benefits. Um, one of the benefits is the office visit, which is $100 up to 4 visits per year. Urgent care is the same thing, but it's a separate benefit, so that one is not combined, that's separate. Um, um, ER visit is the same thing, $100 and that one is up to $2 per year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then you have like surgery surgery benefits. Um, if the surgery takes place in a hospital or surgery center, it covers 1000. If it's an office surgery like a small surgery, it's 250 and you get two of those per year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK, now how do the how does the pharmacy work then?
[AGENT][NEUTRAL] Oh, we don't handle the pharmacy part. Um, the pharmacy is handled by Pharmavale. Um, you can call them or if you have the number, I can give it to you, but, um, you can call them and they can tell you exactly how the pharmacy works. But yeah, it's through Pharmaval. Mhm. And then, yeah, you have several more benefits. I don't know if you need all the benefits or if you need a certificate or anything like that or you have that information.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] No, I, I think that I have that I can you email me the benefits that are available?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can only send you the copy of your certificate which is like 25 pages or something like that. Is that OK?
[CUSTOMER][POSITIVE] That would be perfect, yep, that would be perfect, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me go ahead and get this and you can always get this through the website if you register as well, OK? Um, let's see. All right, if you don't mind holding for me, I can go ahead and send this email to you right now, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh that would be awesome thank you.
[AGENT][NEUTRAL] You're welcome. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being page for me. OK, so, um, I went ahead and send that email. Do you wanna check and see if you got it?
[CUSTOMER][NEUTRAL] Yeah, let me check real quick.
[AGENT][NEUTRAL] It may take a minute or two. I just send it. I had to download and upload everything, so it took a little bit.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] See it just yet, but if it's a large file it may take a little bit.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, yeah, it is a really large file because it's all the documents of the policy together with your um the benefits and everything. Mhm.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Um, that's OK if I don't receive it, um, by later today, I will just call back, um, and we'll go over it, but yeah, I think we have the information and we should be good.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. So I'll go ahead and make a note in the system and that I did send it out so if you don't get it, it's gonna be notated, OK?
[CUSTOMER][POSITIVE] OK perfect thank you so much for all your help you have a great day.
[AGENT][POSITIVE] You're welcome. You as well thank you for calling APR. Have a good day, Miss [PII].
[CUSTOMER][NEUTRAL] Bye.
[AGENT][POSITIVE] Thank you