AccountId: 011433970860
ContactId: 48f8d6a2-76c5-445b-85a1-76d3480e203d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 649000 ms
Total Talk Time (AGENT): 253780 ms
Total Talk Time (CUSTOMER): 251064 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/48f8d6a2-76c5-445b-85a1-76d3480e203d_20250612T18:00_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I'm sorry, what was your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm with a company called Health Advocate. I have a [PII] on my back line. Uh, she has gap insurance and she needs to have an operation. I wondering how that would work. Can you assess?
[AGENT][NEUTRAL] Yes, ma'am. May I have a policy number?
[CUSTOMER][NEUTRAL] I do not have that, but I can give you their social or first name, last name, date of birth, whatever works for you.
[AGENT][NEUTRAL] OK, may I have a social?
[CUSTOMER][NEUTRAL] Sure can hold on one sec.
[CUSTOMER][NEUTRAL] OK, so is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. May I have a first and last name?
[CUSTOMER][NEUTRAL] Certainly there's two last names so it's [PII].
[AGENT][NEUTRAL] And date of birth.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Her date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. And is she able to verify it's OK for me to speak?
[CUSTOMER][POSITIVE] Yep, I have her on my back line. Absolutely. I, I have her on my back line, OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thanks. OK, [PII]'s actually holding. I'm [PII] on the line from the Gap Insurance. She's gonna be able to assist us further. I'm gonna be in the background in case you need, OK, OK, thank you, yep.
[AGENT][NEUTRAL] Hi [PII], how are you today?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] I'm great, thanks for asking. Can you please verify your date of birth, your mailing address, and your email, please?
[CUSTOMER][NEUTRAL] It's um [PII].
[CUSTOMER][NEUTRAL] Um, my mailing address just changed, so I'm not sure what your system is, but I think you guys have it as [PII].
[AGENT][NEUTRAL] No ma'am, that's.
[CUSTOMER][NEUTRAL] Um, in [PII], for OK, then it's [PII].
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, then you must have my employer's address because those are my only two addresses, um.
[CUSTOMER][NEUTRAL] It's and I don't even know it, is it, um, hold on, I can see if I can find it.
[CUSTOMER][NEUTRAL] Um, my email address is the.
[AGENT][NEUTRAL] We can update it.
[CUSTOMER][NEUTRAL] Yeah, because my, my address is [PII] now and prior to that, uh, do you have my [PII] address by any chance?
[AGENT][NEUTRAL] No, ma'am. It's in [PII].
[CUSTOMER][NEUTRAL] Oh, [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's my mail that's my mailing.
[AGENT][NEUTRAL] Would you like to leave it at that or update it?
[CUSTOMER][NEUTRAL] Yeah, that's, that's fine. You can leave it at that. That's my actual mailing address my physical address is different, but that's fine.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and then your email.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you and thank you for verifying that information. May I have a good call back number for you, [PII]?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you and how may I help you today?
[CUSTOMER][NEUTRAL] I'm just calling in regards to the gap insurance. Um, I'm just, I'm trying to understand how it works. Um, I have procedures that I have to pay pretty expensive out of pocket, and I'm just wondering if that's covered prior to the visit or if I have to submit the claim after or how it works.
[AGENT][NEUTRAL] OK, so please be advised that verification of coverage does not guarantee the payment of a claim. So this claim will follow your primary. It will pick up your co-pays, your co-insurance, and our deductibles up to the benefit amount. So when you see the provider, always present this card so they can bill as your secondary.
[CUSTOMER][NEUTRAL] OK, I never did get a card.
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] Is there a place that I can go? I've tried to log into APL and it doesn't allow me to log in.
[AGENT][NEUTRAL] Did you
[CUSTOMER][NEUTRAL] I keep saying like um.
[CUSTOMER][NEGATIVE] I, I went in and I created an account and then it says that I don't even know what it says it says that they're unable to find my my information basically.
[AGENT][NEUTRAL] Did it ask for your address?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] So if we have anything different. Did they ask for social security number?
[CUSTOMER][NEUTRAL] Yes, and I gave that.
[AGENT][NEUTRAL] OK, let's see, and it's the same in our system as which we had. I just want to make sure everything matches.
[AGENT][NEUTRAL] And you went to [PII]?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] Secure.
[CUSTOMER][NEUTRAL] And then I click sign in and then I.
[CUSTOMER][NEUTRAL] And then I created uh is it the OSC account?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Which is online service center. I, I tried that and I did insured.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I could try it again.
[CUSTOMER][NEUTRAL] It just ask my last name, my social, the zip code, and the email.
[AGENT][POSITIVE] Now, on your last name, we have it hyphenated. That would make a difference as well.
[CUSTOMER][NEUTRAL] OK. I just changed it to make it hyphenated.
[CUSTOMER][NEUTRAL] So, OK, so can I, is there a way to print out a card there then on online?
[AGENT][POSITIVE] Yes ma'am, yes ma'am, you can upload a card there and I will actually go in here and email one over to you as well.
[CUSTOMER][NEUTRAL] Yeah, it says error we could not create a new account with this information. Please reach out to the system admin that's what I did yesterday.
[AGENT][NEUTRAL] OK. OK. So I can get you over to
[AGENT][NEUTRAL] The customer service team they can assist you with that, but I'm gonna send this one over via email to you so you'll have a copy of your ID card.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, let's see. So I got that going over to you and.
[AGENT][NEUTRAL] Did you have any questions on your benefits, benefit amounts?
[CUSTOMER][NEUTRAL] Um, what is the maximum amount?
[AGENT][NEUTRAL] For your inpatient, the max allows $5000. For your outpatient calendar year, it allows $1000. You do have a 300 deductible for any services rendered in the emergency room.
[CUSTOMER][NEUTRAL] For your
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][NEUTRAL] Would you like me to transfer you to customer service?
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEUTRAL] OK, one moment, I'm gonna place you on a brief hold and I'll get you over.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling American Public Life. You're so welcome, [PII]. Have a great day.
[CUSTOMER][POSITIVE] Thanks, [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] You also, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Quick connect customer support.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] in claims. How are you?
[CUSTOMER][POSITIVE] Hi [PII], I'm doing well. How are you?
[AGENT][NEUTRAL] I am great, thanks for asking. I have an insured along with uh [PII], who's a health advocate on my back line. She is needing help to get into her online service center. She's tried everything. I've verified the name, so, mail, everything we have matches what she's entering and she still can't access it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, uh, so those transfers are actually supposed to go to the care team and they're supposed to assist them with getting into the OSC.
[AGENT][NEUTRAL] And I asked was the care team and the customer service the same and they said yes. OK, I'm sorry, let me try this again.
[CUSTOMER][NEUTRAL] OK, who it's OK. Who, who said yes and I can make sure we try to get it cleared up because the.
[AGENT][NEUTRAL] It was, it was someone on the care team because I had a call this morning.
[CUSTOMER][POSITIVE] OK, OK, I'm sorry about that. The um customer service support is supposed to be for like call escalations, but I'll reach out and see if I can get some some somebody to clear that up so I'm sorry for the confusion.
[AGENT][NEUTRAL] Yeah, oh.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK. No worries. Thank you. I appreciate it.
[CUSTOMER][POSITIVE] No problem. Thank you, [PII].
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] in claims. How are you?
[CUSTOMER][POSITIVE] Good. How are you?
[AGENT][POSITIVE] I'm great. I have an insured on the line who's having issues getting into her online service center.
[CUSTOMER][NEUTRAL] OK, what's her name?
[AGENT][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] [PII], I'm sorry.
[CUSTOMER][NEUTRAL] That's OK. um, does she have a callback number?
[AGENT][NEUTRAL] Uh, yes, it is [PII].
[CUSTOMER][NEUTRAL] And what's your policy number?
[AGENT][NEUTRAL] 02597213.
[CUSTOMER][NEUTRAL] Can you verify her and everything?
[AGENT][NEUTRAL] Yes, ma'am. The address in our system, she wants that to stay. She does have a different physical address, but this PO box, she wants to stay.
[CUSTOMER][NEUTRAL] Oh, that's OK.
[AGENT][NEUTRAL] Yes, but she's verified.
[CUSTOMER][NEUTRAL] Alright you can send her over whenever you're ready.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][NEUTRAL] Bye.