AccountId: 011433970860
ContactId: 45c975ba-4fbc-4eef-8078-8bae6c16c191
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 483320 ms
Total Talk Time (AGENT): 216076 ms
Total Talk Time (CUSTOMER): 240115 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/22/45c975ba-4fbc-4eef-8078-8bae6c16c191_20250122T17:25_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] calling. I had a couple of questions concerning my coverage with APL right now through my employer.
[AGENT][NEUTRAL] OK [PII], I can help you with your coverage. Can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is your policy number?
[CUSTOMER][NEUTRAL] Group number 21361.
[AGENT][NEUTRAL] OK, thank you and then the policy number it might say inpatient or outpatient certificate number.
[CUSTOMER][NEUTRAL] Yes, uh, both, well, let's see it says outpatient rather sorry, um, that, that number is 01.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] 678.
[CUSTOMER][NEUTRAL] 799 ML.
[AGENT][NEUTRAL] OK, let me pull that policy in real quick, sir.
[AGENT][NEUTRAL] OK, Mr. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you and then also for security reasons can you please verify your address, your phone number and your email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] Oh [PII], all right, it is. I know it's a [PII].
[AGENT][NEUTRAL] Ah
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], that's the address, um, the other was.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Email
[CUSTOMER][NEUTRAL] Let's see email [PII].
[AGENT][NEUTRAL] Thank you and then the number you gave me to call you back on if we're disconnected is that your cell phone?
[CUSTOMER][NEUTRAL] It is, yes.
[AGENT][POSITIVE] OK, thank you. I appreciate you verifying your policy for me, sir.
[AGENT][NEUTRAL] OK, let me take a look. um you said you had questions about your coverage. What kind of questions do you have, sir, that I can help you with?
[CUSTOMER][NEUTRAL] Well, I am, I am have just turned [PII], so what I'm going to do probably.
[CUSTOMER][NEUTRAL] Is go on Medicare, um, because my primary insurance has a $5000 deductible, um, which is very generous, yeah, the employer has been very generous covering um uh insurance through the years, but in order to keep the cost down for us employees, um, our deductible is very, very high as you can imagine, the higher the deductible, the less the premium would be.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh gosh.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] So that because of that 5000, I think I'm better off going on to Medicare and even though I was going to wait and my question is, is APL tied to private insurance and not available through Medicare?
[AGENT][NEUTRAL] Right, that's correct. Um, we only give policies for groups like, like your employer, uh, we do not do individual policies.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the Medlink policy that you have actually is not one that you can take with you when you leave the group.
[CUSTOMER][NEUTRAL] Mhm right OK now if I am trying to compare apples to apples here and choosing basically a supplemental through Medicare, I realize that's not where your expertise may be, but I'm just curious I'm getting prices that would cost me to get a supplemental policy.
[CUSTOMER][NEUTRAL] Outside, you know, through the government, um, Medicare now APL is there a way to find out what that is generally costing, um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I guess it's a group so it's gonna be less money is there any way to kind of figure out what that would cost me?
[AGENT][NEUTRAL] No, sir, um, the only thing that I, I can give you is what your premium is monthly for your policy you're paying $103.73 for your supplemental insurance monthly.
[CUSTOMER][NEUTRAL] 133.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] No, 1103, 103. Yes.
[CUSTOMER][NEUTRAL] 103.
[CUSTOMER][NEUTRAL] OK, which is, which is pretty decent compared to some of the others that I've been looking at too. So, um, does is APL currently with my this med link that I have, does that have a deductible?
[AGENT][NEUTRAL] Let me look and see.
[AGENT][NEUTRAL] No sir, you don't have a deductible um and this is just to verify your coverage is not a guarantee of payment there's not a deductible on this policy because this policy actually helps with deductible co-pay and co-insurance.
[CUSTOMER][NEUTRAL] Uh, 11 more time you're cutting out a little bit sorry about that.
[AGENT][NEUTRAL] I apologize, so there's not a deductible on this policy because this policy actually helps with deductible co-pay and co-insurance.
[CUSTOMER][POSITIVE] Correct, yes it does, and it has in the past which I am grateful for, um, OK, is there a cap that APL, uh, caps at per year?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] For my coverage.
[AGENT][NEUTRAL] Right, yes, sir. So, um, for inpatient care, if you go into an inpatient more than 18 hours in a hospital and you're admitted, uh, your benefit amount is $5000 to go towards the deductible co-pay or co-insurance.
[AGENT][NEUTRAL] And then for outpatient calendar year your benefit amount is $3000 to go towards the deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK, all right, so they will pay up to, uh, let's say outpatient um for walk-in clinics, uh, for medical, uh, clinics and that if I had a, um, I had a colonoscopy, I believe APL kicked in for that because it was a base an outpatient um procedure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Yes, sir.
[CUSTOMER][POSITIVE] OK. All right. Very good. All right, I think that's, yeah, yeah. Uh-huh. Go ahead.
[AGENT][NEUTRAL] So the way it works,
[AGENT][NEUTRAL] The way it works is your your primary insurance, your main insurance, they are billed first.
[AGENT][NEUTRAL] And what they send us the explanation of benefits after they've paid their part of.
[AGENT][NEUTRAL] The claim, the explanation of benefits is sent to us, and then we pick up the second part as far as the deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK, alright, very good. All right, well I think I guess uh my answer is.
[CUSTOMER][POSITIVE] Is, um, or my question rather is answered, uh, as far as being able to carry over into, um, government, um, insurance, the Medicare system. So, well, I thank you so much for, for your help. um I certainly appreciate it.
[AGENT][POSITIVE] Well you're very welcome [PII] and we appreciate you being an APL customer and I hope that you are able to find your secondary insurance and that it's at a good price for you.
[CUSTOMER][POSITIVE] Thank you. Me too. OK. All right. Thank you so much. OK. Bye-bye now.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] You're welcome, sir.
[AGENT][NEUTRAL] Bye bye.