AccountId: 011433970860
ContactId: 4239bff9-914d-4e76-9bb3-44b77b245362
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 360609 ms
Total Talk Time (AGENT): 159581 ms
Total Talk Time (CUSTOMER): 153129 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/4239bff9-914d-4e76-9bb3-44b77b245362_20250612T13:18_UTC.wav
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[AGENT][NEUTRAL] Calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, good morning, [PII]. Uh, I had a general questions about my coverage. Did I reach reach the right extension?
[AGENT][NEUTRAL] I can help you. May I have a policy number?
[CUSTOMER][NEUTRAL] Yeah, it's uh let's see umd small.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 025.
[CUSTOMER][NEUTRAL] 845.
[CUSTOMER][NEUTRAL] 69.
[AGENT][NEUTRAL] And may I have your first and last name and a good callback number?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And may I have a good callback number for you, [PII]?
[CUSTOMER][NEUTRAL] 00, I'm sorry, uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Can you verify your date of birth, your mailing address, and your email, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, mailing address uh [PII].
[CUSTOMER][NEUTRAL] The email address.
[CUSTOMER][NEUTRAL] Is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of the claim. Can I have your plan pulled up and how can I help you today?
[CUSTOMER][NEUTRAL] Yeah, this insurance is kind of unique to me. Like, I didn't, uh, I, I always got like letters from you guys. I always just do them out, so I, I got one that opens from March, so it was a $60 check. What do you guys, uh, reimbursed on uncovered? I think right now you're acting as my secondary insurance, but I was hoping I didn't know if there was any other checks that were previously mailed, but my really my question was, um, I have a colonoscopy scheduled, um.
[CUSTOMER][NEUTRAL] In August and you guys will probably be my only insurance coverage at that time, uh, because my other insurance will be going away, is that something that's covered or you can't tell me that?
[AGENT][NEUTRAL] Um, let me see if it specifies colonoscopy cause if it's considered any type of surgery, you do have the surgery and anesthesia benefit. It allows $1000 as a benefit amount. There's no copays.
[AGENT][NEUTRAL] For surgery and then the anesthesia will be 25% of that benefit amount.
[AGENT][NEUTRAL] Uh, let's see if it specifies. You do have the wellness exam and the test benefit.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] That allows $75 per visit.
[AGENT][NEUTRAL] $75 per test.
[AGENT][NEUTRAL] And any diagnostic wellness test allows $250.
[CUSTOMER][NEUTRAL] OK, alright, so is there a deductible on here because it's kind of weird because I, I, I mean the letters have been opened. I just said oh where we received a claim and just like this regular medical appointments and stuff or a specialist like your brother. What we do is there a standard deductible on this coverage or what? I just don't know much about.
[AGENT][NEUTRAL] No, there is not.
[CUSTOMER][NEUTRAL] There's no deductible, OK.
[AGENT][NEUTRAL] No, there's no deductible. This is a hospital indemnity plan, so it's not like your regular major medical, so it is very limited on this plan.
[CUSTOMER][NEUTRAL] Oh, so it covers hospital stuff, not me, just regular appointments.
[AGENT][NEUTRAL] Correct. Let's see. Yes, let me see if this one does. Sometimes they do offer like a physician's office visit. Let me see if this is one.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEGATIVE] And this one doesn't specify, which is weird.
[AGENT][NEUTRAL] OK. So, under this one, you are allowed 5 office visits. If you have an office visit, it will pay up to $75 per visit. So any services rendered in the doctor's office on that day, they allow you $5.
[AGENT][NEUTRAL] $75 no co-pays.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] OK, so maybe that's explains why I got reimbursed for one. I hope they didn't send any more. Is there a billing because I know you probably can't answer any, but I don't know. You have been answering. I did there was one check that was sent for $60. Was there any other reimbursements that were sent, or you don't know.
[AGENT][NEUTRAL] Let's see, so on that one.
[AGENT][NEUTRAL] Looks like it processed under claim number 3583029.
[AGENT][NEUTRAL] It paid $60. It also looks like there was a $15 on the same claim. Did you receive $15?
[AGENT][NEUTRAL] No, that went to the provider. It, it went to the provider. I do apologize. The 60 went to you. So that's the only one.
[CUSTOMER][NEUTRAL] you know what.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][POSITIVE] Got you OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that's only. OK, good, because I don't wanna make sure I didn't throw it out. OK, alright, well you've been very helpful. I appreciate it.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] [PII], you're so welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, do I have to, do I have to report because the clock is scheduled for mid March or excuse me, [PII], um, do I need to tell you guys about it or no, not really, it just, it'll just go out.
[AGENT][POSITIVE] No, prior art is not required. Whenever you have um services rendered, just present that card and they can file for you, so you don't have to worry about it.
[CUSTOMER][POSITIVE] Oh, OK, will do. Alright, thank you very much. You've been very helpful have a good day.
[AGENT][POSITIVE] You're so welcome, [PII]. Thank you for calling American Public Life. Have a great day. Bye-bye.