AccountId: 011433970860
ContactId: 4bf1a2bf-e7f3-4ab3-85c5-1176c40ade55
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 870580 ms
Total Talk Time (AGENT): 376856 ms
Total Talk Time (CUSTOMER): 210759 ms
Interruptions: 4
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/4bf1a2bf-e7f3-4ab3-85c5-1176c40ade55_20250225T22:39_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Hello, good afternoon. This is [PII] with APL. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, I just, uh, enrolled in there is, uh, hospitality, and I don't know what is the plan and, and what is my plan cover exactly.
[AGENT][NEUTRAL] I'm sorry, you're breaking up. Can you repeat again?
[CUSTOMER][NEUTRAL] I enrolled in group hospital insurance.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I want to know what is my plan cover?
[AGENT][NEUTRAL] OK, um, do you have the policy number?
[CUSTOMER][NEGATIVE] No, I don't have anything.
[CUSTOMER][NEUTRAL] Because I never use it, but I used it last week.
[AGENT][NEUTRAL] OK. um OK.
[CUSTOMER][NEUTRAL] If you want my social or
[AGENT][NEUTRAL] May I have
[AGENT][NEUTRAL] OK. First, let me have your name and a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] You want my social?
[AGENT][NEUTRAL] And your name and a callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] My phone [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, one moment.
[AGENT][NEUTRAL] OK, go ahead with the social.
[CUSTOMER][NEUTRAL] You want a social?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and Ms. [PII] for security, may I have the mailing address and email address on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's the email address?
[CUSTOMER][NEUTRAL] Last what you say?
[AGENT][NEUTRAL] The email address?
[CUSTOMER][NEUTRAL] Email address is [PII]. [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, let me pull your benefits and see what we have. OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] And you didn't never receive the policy certificate or any other information?
[CUSTOMER][NEUTRAL] No, I don't have any information include the ID, the ID card, because I have dental and vision, but I have card for them, but I don't have any insurance card for Group Hospital.
[CUSTOMER][NEUTRAL] And I don't know what is my plan cover. I don't know anything.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. OK, let's see what we can fix this.
[AGENT][NEUTRAL] Um, do you mind holding for me, Miss, um, [PII]?
[CUSTOMER][NEUTRAL] Yeah, sure, sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding and being patient for me, Miss [PII] OK, so, um, the group has requested for this policy to have online benefits like it's gonna be on all the paperwork is gonna be online, OK? So you will have to go to.
[AGENT][NEUTRAL] The website and register so you'll be able to get a copy of your benefit, OK? I can go ahead and give you a verbal today over the phone, but if you want to save um some documents of your policy, you have to go and register online, OK?
[CUSTOMER][NEUTRAL] Uh, what is the cycle to go to register.
[AGENT][NEUTRAL] OK, the website is [PII], like in the morning. OK, it's gonna be like in the morning AM, uh-huh, public.
[CUSTOMER][NEUTRAL] Hold on. Say again.
[CUSTOMER][NEUTRAL] AM
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What's that?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]? Oh, OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and then I like, I create an account.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yes, you will click on sign in it's gonna take you to another page and you're gonna create an account.
[CUSTOMER][NEUTRAL] OK, and then I will found my plan.
[AGENT][NEUTRAL] Yes, you will see your benefits and the information of your policy by double clicking the policy number which is going to be blue, OK?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, what about the ID card?
[AGENT][NEUTRAL] OK. For the ID cards, um, let me see. It looks like it's also gonna be electronically. So you, you're gonna see a little PDF on the right side. It's gonna be a PDF sign. Um, you're gonna click on that PDF and you're gonna get your um policy card electronically.
[CUSTOMER][NEUTRAL] P G S
[AGENT][NEUTRAL] Yes, it's gonna be a PDF file once you go in. Are you in front of the computer right now where you can register?
[CUSTOMER][NEUTRAL] No, no, I just, I just look at my phone. If you can just email me my ID card.
[AGENT][NEUTRAL] No, OK.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Oh
[CUSTOMER][POSITIVE] I will appreciate that.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And I will sign in now and create account.
[AGENT][NEUTRAL] Let me see because it didn't give me no information because everything is electronic. Um, let me try this one more time.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah, before the lady send me the ID card for the dental and vision.
[AGENT][NEUTRAL] Yeah, for the dental and vision, we do have the cards available for the medical part, it looks like everything is gonna be electronic, um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Mm.
[AGENT][NEGATIVE] It's not even giving me an image.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Yeah, I have no documents um.
[AGENT][NEUTRAL] Let me go ahead and send the request um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So as your experience, is this group uh hospital cover anything?
[AGENT][NEUTRAL] Yes, um, let me give you the benefits, and this is not a guarantee of payment, just a verification of coverage. So this one has a hospital admission benefit. The admission is if you're hospitalized, OK? Um, and that covers $500.
[CUSTOMER][NEGATIVE] Yeah, I'm hospitalized.
[AGENT][NEUTRAL] Uh-huh. Uh-huh.
[CUSTOMER][NEGATIVE] Last week, I'm, yeah, hospitalized last week.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. So it looks like this policy covers $500 the first time that you're hospitalized, and then it covers $100 daily up to 15 days.
[AGENT][NEUTRAL] If, um, if you had to be put on uh intensive care, then it covers $200 daily.
[CUSTOMER][NEUTRAL] I stayed 2 days in the hospital.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] OK, so that's $100 each day. And then um rehabilitation benefits is 1515 rehabilitation, um, days, and that's $100 each day.
[AGENT][NEUTRAL] Then you have um did you have any surgeries or any?
[CUSTOMER][NEUTRAL] I did the surgery, but outside the hospital and the dentist office, uh, so the dental insurance cover it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I'm staying in the hospital 2 days include CAT scan and you know.
[CUSTOMER][NEUTRAL] The antibiotic and something, you know, how much I have to pay 9000.
[AGENT][NEUTRAL] Yeah, the policy is a limited policy, so it doesn't cover uh just the amount that is stipulated on the policy, which is the $500 and $100 daily.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 500
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] $500 and $100 daily.
[CUSTOMER][NEUTRAL] Oh yeah, yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, and that's it.
[AGENT][NEUTRAL] Mhm. Yes, if you had a surgery in the hospital, then it will cover $500 of the surgery. Um, that's if the surgery took place in a hospital. If the surgery took place in a physician's office, it's $125.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The hospital, uh, preferred me to the, to the dentist office.
[CUSTOMER][NEUTRAL] Because they can't do the surgery in the hospital, yeah. But, but the dental insurance cover it.
[AGENT][NEUTRAL] Yeah, if it's dental is not covered.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Yeah, so, yeah, that one, so it looks like that's gonna be the benefits that you probably will utilize right now about the policy, but you also have like an ER visit, you have $100 for an ER visit. You have $100 for an urgent care, um, $100 for an office visit, and that, that is one time per covered person per calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then you have um let's see.
[CUSTOMER][NEGATIVE] No, I went to the ER in the hospital and then they asked me to stay overnight because I have aggressive infection.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh, OK. So it was not for accident, it was for an infection, so it's health related. OK, so yeah, the, the benefit then is gonna be the first part that I mentioned, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, but if you wanna look at all the benefits on your policy and or have a copy for you and just keep it, um, you can go ahead and uh go to our website and register so you can get that information, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, is there anything else I may help you with today, Miss?
[CUSTOMER][POSITIVE] No, thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] In the