AccountId: 011433970860
ContactId: 43f6bb1e-4de7-48db-93bf-0c755093be98
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1142869 ms
Total Talk Time (AGENT): 614413 ms
Total Talk Time (CUSTOMER): 531919 ms
Interruptions: 11
Overall Sentiment: AGENT=1.5, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/43f6bb1e-4de7-48db-93bf-0c755093be98_20250124T18:45_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I was calling to, uh, verify my benefits and my status as well as to check in to see if what it covers because I'm, I'm ending one insurance and then I'm picking up this one because I got a new um a new freelance contract through uh Creative Circle.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yeah, we could take a look at your benefits um what was your name?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] OK, and tell you, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, uh, it's [PII].
[CUSTOMER][NEUTRAL] 254
[CUSTOMER][NEUTRAL] 1959
[AGENT][NEUTRAL] Alright, thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, I do. Mhm, um, the first, the first one that I'm giving you, like they gave me two sets of cards.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, is, uh, the medical ID on this one is.
[CUSTOMER][NEUTRAL] Uh, for the multi plan is D.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 412.
[CUSTOMER][NEUTRAL] 03519
[AGENT][NEUTRAL] OK, so that's not a policy number through us, [PII], that's actually going to be through, uh, they're called 90 Degrees.
[CUSTOMER][NEUTRAL] They say APL on my card. This is American Public Life.
[CUSTOMER][NEUTRAL] Um, yeah, and it says to call this number for medical uh benefits verification call [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Right, um, that policy number you gave us just isn't ours, um, it's not to say that you don't have a policy with us that's 90 degrees, um, is what they're called, the ones that do the multi plan, that's their policy number.
[CUSTOMER][NEUTRAL] Oh, I see a policy. I see something that says policy certification number.
[AGENT][NEUTRAL] OK, yes, please.
[CUSTOMER][NEUTRAL] That is 02.
[CUSTOMER][NEUTRAL] 586.
[CUSTOMER][NEUTRAL] 264.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, [PII], just gonna verify some information really quick. Uh, what was your last name?
[CUSTOMER][NEUTRAL] [PII], [PII]
[AGENT][NEUTRAL] OK, and then can I get your date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, just gonna verify a couple other things really quick. Uh, can I get your mailing address?
[CUSTOMER][NEUTRAL] Yeah, it's um [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that. Last thing I need is the uh email address we've got on file for you uh looks like it is a Gmail account.
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying all of that information [PII]. Alright, bear with me just a moment. I'm gonna get your policy pulled up here and we can take a look. Um, I also send you a copy of the policy so that you've got it. Um, it's very easy to read, not just a bunch of jargon, I promise, um, but it does go in depth as to what is and is not covered, uh, frequencies, prices, things like that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you want me to go ahead and send it to you?
[CUSTOMER][NEUTRAL] Yeah, I, if it will give me more detail, yeah, yeah, like after I have the conversation with you guys.
[AGENT][POSITIVE] Happy to talk over the phone of course absolutely um I just mentioned I'm a very visual person. I like having something to go back in reference um OK um.
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] So am I.
[CUSTOMER][POSITIVE] Yeah, I, I appreciate it, yeah.
[AGENT][NEUTRAL] Of course, yeah, did you want me to just send it to your email?
[CUSTOMER][NEUTRAL] Yeah, mhm.
[AGENT][NEUTRAL] OK, alright, I will do that.
[CUSTOMER][NEUTRAL] I'm seeing a lot of yeah.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, yeah, I said I'm seeing a lot of, yeah, yeah, yeah, yeah.
[AGENT][NEUTRAL] Yeah, yeah, yeah.
[AGENT][NEUTRAL] Sometimes that's all you got to say.
[CUSTOMER][NEUTRAL] Right, yeah, yeah, yeah, yeah, yeah. So like busted lines.
[AGENT][POSITIVE] All right, I'm gonna get that.
[AGENT][POSITIVE] Alright, I'm gonna send it to you first really quick just you know so I don't forget, um, and then I'm happy to go through we can go through your benefits and everything that's covered, let's see.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Alright, so I did just send that to you. Let me get the schedule of benefits up here.
[AGENT][NEUTRAL] OK, uh, first, before we go into anything in depth, did you have any specific questions for me or did you want me to kind of give you a, uh, breakdown?
[CUSTOMER][POSITIVE] Yeah, my specific question is like, um, I'm currently in therapy. I lost my dad in September and um the therapy has been very helpful. And so my therapist, he's really invested into like, you know, helping me get through this grieving process. So he called and inquired.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] About my coverage, but they're saying I could only have like 5 visits for the entire year. And so I just want to know, is that true, or because he was like trying maybe you need to look into it because he's like maybe this is, I don't know, I've never had this type of insurance and I'm not trying to say it's bootleg but it sounds like it and for me it's.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] No, no, I completely understand. Yes, that's very valid and before we go any further, I am very sorry for your loss, but I'm glad that you are going to therapy. I know how helpful that can be, um, so this policy is very different, um, than most, I guess I'd say like traditional, um, medical.
[AGENT][NEUTRAL] Policies, so this is as it's called a limited indemnity medical plan. So with that being said, it is very limited um also uh doesn't have a copay or a deductible, um, but it just pays like a set dollar amount per procedure or office visit.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, so that information that he gave me that he got was accurate. Um, office visits pay up to $75 per visit, and that is flat regardless of, um.
[AGENT][NEUTRAL] You know if it's just a consultation if y'all are just talking anything like that $75 and that is maximum of 5 visits per calendar year.
[CUSTOMER][NEUTRAL] OK, so, so, OK, you know what? I wish Creative Circle would have told me this. I probably wouldn't have took this contract, but there, because I have, I had, yeah, and I also had a surgery lined up. I tore my meniscus, so I'm not walking, and they were like, oh yeah, no problem. So I literally just left another contract where I, it would have paid for my whole operation and so now.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I understand. I completely understand.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Oh goodness.
[CUSTOMER][POSITIVE] Now they put me in a position where if I don't get the surgery, he told me that um it looks like I almost broke my leg and it's bow legged and so if it heals, continues to heal like this, I might not be able to walk and I'll have arthritis. And so I am like when I'm seeing over the moon, like really feeling like.
[AGENT][NEUTRAL] Oh,
[AGENT][POSITIVE] Oh my gosh.
[CUSTOMER][NEGATIVE] They bamboozled me. I would have, they even said that's the reason why I even got I even took a 20,000 decrease because it's an opportunity just to work for Verizon and so I'm like really, really upset now so you're telling me that pretty much this won't even cover my surgery.
[AGENT][NEUTRAL] I, yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, there is a surgical benefit on here um but um can I ask, uh, before the coverage that you had before, um, who is that through?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you remember?
[CUSTOMER][NEUTRAL] How
[AGENT][NEUTRAL] OK, I'm not familiar with them. Was that also through your employer?
[CUSTOMER][NEUTRAL] I was.
[CUSTOMER][NEUTRAL] Yeah, like, everything would have been covered. I wouldn't have, I wouldn't have to pay for anything.
[AGENT][NEUTRAL] Yeah, um, it really does depend. I'm not sure what kind of surgery that would be considered, um.
[AGENT][NEUTRAL] Would they be doing, um, I'm sorry, you said like a broken leg and it just maybe didn't heal properly?
[CUSTOMER][NEUTRAL] It's a torn meniscus where it's like my knee shifted out to the side and so I'm not right now I'm walking with a cane and so I ended up having my surgery scheduled for December, then it was pushed out because my dad passed.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And then I put it to the [PII] and then I got this new contract and so they're telling me that my insurance wouldn't kick in until February. So what I did is I pushed it my surgery from January, which would have been covered under my own insurance because they, it was, it's my my surgery is supposed to be yesterday and it would have been covered because I have a 30 delay from my other job to this job, but because.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I'm not because I kept on asking what is this insurance? They're like, oh no problem, it's gonna cover it. I even told them what it was for. And so they were like, no, no problem, you're just you can call this number. It's gonna, it's really good insurance and then now it's, it's basically it's disrupting my whole entire life. My therapy is not covered now and it's like, are you kidding me?
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Oh my gosh.
[AGENT][POSITIVE] Yeah, I completely understand. Yeah.
[AGENT][NEUTRAL] Well, uh, regarding your surgery.
[CUSTOMER][NEUTRAL] And I'm already in the role.
[CUSTOMER][NEUTRAL] Pardon?
[AGENT][POSITIVE] Yeah, no, just so that you are aware, um, regarding your surgery, you do have surgical benefits. What I would recommend is because the, it goes down and there's a massive list of all kinds of different um surgeries. So just so that um I don't give you any incorrect information. If I were you, I would have your doctor give us a call.
[AGENT][NEUTRAL] Uh, so that they could tell us exactly what kind of surgery it's going to be, and then we'd be able to give more accurate information as to how much this policy would pay for that. I certainly don't want you to have to, you know, be in a rut or anything like that, but that way you can actually make an informed decision on, you know, what the best option is going forward.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So does this even cover like eyeglasses, eye exams, dental cleaning, like.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] So this plan is, this plan is strictly medical. Now you do have other policies with us.
[CUSTOMER][NEUTRAL] Pardon?
[CUSTOMER][NEUTRAL] OK, OK, I got another card, yeah.
[AGENT][NEUTRAL] Yes, um, you do have other policies with us. So this one is strictly medical. You've also got an accident policy, a critical illness, a term life, and a dental policy. No vision though, we don't offer vision.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So if you have vision that might be through a different carrier um I would ask your employer, oh OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No, I don't, yeah, I don't know. I honestly, I just think that I made the wrong decision.
[AGENT][NEUTRAL] Gosh, I'm so sorry. I hate that. And unfortunately we do hear that quite a bit. They're not always very open about coverages and such.
[CUSTOMER][NEUTRAL] I just think it's it's and it's like I've never experienced like a recruiting officer office like like this one before.
[CUSTOMER][NEUTRAL] Um, OK.
[AGENT][POSITIVE] I'm so sorry to hear that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, get, you know, give the policy a look, um, get in touch with your doctor, like I said, just so that you've got all of your ducks in a row.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So have my doctor, have my doctor call what number? What number directly should he call?
[AGENT][NEUTRAL] The same number, the same number you called the [PII], we talk to providers all the time, um, and we would be able to go, you know, of course they'd be able to let us know exactly like I said what kind of surgery it is so that we'd be able to give a more accurate amount for how much this would cover.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Gosh, I'm so sorry to have to weigh all this on you. Sounds like you're already going through it, plenty.
[CUSTOMER][NEUTRAL] It, yeah, it, it's what it is, right? You just gotta move forward.
[AGENT][NEGATIVE] I hate that saying, but.
[AGENT][NEUTRAL] I guess so.
[CUSTOMER][MIXED] Yeah, I hate it too, but then it's like when I relax in it and I say, you know what, like.
[AGENT][NEUTRAL] Yeah, I.
[AGENT][POSITIVE] Completely understand that.
[CUSTOMER][NEUTRAL] I'm still here and so I feel like vengeance, you know, like vengeance of the Lord, like I can only go with what people feel in their heart is intentionally.
[AGENT][POSITIVE] You're right.
[CUSTOMER][POSITIVE] Just good for me, you know, so.
[AGENT][POSITIVE] I understand and there it's, I've always, you know, and it's not always pleasant, but you know, sometimes things happen for a reason and that just means something better will happen. So I just don't want you to have to be in any more pain than necessary, but you know, things will work out one way or another, they will work out.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, I mean.
[CUSTOMER][NEUTRAL] Yeah, OK, and then for dental, what is this cover for, oh, you can, OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I can send you that policy as well. Let me go ahead and get that pulled up too.
[AGENT][NEUTRAL] And so for the, uh-huh.
[CUSTOMER][NEUTRAL] Do you know if it covers certain offices or do I like, do you know if how would you know if like, like I go to Smis [PII] and I don't know if this will cover.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So this plan um you can again I'd give them a call this plan participates in the Carrington PPO network so you can just simply ask the provider if they are within the Carrington network um but that's simply the PPO that they go off of it does not have to be within that network so even if they don't participate, that's OK that's just the fee schedule.
[CUSTOMER][NEUTRAL] Yeah well what?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Um, and again, same thing with them if there's any confusion, if they've not heard of us or they want to see, uh, specific things that might be covered, they are also more than welcome to give us a call and we'd be more than happy to explain it to them.
[CUSTOMER][POSITIVE] OK, OK, sounds good.
[AGENT][POSITIVE] All right, I will get the dental policy sent to you as well, [PII], just so you've got that again that kind of visual reference, um, and if something is confusing to you, you don't understand anything, um, feel free to give us a call back. We'll definitely do what we can to help.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I, and my next question, so this is not like other health benefits like Aetna, Health First, Blue Cross Blue Shield. So who do you guys, so you guys do.
[AGENT][NEUTRAL] No. No, they are not like traditional major medical.
[CUSTOMER][NEGATIVE] So who do you guys partner with because like I don't know if this is even gonna work for me.
[AGENT][NEUTRAL] So this, as I said, it is our policy. It is uh through American Public Life um this our medical essentially what we do is supplemental coverage, um, so you know like the dental, the accident, things like that, um.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Our health, the hospital indemnity plan, the medical plan, it does not have a set network like Blue Cross or Aetna, um, so it's gonna be kind of similar to the dental situation.
[AGENT][NEUTRAL] Where you know the wherever you go, the providers, it's essentially going to be up to them if they would file the claims for you or not you can technically receive treatment anywhere it's just going to be up to them if they would file the claims for you. That being said, if they don't or they say they don't accept it or something like that, you can still file those claims.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] So if there was like an emergency and you had to go somewhere right now and you already received the treatment and they said oh we don't take American Public Life, you can still file the claims with us.
[CUSTOMER][NEGATIVE] OK, OK, so how much is your, yeah, but how much is your full coverage medical cost because that's what I was told that I was getting. They did not say that it was supplemental, and it should be, it should be bad that they're, they're selling stuff that represent you guys, but they're misleading other people so it's not really affecting kind of their equity, it's affecting your equity by them partnering with you, get what I'm saying? It, yeah, it's bad.
[AGENT][NEUTRAL] Does that make sense?
[AGENT][POSITIVE] Yeah, you're absolutely right you are absolutely right, um, and just to clarify, uh, [PII], this was through your employer or was this through one of our agents, um, that gave you this information?
[CUSTOMER][NEUTRAL] This is uh
[CUSTOMER][NEGATIVE] This is through my employer Creative circle, but I just don't wanna be a whistleblower about them. I'm just letting you know that it for me I would never want somebody representing my company and misrepresenting the benefits, the solutions, or whatever, you know, just so that they can get somebody to work for them.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] Well, you're absolutely right. Um, well, and it's, it's that, that kind of expectation, yes, building that kind of expectation because you know, for some people this kind of plan is perfect, you know, like if they opt to take this kind of medical plan, it's perfect for them and that's great, but you know, there's other people that have other kinds of needs and priorities and you know it won't work for them. And so that's what again, I'm a very transparent kind of person and.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] I completely understand what you're going through and I cannot apologize enough.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I get it.
[CUSTOMER][NEUTRAL] Yeah, OK, so like, like do you guys have one that is full benefits like and how much is that a month?
[AGENT][NEUTRAL] We don't offer any kind of major medical like that, but this is gonna be the closest to major medical that we do offer. Again, most of ours are going to be considered more supplemental, um, and it also everything that we offer is going to be through employers or specific groups. So essentially it would boil down to whatever your employer offers.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Got you. OK.
[CUSTOMER][POSITIVE] Yeah. OK, thank you.
[AGENT][POSITIVE] Yeah, you're welcome. Uh, did you have any other questions for me? Again, I'm so sorry I can't help you further. All right, well, I did send, I sent both of those policies to you, um, you know, when you're filling up to it, give them a look, talk to your doctor, have them give us a call, um, we'll get everything, you know, clear cut and dry, and then, you know, you could see how you wanna proceed from there.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, that is it.
[CUSTOMER][POSITIVE] OK, OK, sounds good, thank you.
[AGENT][POSITIVE] All right yeah thanks for giving us a call. I sure hope you have a great rest of your day and a nice weekend.
[CUSTOMER][NEUTRAL] OK. You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye bye.