AccountId: 011433970860
ContactId: 4efedd2e-998f-4857-b44b-bed042f44347
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 718049 ms
Total Talk Time (AGENT): 289777 ms
Total Talk Time (CUSTOMER): 169124 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/4efedd2e-998f-4857-b44b-bed042f44347_20250603T22:05_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I am calling to confirm that my insurance is active.
[CUSTOMER][NEUTRAL] When I called over the weekend, the representative said it wasn't, but my employer is showing it active on their end.
[AGENT][NEUTRAL] OK. Uh, do you have a policy number?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I don't have it offhand right now.
[AGENT][NEUTRAL] OK, I can look it up by your last name or your social.
[CUSTOMER][NEUTRAL] Uh my last name is [PII]
[AGENT][NEUTRAL] And first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, um, let's see here.
[AGENT][NEUTRAL] Uh, is the last three of your social [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I've got several policies active. Is there a particular one that you're wanting to check on?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I don't, American public life. Why are there so many?
[AGENT][NEUTRAL] Um, we've got, let's see.
[AGENT][NEUTRAL] Um, can you verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then your address and email address.
[CUSTOMER][NEUTRAL] My address is the [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] So it looks like it's through your employer, um, you have
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um, you have an accident policy, short term short term disability policy, dental group term life, and critical illness, and a hospital indemnity.
[CUSTOMER][NEUTRAL] OK, what about just like regular medical coverage? I mean, I don't know which one that falls under.
[CUSTOMER][NEUTRAL] Is that all with the, what's with American public life?
[AGENT][NEUTRAL] Those are all the policies that we administer. So when you go to a provider, you give them um our information and we'll confirm that you have coverage. Um, so under this, you don't have like a major medical like Blue Cross Blue Shield United Healthcare. These are all just like there's a hospital indemnity policy, it's a very limited medical policy.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Um, group accidents very specific to paying on, you know, specific diagnosis is related to accidents.
[AGENT][NEUTRAL] Um, short-term disability is
[CUSTOMER][NEUTRAL] So if I went to the emergency room.
[CUSTOMER][NEUTRAL] If I went to the emergency room, which one would I be submitting it through?
[AGENT][NEUTRAL] Um, let me see. So probably your hospital indemnity.
[CUSTOMER][NEUTRAL] Or if I went to
[CUSTOMER][NEUTRAL] In the
[AGENT][NEUTRAL] Um, I can send you your cards, um, for the policies.
[AGENT][NEUTRAL] The ones that have
[CUSTOMER][NEUTRAL] OK. Are you showing that they're active?
[AGENT][NEUTRAL] Uh yes. Let me make sure.
[AGENT][NEUTRAL] of each one.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So if I were to go get, want to go see my primary care physician.
[CUSTOMER][NEUTRAL] Which information would I be giving? Like which card would I be giving?
[AGENT][NEUTRAL] Well, it looks like.
[AGENT][NEUTRAL] We had one policy active, but it doesn't look like, let me look at these other ones.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] I have a group term life policy that is active.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Go and make sure
[AGENT][NEUTRAL] Are you still with the employer?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so your group
[CUSTOMER][NEGATIVE] And they switched companies, so then there was a lapse, a gap in my insurance. And then um when I was calling last week because I had a hospital visit, and they said nothing had been processed on their end and a representative from you guys said my insurance wasn't active.
[AGENT][NEUTRAL] Yeah, and I'm showing.
[CUSTOMER][NEUTRAL] But I'm
[AGENT][NEUTRAL] Your group term life is active. Let me see what else we have active.
[AGENT][NEUTRAL] Your dental policy is active.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] It's dental.
[AGENT][NEUTRAL] OK, so your hospital indemnity, which is like a limited hospital plan.
[AGENT][NEUTRAL] let me see if that's active.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] That one I don't show active. That one termed.
[AGENT][NEUTRAL] 427 25.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And which one is it?
[AGENT][NEUTRAL] It's a hospital indemnity policy.
[CUSTOMER][NEUTRAL] And is there a reason why that one would not be active anymore, but the others are?
[AGENT][NEUTRAL] Um, we get all the information from benefits in a card.
[AGENT][NEUTRAL] Um, so that's, I could transfer you over there to talk to them about it, um, but that's who sends us the eligibility for the policies.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so that, and that's where we received the information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and then it looks like, so your hospital indemnity term 427.
[AGENT][NEUTRAL] Um, the only thing I've got active is the group term life and the dental.
[AGENT][NEUTRAL] Sorry, we're in like a tornado tornado situation.
[CUSTOMER][NEUTRAL] It's their vision?
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Is there vision?
[AGENT][NEUTRAL] Uh, vision, um, we don't do the vision part, um, so if there is, you would have to check with benefits in a card.
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] I was asking about the primary care. Which one would I use for a primary care physician?
[AGENT][NEUTRAL] So that would be like your hospital indemnity. Um, and they'll pay a certain dollar amount for doctor visits, but that's the one that I show lapsed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, so,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, do you want me to transfer you, OK, do you wanna call them yourself or do you want me to?
[CUSTOMER][NEUTRAL] I have to call my employer.
[CUSTOMER][NEUTRAL] No, I just eat my own for.
[AGENT][NEUTRAL] Uh, OK, yeah, I would check with them on that because what we've received is that that policy lapsed, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you are sending emailing me those insurance cards.
[AGENT][NEUTRAL] I can send you the dental one. The dental one would be the only card that I have available. The hospital indemnity has a card, but it's lapsed, so I, I wouldn't have anything to say.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But I can, I can email you over your dental card.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And are you showing any claims that made an attempt to be processed?
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The girl.
[AGENT][NEUTRAL] I don't have any claims on your accident policy.
[CUSTOMER][NEUTRAL] It would have been on the indemnity policy before it lapsed.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEGATIVE] Because the emergency room said they sent the information to you guys, they just hadn't received anything and I'm trying to pay the bill.
[AGENT][NEUTRAL] OK, um, let me see what we received.
[AGENT][NEUTRAL] So yes, it looks like we received a a claim.
[AGENT][NEUTRAL] Uh, for [PII], uh, that was for [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] That one.
[AGENT][NEUTRAL] Let's see what.
[AGENT][NEUTRAL] That one we paid $90.
[AGENT][NEUTRAL] Let me see if I
[CUSTOMER][NEUTRAL] The total bill was like $6300.
[CUSTOMER][NEUTRAL] But you're not saying that.
[AGENT][NEUTRAL] Yeah, let me see if uh there's one more here. Let me check that that was.
[AGENT][NEUTRAL] OK, that was a
[AGENT][NEUTRAL] Just a duplicate. So no, I don't see, I do not see that. Um, and on your policy, this policy, um, which is not a guarantee of payment, just a basic outline.
[AGENT][NEUTRAL] This policy would have paid $350 maximum. That's the max that they will pay for the ER per day.
[CUSTOMER][NEUTRAL] So, for real.
[AGENT][NEUTRAL] Yeah, yeah, it's just.
[CUSTOMER][POSITIVE] Oh my gosh.
[AGENT][NEUTRAL] Uh, so it's a very long.
[CUSTOMER][NEUTRAL] Is there a better plan? Is there a better plan that I could have for transition to?
[AGENT][NEUTRAL] Um, you'd have to check with your employer, um, and see if they have other options available. Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, well thank you for your help.
[AGENT][NEUTRAL] OK. Anything else I can help with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thank you. You be safe.
[AGENT][POSITIVE] Thank you. Bye.
[CUSTOMER][NEUTRAL] Uh huh bye.