AccountId: 011433970860
ContactId: 41cf4579-5a36-49d3-ad7a-2a6136592543
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 572659 ms
Total Talk Time (AGENT): 215970 ms
Total Talk Time (CUSTOMER): 165674 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/41cf4579-5a36-49d3-ad7a-2a6136592543_20250421T15:57_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] And I, I have two questions. We have a family policy and my husband is deceased. Is that going to change the amount of the policy?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, it should decrease because he, he's not on there.
[CUSTOMER][NEUTRAL] OK, well, I didn't know if it was just one. Alright, let me give you the policy.
[AGENT][NEUTRAL] I can double check for you though.
[CUSTOMER][POSITIVE] OK thanks.
[AGENT][POSITIVE] You're welcome. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII] The number is [PII].
[AGENT][NEUTRAL] Thank you for that, and Ms. [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] 00590311
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Alright, so it's coming up now, so just while it's doing its thing, just to make sure I understand, so you want to go from like family to like individual or how did you want?
[CUSTOMER][NEUTRAL] Well, it, OK, see that's, it's, it's me and my daughter, she's disabled, so she's carried on the policy, that's [PII] and [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And then [PII] was my husband, and he died a year ago, um, well yesterday, [PII].
[AGENT][NEUTRAL] OK, so let me do this. I have the policy pulled up here. Um, Ms. [PII], can you verify your date of birth, your mailing address and the email address on file?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, fiscal address is [PII], and the email is [PII].
[AGENT][POSITIVE] Thank you for that.
[AGENT][NEUTRAL] And all the information provided is a verification of benefits, not a guarantee of payment. So it looks like actually, hold on one second, let me go to the notes.
[AGENT][NEUTRAL] Because from what I see here,
[AGENT][NEUTRAL] Mr. How, do you mind if I place you on just a brief hold, I from what I see, it looks like Mr. Mr. [PII] is not on this policy anymore. I just see you and your daughter and it's listed as a single parent policy. Is that what you're trying to, you want that, right, or no?
[CUSTOMER][NEUTRAL] Yeah, I don't know. Nobody's taking him off, but that's OK, yeah, that's what I want.
[AGENT][NEUTRAL] OK, let me just double check because it looks like we received the
[AGENT][NEUTRAL] Sorry, I'm trying to go through the notes, but it looks like we received the death certificate or did you, OK, yeah, we received the death certificate on [PII], so that's when it changed. When we received that um the death certificate, the, they changed it to single parent because there's a note on here that says not to drop [PII]. So it's just you and your daughter.
[CUSTOMER][NEUTRAL] OK, and how much is the premium going to be then?
[AGENT][NEUTRAL] Let me see, hold on one second.
[AGENT][NEUTRAL] So the total premium is $691.80.
[CUSTOMER][NEUTRAL] That's for the two of us only, right?
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] OK, now another quick question on the wellness events benefit.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It says that they will pay not to exceed $75 per year.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For mammograms, chest X-rays, and things like that.
[CUSTOMER][NEUTRAL] OK, what if you have another insurance it's also paying? Does it pay in addition to that?
[AGENT][NEUTRAL] So, for that one, I'm gonna check with claims and the reason being I don't know what the difference uh.
[CUSTOMER][NEUTRAL] I understand. I understand.
[AGENT][NEUTRAL] Well, I know the differences in what you're saying, but there's sometimes they say no, and then sometimes I do see where they pay out to the insured because, you know, whoever else has paid everything, so they, but you still have that benefit, so they just give the check to you. So let me double check just to make sure because I've seen it both ways. You're welcome. Hold on one moment, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Ferring
[CUSTOMER][NEUTRAL] APL, this is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you doing?
[CUSTOMER][NEUTRAL] Fine. How are you?
[AGENT][NEUTRAL] I'm doing good. I just have a quick question. Um, so it's a cancer policy. The insured is asking me if her primary pays everything and they and she files with us, does that get denied or does she still get paid out from her benefits with us for wellness?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is this in regards to if she filed the claim or the provider, yeah, she'll be reimbursed still.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So, this is just for me because, because, uh, cause sometimes I get tripped out on it. So is it because it's a cancer policy versus like Medlink when we're second, we'll deny it as a primary, right?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Well, if the primary, if the provider files a claim and there's a patient responsibility applies for their deductible co-pay, co-insurance and they have assignment of benefits, we would still pay those benefits to that provider.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now, we get a claim in where it's been paid already.
[CUSTOMER][NEUTRAL] Then it will be paid to the insured.
[AGENT][POSITIVE] Yeah, sure. OK, thank you.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][POSITIVE] That's all I needed. Have a good day.
[CUSTOMER][POSITIVE] Mhm you're welcome.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Alright bye bye.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Hello, Mrs. [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Thank you so much for holding. I apologize for the wait. So yes, that um if the other insurance does pay and they, you know, they've satisfied everything, but you still file a claim for that wellness benefit, yes, you will be reimbursed.
[CUSTOMER][NEUTRAL] OK and now on the.
[CUSTOMER][NEUTRAL] Uh, on the recording when it was asking did we need this, did we need that, is there a benefit card that goes with this policy?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Not with the cancer policy. We only have cards for the health insurance and dental.
[CUSTOMER][NEUTRAL] OK, alright, that's because I thought we were never given a card and so that's why we're not supposed to have one.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, sweetheart, thank you. I hope you have a good week.
[AGENT][NEUTRAL] You too, Ms. [PII]. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, ma'am, thank you.
[AGENT][POSITIVE] Alright, and just for the call, all the information provided was a verification of benefits, not a guarantee of payment, and thank you so much for calling APO Ms. [PII]. I hope you have a good day.
[CUSTOMER][POSITIVE] OK, thank you. I hope you do too, darling. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.