AccountId: 011433970860
ContactId: 509f9649-1d48-4b25-958f-8ee6e3bec820
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2818620 ms
Total Talk Time (AGENT): 1162640 ms
Total Talk Time (CUSTOMER): 468115 ms
Interruptions: 3
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/509f9649-1d48-4b25-958f-8ee6e3bec820_20250612T13:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], good morning. Uh, my name is, uh, [PII], and I was calling to see what benefits I have for you guys.
[AGENT][POSITIVE] I can help you with benefits. Uh, can I get a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And do you have your policy number with you?
[CUSTOMER][NEUTRAL] Uh, no, I don't.
[AGENT][NEUTRAL] Is it alright if I look you up by your social?
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] And what is that?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] Alright, can you spell your last name for me?
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][NEUTRAL] You said first name was [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Give me just one more moment. My computer's going a little slow this morning.
[CUSTOMER][POSITIVE] It's all good.
[AGENT][NEUTRAL] And what state are you calling out of?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I live in [PII], but it was through [PII] that's where my job is.
[AGENT][NEUTRAL] OK, let me see here.
[AGENT][NEUTRAL] And what is your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the address that we have on file for you?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Let me see here.
[AGENT][NEUTRAL] Which benefits were you wanting? Because you have, it looks like 4 policies with us.
[CUSTOMER][NEUTRAL] Uh, I wanna know all of them. I can't.
[AGENT][NEUTRAL] Oh, OK, uh, well, one is short term disability. Let's go through your secondary gap first.
[AGENT][NEUTRAL] Let me go ahead and pull that up real quick.
[AGENT][NEUTRAL] I will say I am seeing that we have an email on file, so if you ever need your policy documents or um another member ID card or your um.
[AGENT][NEUTRAL] If you need your policy number, you can always uh go to [PII] and create an online portal account and from there you'll be able to access all of your documents, um, and file a claim and check claim status.
[AGENT][NEUTRAL] So I just wanted to put that out there while. Mhm.
[CUSTOMER][NEUTRAL] Can you can you send that to me? is that possible to send to me in an email that?
[CUSTOMER][NEUTRAL] Information
[AGENT][NEUTRAL] Sure, give me just one moment, let me go ahead and do that now while we're on the phone.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you verify that I have the email correct? What is your email address?
[CUSTOMER][NEUTRAL] Um, it's probably under a [PII].
[AGENT][NEUTRAL] Uh, it would be a personal email.
[CUSTOMER][NEUTRAL] Oh, it's uh [PII].
[AGENT][NEGATIVE] All right, let me fix it because that's not what we have.
[CUSTOMER][NEUTRAL] OK, what did you what did y'all have?
[AGENT][NEUTRAL] Hey [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][NEUTRAL] OK. And so what is the new one?
[CUSTOMER][NEUTRAL] Uh, it's my first name and last name, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I went ahead and updated that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, give me just a second to get that document in here for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I just sent that out to you. Now let's look at your benefits.
[AGENT][NEUTRAL] And for your Medlink policy, it's secondary gap insurance so you will need to whenever you file a claim.
[AGENT][NEUTRAL] Uh, you or your provider file a claim, we will need to have the, your primary insurance explanation of benefits showing that they paid, uh, some benefits first.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull up the benefits for this.
[AGENT][NEUTRAL] Alright, and I'll just go over some basic benefits with you. Um, this is also just a verification of benefits and not a guarantee of payment. It looks like you have an an inhospital benefit maximum of up to $2500 per calendar year.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] An outpatient benefit maximum of up to $250 per calendar day.
[AGENT][NEUTRAL] Uh, $0 in hospital and outpatient deductible, $0 emergency room deductible.
[AGENT][NEUTRAL] This plan does help cover co-insurance, co-pay, and co-deductible. So sometimes your um benefits will go towards paying your deductible, so just keep that in mind.
[CUSTOMER][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] It looks like you have a cancer outpatient treatment writer.
[AGENT][NEUTRAL] An independent lab facility rider, which means that if you ever need to go to an independent lab facility to get um lab work done, that's covered. And you have a durable medical equipment writer, so, um, you might hear it called DME. So anytime the doctor um gives you medical equipment, certain medical equipment is covered under this policy as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like you have a maximum of up to 30 days of treatment.
[AGENT][NEUTRAL] Uh, for either urgent care, surgery in an outpatient hospital, diagnostic testing.
[AGENT][NEUTRAL] Um, in an outpatient facility or MRI facility, outpatient treatment for a mental or emotional disorder in a hospital, physical therapy, and ambulance.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] And so that is your Medlink policy. Do you have any questions on that one before we move on to the next one?
[CUSTOMER][NEUTRAL] Basically that's like secondary insurance, right? So I would, I would do my primary insurance first and then.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I would submit whatever is left to
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] You guys afterwards correct?
[AGENT][NEUTRAL] Right, and so typically after you bill, yeah, after you bill your primary insurance, they end up, they will send you an explanation of benefits or send your hospital depending on who's filing the claim. They will send you an explanation of benefits showing what was paid and what wasn't or if all of it was paid, and then you'll file a claim through this um policy and you'll need that explanation of benefits so that we know what was picked up.
[CUSTOMER][NEUTRAL] Is that how that works?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I will say that if, mhm.
[CUSTOMER][NEUTRAL] OK, so like, so I wouldn't give, go ahead, go ahead.
[AGENT][NEUTRAL] Oh, I was just gonna say, so if your primary insurance denies anything, uh, this one will deny it as well. It has to be covered at least partially by your primary.
[CUSTOMER][NEUTRAL] OK, got you, um, so then this wouldn't be something where like I would, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I can get the doctor's office obviously they'll have my primary, but then also give them this or this insurance that this would be something that I would have to buy separately.
[AGENT][POSITIVE] Yes, yes, you'll wanna give them this too.
[AGENT][NEUTRAL] Well, they can do it for you on your behalf as well. Yeah, you'll just tell them that this is secondary, yeah. They typically, a lot of times they'll call ahead of time and check and make sure that you're eligible and check benefits, um, typically before any appointments. Uh, it just depends on the, the provider.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] Oh, OK, yeah, OK.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you. OK, um, so and this, and this can be used for like if I have a injury or something like that outside of work and it's not workers comp related, um, this can use like supplementally to help.
[CUSTOMER][NEUTRAL] Help me out kind of thing, right?
[AGENT][NEUTRAL] Right. You do have an ambulance benefit and a hospital emergency room benefit, um, depending on what it is, I will say you do have a group accident one too that we'll go over, um, in a moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, got you, alright.
[AGENT][NEUTRAL] But yeah, but yeah this is this is anything related to those.
[CUSTOMER][NEUTRAL] OK, like, so like I, I had a, uh, or uh.
[CUSTOMER][NEUTRAL] I had a knee injury at work, and this was a while ago and if it starts to like, or like I, if I'm out of work and I'm just like at the gym or whatever, I hurt my other knee.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So it wouldn't be covered by workers' comp. This would be
[CUSTOMER][NEUTRAL] I could use this to help instead of using my or on top of my primary insurance, right?
[CUSTOMER][NEUTRAL] Is that, am I understanding that correctly?
[AGENT][NEUTRAL] It should um so when you go create your online account.
[AGENT][NEUTRAL] And you fill out the paperwork for that since you do have several different insurance or several different policies with us like a group accident and short term disability, they will typically once they review your records, they'll see, they'll try to see which one it will go for, um, which policy it will go towards, so you don't have to worry about.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Yeah, if you're filing under the wrong claim, so sometimes you might see it denied, but it'll look in, we'll look in another or another policy and see if it works. Uh, it just depends on the type of injury that you're, that you're talking about mhm because it might, it might fall under the other ones. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I got it, yeah.
[CUSTOMER][NEUTRAL] OK, got you. OK, cool, that clears that up. All right, so that's that one and that that's got the cancer in it too?
[AGENT][NEUTRAL] Yes, it does have a cancer treatment writer in it.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] All right, um, can the cancer one be used on a cancer that I've already had, or is it only able to be used on a new cancer?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Let me look at that.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Alright, this is just for treatment, so let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said this also all this is like in my uh.
[CUSTOMER][NEUTRAL] Online so like when I create a portal I can access all this stuff and it tells me everything but it covers and whatnot, correct?
[AGENT][NEUTRAL] Right, you'll go to.
[AGENT][NEUTRAL] On your dashboard you'll go to my policy and it'll have all of your, you'll be reading the policy certificate.
[AGENT][NEUTRAL] And um when you get to your policy certificate, you will look at the schedule of benefits and that gives a breakdown like what I just gave you and then there's also um exemptions, how to file a or there's exemptions and definitions so if you're ever unsure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. Let me see.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] And I still have not received that email yet. I don't know if it should have come through already.
[AGENT][NEUTRAL] Um, let me see if it bounced back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, give me just one second.
[CUSTOMER][NEUTRAL] We
[AGENT][NEUTRAL] Alright, let's see if it went through this time.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] It doesn't specify. Let me see real quick because it's not specifying that it has to be.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, that's fine.
[AGENT][NEUTRAL] Yeah, it didn't specify that it had any preexisting condition writer or clause in there.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Right, are we ready to move on to the next one?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Yes, yes, go ahead.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, that was your Medlink policy. Let's go to the next one.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] The next one is your group accident policy.
[CUSTOMER][NEUTRAL] The next
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this is one that whenever you get the time, you will want to look at because it has um set amounts for uh various injuries.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, I'm looking at 12.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] About 2 full pages of just different um injuries that could happen, um, such as dismemberment, what type of dismemberment, and how much we'll pay.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Again, this is just a verification of benefits, not a guarantee of payment. Um, some of these are, that are included are a hospital admission benefit. You get up to $1500 for hospital admission.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, if you're admitted into the ICU, you get the same amount, 1500.
[AGENT][NEUTRAL] It has things such as dislocation of a knee, you get $3600.
[AGENT][NEUTRAL] Dislocating a wrist, $900.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] OK, now, is any of this stuff like do they have preexisting conditions like if I already had a previous wrist or knee injury?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] It looks like it needs to have been while this policy was active.
[AGENT][NEUTRAL] Let me double check.
[CUSTOMER][NEUTRAL] OK, does it tell you when the policy became active? I think it was a while ago or should have been the first of this year, I think.
[AGENT][NEUTRAL] It it was it was [PII].
[AGENT][NEUTRAL] Yeah, I believe it needs to be while you, while your uh policy was active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Um, you do have some other benefits such as an accident screening benefit of up to $100. You're allotted, uh, one of those.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] If you have an accident and you go and you need the ambulance, uh, we pay up to $500. If you get treated in an emergency room, $300.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Physical therapy, $75.
[AGENT][NEUTRAL] If you need an X-ray for.
[CUSTOMER][NEUTRAL] Is this like a one time?
[AGENT][NEUTRAL] Um, I believe physical therapy and let me see.
[CUSTOMER][NEUTRAL] Like a is that a one time?
[AGENT][NEUTRAL] I believe it's 10 days, but give me just one moment and I'll look that up.
[AGENT][NEUTRAL] For yours, um, it says physical therapy must begin within 90 days and rendered within 365 days after the accident occurs, and it's payable up to 5 days per plan year.
[AGENT][NEUTRAL] So you get 5 visits under this policy. Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, got you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Right. Do you have any questions about this one?
[CUSTOMER][NEUTRAL] That's just the accident one correct?
[AGENT][NEUTRAL] Right. This one is pretty cut and dry. It tells, it has a bunch of different types of um accidents um that are covered and how much we'll pay for them.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Yeah, so unless there's like a very like, yeah, unless there's a specific one, I don't think you want me reading two pages' worth of accidents to you.
[CUSTOMER][POSITIVE] OK, cool.
[CUSTOMER][NEUTRAL] Yeah, no, I'll, I'll, whenever I still have not gotten the email, but whenever I get it, I'll, uh, I'll get on there and read it up.
[AGENT][NEUTRAL] Still,
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Yeah, um, do you, so do you have, do you have my name and do you have my email correct?
[AGENT][NEUTRAL] Yes, for whatever reason, it keeps adding.
[AGENT][NEGATIVE] Something to your name, and I don't know why it's doing that. It's putting an asterisk in front of you for some reason.
[CUSTOMER][NEUTRAL] Should be
[AGENT][NEUTRAL] Let me see what's going on here.
[CUSTOMER][NEUTRAL] OK, yeah, it should be A I D A N.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Why is it not working?
[AGENT][NEGATIVE] I'm not putting anything in the field, but it's putting something in front of your name every time and I don't know why.
[AGENT][NEUTRAL] Let me see if it works this time.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Alright, it should have worked this time.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, and that was group accident. Let's look at your short-term disability.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you don't see the email after this one, let me know and I'll, I'll have a colleague send it send the help guide to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Check my spam, make sure it's not going there.
[CUSTOMER][NEUTRAL] Hey
[AGENT][NEUTRAL] Right, and this is a, uh, for your short term disability, this is um a monthly amount.
[AGENT][NEUTRAL] Um, available from anywhere between $300 up to $7500 in $50 increments. Let me see.
[AGENT][NEUTRAL] It looks like your disability benefit will be $7000 not to exceed 60% of your monthly compensation.
[AGENT][NEUTRAL] So that is monthly?
[CUSTOMER][NEUTRAL] OK, what's the what.
[CUSTOMER][NEUTRAL] OK, what, what does it mean by monthly compensation like my, uh, my pay, my normal pay for my job?
[AGENT][NEUTRAL] Right, so if you are unable to work and we, uh, after you fill out the form, claim form and your disability gets accepted, I'm sorry, uh, approved, you will get um a sum of $7000 each month. It's typically around the [PII] of the month, um, and you'll get $7000 since you're unable to work.
[AGENT][NEUTRAL] Um, with your short term dis yeah, with your short term disability, uh, the first time you go on disability, you will fill out a claim form that says insured's statement, which would be you, your employer's statement, which um you will send to your employer and they will fill it out and send it to either you or to us, and then it might say um
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Subscriber or provider's statement or a physician's statement and then your physician will put in there when you are not allowed to work anymore, um when they expect you to be back at work. And I will say once that gets um approved, every month you'll fill out the insured's uh portion. So every month you'll need to send in the yeah. So you'll need to send that in in order to get your payment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] Um, it looks like you also get a maximum, oh, go ahead.
[CUSTOMER][NEUTRAL] OK, is it so.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Is it, is it prorated to like, say I get injured like today and I'm out of work for
[CUSTOMER][NEUTRAL] You know, I don't know, let's say 2 weeks.
[CUSTOMER][NEUTRAL] Um, then.
[CUSTOMER][NEUTRAL] If I submit the claim, then that does that mean that I'll only get paid like a percentage of the $7000 that would be for the two weeks?
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] And also do you know if it's taxed?
[AGENT][NEUTRAL] I do not know if it's taxed. Um, I would imagine it is just because it's um a payment.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] But I'm not 100% on that. I can ask real quick.
[CUSTOMER][NEUTRAL] Hey
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] You should get paid from the moment your um physician had told you.
[AGENT][NEGATIVE] That you were unable to work and we got that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Hey
[AGENT][NEUTRAL] Cause I don't believe you get a lump sum, um, if it's going, if you're getting, um,
[AGENT][NEUTRAL] Back rated since it will, it takes a couple of weeks sometimes for it to get processed. I believe.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Um, it'll be half and half, I believe, but I'm looking at your policy right now.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like you will let us know on the disability claim form if you want it pre-tax or not.
[CUSTOMER][POSITIVE] Got you OK.
[CUSTOMER][NEUTRAL] And again, so if I'm, if I'm receiving workers' comp, I can, I, I can't use this correct?
[AGENT][NEUTRAL] You will want to put it on your disability claim form because it will ask um if you're making, if you're getting any other payments, um it'll ask for your uh income sources while on disability.
[AGENT][NEUTRAL] So I, yeah, I'd still fill out the form and fill out the claim form and then just, yeah, and then turn it in.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] You still fill it out? OK.
[AGENT][NEUTRAL] Um, just make sure that you include all of that in there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, does, um, see here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, is there a certain amount of time that you have to be off in order for it to, to kick in? Like, is it like something you have to be out for?
[CUSTOMER][NEUTRAL] Two weeks prior to being able to use it or is it something that like.
[CUSTOMER][NEUTRAL] As soon as your doctor's like, hey, yeah, you're gonna go to work, you can start using it.
[AGENT][NEUTRAL] As soon as your doctor, um,
[AGENT][NEUTRAL] Put you on, uh, where you're not allowed, where you're not able to work and they'll put that in their physician's statement. And that's when your benefits will start kicking in. Yeah, and it will end on the day, uh your doctor states that you're able to return to work unless they provide, unless, um, if you ever have a change.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Whenever you go see your provider and they say that you need to either come back to work early or you need to come back to work late, they will need to fill out a new physician statement and depending on when they tell you that you can come back to work, that's when the benefits will end.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][POSITIVE] All right, um, I think that's the short term disability. I think I understand that pretty good now.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, and I think we have one more.
[AGENT][NEUTRAL] It looks like.
[AGENT][NEUTRAL] Let me pull it up.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, and it looks like you do have a uh separate cancer policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And so that would be the last one. Let me see.
[AGENT][NEUTRAL] It looks like you're allotted a diagnostic test for cancer screening, a maximum of up to 1 test per calendar year, and you'll get the benefit amount of $100 towards that test. Um, if you have, if you need any follow-up diagnostic testing for cancer screening, you're allotted up to one of those per year for the same amount of $100 towards that.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you need any sort of medical imaging, uh, you will get up to $500 per test with a maximum of 2 tests per calendar year following the diagnosis of cancer.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] You do have a surgical benefit that goes up to $6000 per operation. I will say, um, and this is for all of your policies, you will want an itemized receipt or an itemized bill with procedure codes, especially for this one, because a lot of these will go based off of the procedure code and how it's billed, and that's how we, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Determine what benefit to use. So you will need the itemized bill for that. It looks like you do get anesthesia covered for surgery up to 25% of the amount that they bill you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, you have a stem cell transplant, a maximum of $1200 and that's for a lifetime?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You have radiation therapy, chemotherapy, and imm immunotherapy, um, a maximum covered per 12-month period up to $15,000 and that's in a 12-month period. So say you get your first radiation treatment in June, it will be June to June.
[CUSTOMER][NEUTRAL] Got you, OK.
[AGENT][NEUTRAL] All right. And you also have hormone hormone therapy. Um, you get up to $50 per treatment with a maximum of 12 treatments per calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, and there's more. It looks like you also have a hospital confinement. You get $100 per day of confinement. Confinement typically means 18 hours or more.
[AGENT][NEUTRAL] Looks like you have an outpatient facility benefit of $200 per day. The surgery is performed.
[AGENT][NEUTRAL] You're allotted home healthcare, um, up to $100 per day.
[AGENT][NEUTRAL] For the same number of hospital confinement days. So if you were in the hospital for 18 days, you'll get 18 days of home healthcare.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And then you've got, it looks like you also have um some other benefits related to this, um.
[AGENT][NEUTRAL] You have transportation and lodging benefits, family transportation and lodging benefits.
[AGENT][NEUTRAL] Um, ambulance benefits.
[AGENT][NEUTRAL] Inpatient and outpatient, special, special nursing services benefits.
[AGENT][NEUTRAL] Uh, medical equipment benefits.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Uh, physical, occupation, speech, or audio therapy or psychotherapy benefits up to $25 per visit.
[AGENT][NEUTRAL] If you have an internal cancer, you get a lump sum benefit of up to $10,000 per lifetime, and that's for the first occurrence. So when you are first diagnosed with an internal cancer, and you'll get a lump sum of $10,000.
[AGENT][NEUTRAL] That's a one time only.
[CUSTOMER][NEUTRAL] OK, and again this is and this is um a.
[CUSTOMER][NEUTRAL] Uh, benefit that is only applicable.
[CUSTOMER][NEUTRAL] Uh, if I get cancer after I start the policy, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You also do have a heart attack and stroke benefit on here.
[AGENT][NEUTRAL] So should you get a heart attack or stroke, um, you're allotted $10,000 as a lump sum, and that's also a one-time, uh, per lifetime.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then should you need a hospital intensive care, uh, you get a an intensive care unit of up to $600 per day.
[AGENT][NEUTRAL] And then your step down unit, you get $300 per day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then it looks like you do have some like a
[AGENT][NEUTRAL] Hairpiece, drugs and medicine.
[AGENT][NEUTRAL] Um, you do get, uh, for drugs, you get an outpatient per prescription of $50.
[AGENT][POSITIVE] And then you also have a prosthesis um benefit as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have any questions on this one?
[CUSTOMER][NEUTRAL] Alright, um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you hear me?
[AGENT][NEUTRAL] Yes, I can hear you.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Oh God.
[CUSTOMER][NEUTRAL] So OK, the short term, um.
[CUSTOMER][NEUTRAL] Is so if I get injured outside of work and it's not covered or I guess even if it is at work.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You're saying to just for it anyway and then see what they cover if they cover anything.
[AGENT][NEUTRAL] Yes, I would, um, I, I would personally do that just because it's better safe than sorry. Um, the worst that can happen is it gets denied. Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I got you and then if I use any of these benefits is my uh monthly payment like.
[CUSTOMER][NEUTRAL] My rate or is that going, going to increase?
[AGENT][NEUTRAL] Uh, just for using the benefits?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It shouldn't um that would be up to your employer because they you're if you're getting this through your employer they have the premium rates but not just because you use it.
[CUSTOMER][NEUTRAL] OK, um, and then I guess last question if I leave my job.
[CUSTOMER][NEUTRAL] Can I keep this policy and pay for it myself and or transfer it to a new job?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me look. I'll need to look at each of them individually. Um, what you'll look for in your policy certificate is it's called portability.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And so, um, it looks like for your cancer one, you do have a portability rider. Um, so, portability just means that you can always transfer out of from your employer and pay for it yourself.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] So your cancer one does have a portability rider. Let me look at the others real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] I'm not seeing a portability writer for your secondary gap.
[AGENT][NEUTRAL] You'll need to contact your employer for that one, but I'm not seeing it in your secondary gap, that Medlink policy we first went over.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look at your group accident one.
[AGENT][NEUTRAL] It looks like you may have portability coverage on your group accident one. You'll need to get with your employer on that one specifically, but you should be able to, um, I'm not seeing it as an exemption, but you'll need to talk with your
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Employers specifically for that one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I, I don't think short term disability transfers over. Let me look.
[AGENT][NEUTRAL] Yeah, I don't think your short term disability ports. So your group accident and your cancer policy will port. You will need to get with your employer um beforehand for that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, um,
[CUSTOMER][NEGATIVE] And I still have not gotten the email.
[AGENT][NEUTRAL] Alright, let me have someone else send it to you give me just one moment.
[AGENT][NEUTRAL] Alright, am I doing it right? [PII]
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Oh, it's with an [PII]
[CUSTOMER][NEGATIVE] It's that that's that's not correct it's AID.
[CUSTOMER][NEUTRAL] [PII] yep.
[AGENT][NEUTRAL] That's why.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] I apologize for that.
[CUSTOMER][NEUTRAL] Yeah, you're fine.
[AGENT][NEUTRAL] ID it keeps changing it. Let me just type it in myself.
[AGENT][NEUTRAL] All right, let's see if that worked real quick.
[CUSTOMER][NEUTRAL] Oh right yeah.
[AGENT][NEUTRAL] And if you don't see it, check your spam and see if that works.
[CUSTOMER][NEUTRAL] Nothing yet.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Oh, here we go care [PII].
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, yep, that is I got the email.
[AGENT][POSITIVE] Alright, great.
[CUSTOMER][NEUTRAL] [PII], right?
[AGENT][NEUTRAL] Yes, and it will be on that uh user guide too mhm.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Am I gonna need my policy number and stuff like that, or is, or is that in this email?
[AGENT][NEUTRAL] No, um, whenever you sign in you'll want to just fill up the uh the boxes that are required, which I believe is just last name, uh date of birth, and email address. You don't need to fill out the rest if you don't want to.
[AGENT][NEUTRAL] But then your policy numbers will be in there when you're done, yeah.
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] OK, I just didn't know if I needed it to create the account.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Awesome sounds good alrighty well that is very helpful and I do really appreciate your help.
[AGENT][NEUTRAL] Oh, anytime. Do you have any other questions?
[CUSTOMER][POSITIVE] No, I think I got everything. If I have more questions, I'll either call back or I'll get, I'm gonna get on that website later and, uh, sign up and go through everything.
[AGENT][POSITIVE] Alright well thank you so much for calling [PII]. I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][NEUTRAL] Alright bye.