AccountId: 011433970860
ContactId: 488323f2-071f-448f-af20-5a42fc2bd6cd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1150609 ms
Total Talk Time (AGENT): 245771 ms
Total Talk Time (CUSTOMER): 383489 ms
Interruptions: 4
Overall Sentiment: AGENT=0.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/488323f2-071f-448f-af20-5a42fc2bd6cd_20250107T19:03_UTC.wav
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[AGENT][NEUTRAL] APR, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], how are you? My name is [PII]. Um, good, good. Hey, so I was calling because, um, I currently have gap through you guys through my job, and, um, I'm currently at the doctor's appointment and they're asking me for like uh a member's ID or maybe like a, a card or something.
[AGENT][POSITIVE] I'm good how are you? Hi.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I don't have that with me, so.
[AGENT][NEUTRAL] OK. Spell your last name [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Is that one word or two words?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, give me just a second to search by your name, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And the spelling of your last name is [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] When did your coverage become effective, [PII]?
[CUSTOMER][NEUTRAL] Um, I don't know, I did it in the beginning of November, I guess, I don't know.
[CUSTOMER][NEUTRAL] I did it through my job when they had the opening, the opening listing.
[AGENT][NEUTRAL] OK, who is your employer?
[CUSTOMER][NEUTRAL] Uh, Bo and automotive.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you mind if I search by your social security number?
[CUSTOMER][NEUTRAL] Um, sure.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any other, other different way maybe cause I, I don't have my card with me. I'll have to see if I can get my hands on it.
[AGENT][NEUTRAL] Yeah, it's either by your name or your social um and what's your group name again, your employer's name?
[CUSTOMER][NEUTRAL] Bombing automotive.
[AGENT][NEUTRAL] Spell the first
[CUSTOMER][NEUTRAL] And my first name is [PII].
[AGENT][NEUTRAL] Spell the first name of the employer.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Automotive. OK, let me search under the group name and see what I can find.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you have a card, you just don't have it with you is that what I'm understanding?
[CUSTOMER][NEUTRAL] Alright, correct, and I need the member's ID because I'm currently at a at a.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Understood.
[CUSTOMER][NEUTRAL] At an appointment.
[AGENT][NEUTRAL] Understood.
[AGENT][NEUTRAL] And you are the policyholder?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Do you know when your effective date was?
[CUSTOMER][NEUTRAL] I'm not sure, ma'am. I don't know, like I said, I paid it two months ago, so I'm pretty sure as soon as I paid it, it should have came into effect right away.
[CUSTOMER][NEUTRAL] I'm already paying for it, so I'm, I'm pretty sure it's starting to affect.
[AGENT][NEUTRAL] Yeah, I'm looking at the group roster and I don't see your name listed so you may have become effective one.
[AGENT][NEUTRAL] Were you effective in 24 or 25?
[CUSTOMER][NEUTRAL] 24.
[AGENT][NEUTRAL] 24, OK.
[AGENT][NEUTRAL] One second.
[CUSTOMER][NEUTRAL] November.
[CUSTOMER][NEUTRAL] And when they first did the, the enrollment thing, it was supposed to take effect in December.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Here in my, when I go to my job, it says S gap 6350-EMP only and it says ongoing.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I'm getting charged every year.
[AGENT][NEUTRAL] Yeah, I, I believe you. I'm just trying to locate it so I can give you the card, get the card for you.
[CUSTOMER][NEUTRAL] Unless you I'm gonna tell you my last name again maybe.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yeah, I have it. I have [PII].
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Correct, you have one P or two pieces?
[AGENT][NEUTRAL] One
[CUSTOMER][NEUTRAL] Yeah, correct. [PII] elephant, S as in Sam, P as in Pablo, A as in Apple, U as in Umbrella, and X as in X-ray.
[AGENT][NEUTRAL] Roger that. That's what I have.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just bear with me here for just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] So that's right, right.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You're at the doctor's office right now, [PII].
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Were you able to find it?
[AGENT][NEUTRAL] I'm not showing you listed under that group. Give me a second.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So I don't want to.
[CUSTOMER][NEUTRAL] To do it
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] What did you get for [PII]?
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] I am conferring with a different area, uh, [PII], what time is your appointment?
[CUSTOMER][NEUTRAL] It's already done. It was supposed to be [PII].
[AGENT][NEUTRAL] I'm sorry, what time is it?
[CUSTOMER][NEUTRAL] It is currently [PII]. I mean it was at [PII]. I'm sorry, it was at [PII].
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] OK, what time is it your time?
[CUSTOMER][NEUTRAL] [PII] and it's [PII] right now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there, OK, because I'm gonna have to uh make find out some more information and give you a quick call back if I can do that.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] The thing is that it's ridiculous because I've been paying already for the past 2 months and the fact that I'm not showing up, it's, it's pretty crazy, you know, because it shouldn't be this hard.
[AGENT][NEUTRAL] I understand.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] And you are the policy holder, right? You're the cardholder?
[CUSTOMER][NEUTRAL] I'm the policy holder. I do it through my job. I'm already been getting charged for the past two months, so I, I, I.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I get it. I'm just trying to make sure all of my boxes are are checked because I'll be asked these questions.
[CUSTOMER][NEUTRAL] Would, would it, would it make it easier for you if I give you my social? Would it save you more time?
[AGENT][NEUTRAL] I can check it under your social in case we have it, yeah, I can check it under your social.
[CUSTOMER][NEUTRAL] OK [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, so we have it under your first name spelling is [PII] [PII] So I did locate it, that's what the difference is.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Give me a second.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Verify your date of birth for me please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what's your complete mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your email address on file?
[CUSTOMER][NEUTRAL] Um, I believe it should be my job. [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] What's your your personal address? It looks like it's a Gmail account that we have.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] P A U X
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Your last name?
[AGENT][NEUTRAL] Your last name?
[AGENT][NEUTRAL] Yes, that's what I have to have. We have a Gmail account on file. Do you want me to update it to the one you just gave me?
[CUSTOMER][NEUTRAL] But the
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Really
[AGENT][NEUTRAL] All right, I just emailed you the identification card. I'll hold the line to make sure you did receive it and are able to open the PDF attachment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And there should be an E in your name, right?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] [PII].
[CUSTOMER][POSITIVE] [PII]
[AGENT][NEUTRAL] [PII], no [PII], OK.
[AGENT][NEUTRAL] That was my bed.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, I got it. The identification cards.
[AGENT][NEUTRAL] Yes, make sure you can open it.
[CUSTOMER][POSITIVE] OK, perfect. I believe it should be this one. Just give me one second. Let me make sure with them and um give me one minute, OK?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK. Hello?
[AGENT][NEUTRAL] Yes, I'm here.
[CUSTOMER][POSITIVE] Yes, so everything went good. They said they're they're gonna reach out to the company just to make sure everything's good.
[AGENT][NEUTRAL] OK, very good. Do we need to verify benefits for them for you?
[CUSTOMER][NEUTRAL] They said that they need to verify benefits.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] They said that if they need to verify benefits with you.
[CUSTOMER][NEUTRAL] Yeah, that's what they're gonna call for, or can she do it with you? Oh, never mind, they have to call from the work.
[AGENT][NEUTRAL] [PII], what type of service is it? Is it for a doctor's visit today?
[CUSTOMER][NEUTRAL] I said the dermatology.
[AGENT][NEUTRAL] What type of service is it today?
[CUSTOMER][NEUTRAL] A skin tag?
[AGENT][NEUTRAL] A what?
[CUSTOMER][NEUTRAL] A skin tag removal?
[AGENT][NEUTRAL] OK, a treatment. OK. And is that gonna be done like in a specialist office or is it being done at a hospital?
[CUSTOMER][NEUTRAL] It's uh Miami Children's Hospital.
[AGENT][NEUTRAL] OK. Yeah. We can provide the outpatient benefit if we need to, while we have you here on the phone.
[CUSTOMER][NEUTRAL] She said she could provide the outpatient benefit to the phone if that's OK.
[CUSTOMER][NEUTRAL] She says she won't be able to use personal phone.
[AGENT][NEUTRAL] OK. All right. So they can call us back.
[CUSTOMER][NEUTRAL] Yeah, they said that they have to call to work on him.
[AGENT][NEUTRAL] Understood.
[AGENT][NEUTRAL] Any other questions I can assist with today, [PII]?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] No, that'll be all. So it, it would, it would, the gap would take care of it, correct?
[AGENT][NEUTRAL] You do have outpatient benefit. It's up to $500 per calendar day, so it's a daily benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Of course information is just a verification, not a guarantee.
[CUSTOMER][NEUTRAL] She, she's saying if they need to send it out to the lab, do I need to pay for it?
[AGENT][NEUTRAL] What was that? I'm sorry?
[CUSTOMER][NEUTRAL] She said that if I need to take it out to the lab, do I have to pay for it?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So like an independent lab?
[CUSTOMER][NEUTRAL] Independent lab?
[CUSTOMER][NEUTRAL] She said yeah.
[AGENT][NEUTRAL] So you do not have the independent labrider under your policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I it's through the hospital, it still goes to independent or does it go directly to
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, they said they send it out to a private.
[AGENT][NEUTRAL] So they'll send it off to an independent laboratory?
[CUSTOMER][NEUTRAL] Yeah, independent laboratory, right?
[CUSTOMER][NEUTRAL] Independent you said? Yeah.
[AGENT][NEGATIVE] Yeah, so if they send it to an independent laboratory and that laboratory send us a bill, it's not gonna be covered because you do not have that writer, that lab writer under your policy. If it's billed with a hospital charge.
[CUSTOMER][NEUTRAL] Can.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Then it could be considered.
[CUSTOMER][POSITIVE] OK, perfect. And then that they would explain that everything to her when she calls now correct?
[AGENT][NEUTRAL] We'll provide the outpatient benefit.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] Perfect, so she'll have to call and you guys provide her with that correct?
[AGENT][POSITIVE] We'll provide her with the outpatient benefit, yes.
[CUSTOMER][NEUTRAL] a
[CUSTOMER][POSITIVE] OK perfect alright thank you.
[AGENT][POSITIVE] All [PII], thank you for calling APL. Have a good day, right?
[CUSTOMER][POSITIVE] You too bye bye thanks bye.