AccountId: 011433970860
ContactId: 52e781df-45aa-44cc-860f-eb4f2cfb89f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 523217 ms
Total Talk Time (AGENT): 308325 ms
Total Talk Time (CUSTOMER): 158922 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/52e781df-45aa-44cc-860f-eb4f2cfb89f4_20250127T15:29_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] in customer service. How are you doing today?
[AGENT][POSITIVE] I'm doing fine [PII] how are you?
[CUSTOMER][NEUTRAL] I'm good. um, I have an insured on the line. He is calling, uh, wanting to see if he can use his insurance for a visit that he's having today, a doctor's visit. Can you look at his policy for me and tell him how to use?
[CUSTOMER][NEUTRAL] His benefits.
[AGENT][NEUTRAL] I sure can um go ahead and provide me the policy number.
[CUSTOMER][NEUTRAL] It is 254.
[CUSTOMER][NEUTRAL] 5006.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And um he's been verified.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK and.
[AGENT][NEUTRAL] Is that his phone number that's listed on the screen [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am and it's also the phone number that's on his account.
[AGENT][NEUTRAL] OK, and it's [PII] correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] All right. Thank you so much, Ms. [PII]. Have a good day.
[AGENT][NEUTRAL] I will take it from here.
[AGENT][POSITIVE] You too thank you so much.
[CUSTOMER][NEUTRAL] Mhm. Bye-bye.
[AGENT][NEUTRAL] Bye.
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Hey, how you doing?
[AGENT][POSITIVE] I'm doing well. Did I say your name correctly?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] All right. Uh, so, uh, Ms. [PII] transferred you over to me. She said she had some, you had some questions in regards to, uh, your coverage with us, with your hospital indemnity, um, and you're going to see a physician?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][POSITIVE] I'm about to go, yeah, I'm about to go see a doctor um just get a good checkup cause I'm feeling kinda like under the weather a little bit.
[AGENT][NEUTRAL] OK, so, um, so you are going to see them for a sickness and it's not like a well visit, is that right?
[CUSTOMER][POSITIVE] Yes ma'am, yes ma'am.
[AGENT][NEUTRAL] OK, alright, so are you familiar with your policy benefits under this plan?
[CUSTOMER][NEUTRAL] Um, no, ma'am. Um, that's why I'm trying to call and get information about it now because I gotta be in there. I gotta be in there at [PII], so I got them in my hands, so it's like 4 cards or something like that. Got the medical business verification because that right there and uh.
[CUSTOMER][NEUTRAL] APL management analysis or something like that.
[AGENT][NEUTRAL] OK, and did you check to see if this provider is in uh or is part of that multiplan network? do you know?
[CUSTOMER][NEUTRAL] Oh no, no, ma'am, I don't even know.
[AGENT][NEUTRAL] OK, so, um, do you have a copy of your ID card?
[CUSTOMER][NEUTRAL] ID card. I got, I got them right here. I got some cards right here, the medical bill verification cards, the ones you're talking about.
[AGENT][NEUTRAL] Yeah, um, yes, it's, it's a ID card and it should say at the top group is management analysis and utilization then it should have your name and then the policy certificate number of 02545006.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hello, um.
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] I think I, I don't see no 02. I'm looking right now.
[AGENT][NEUTRAL] If you're looking at
[CUSTOMER][NEUTRAL] Oh, I see like.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] I'm looking at um hold on for one second. I don't need no glasses but.
[CUSTOMER][NEUTRAL] I see a a pay ID number or something like that 64556 or?
[CUSTOMER][NEUTRAL] This one got OK, policy number is 025.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, 025.
[CUSTOMER][NEUTRAL] 45006
[AGENT][NEUTRAL] Yes, yes, sir. OK, so that's the correct card. So what you'll wanna do, um, Mr. [PII], you're gonna wanna see it the, um, right underneath, uh, there's a little bit, there's another line for the effective day, and then the plan type is limited hospital indemnity. Do you see that, um, on the bottom of the card where it says to locate a provider use that [PII].
[CUSTOMER][NEUTRAL] Yep, yep, I
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Or there's a phone number listed as well.
[CUSTOMER][NEUTRAL] It's both your phone number as well.
[AGENT][NEUTRAL] OK, so the doctor that you're going to see if I, I would advise you to just make sure that they participate with multi plan and I'll explain that a little bit more um to you. So this plan, um, just to let you know it is a verification of your coverage only, not a guarantee of payment. I have to read that to you. So under this plan it is limited, uh, it is limited benefits so it's a hospital indemnity plan now it does have an outpatient sickness benefit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, under this plan, which would cover you in the event you need to see a physician in a physician's office, an urgent care facility, emergency room, or clinic, OK?
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it does pay a limited benefit, so this isn't this, this insurance, it doesn't work like a major medical. So in other words, when you present that, when you present that card to that doctor's office, they're gonna probably go ahead and verify your coverage, but just to let you know, we will only pay a $75 benefit for that outpatient sickness visit with the doctor. That's why it's important, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's why it's important to see if they participate with multi plan because if they participate with multi plan they may be able to offer you a a discount because this insurance doesn't cover everything.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK, so you'll wanna check with that multi plan uh either the phone number or the website and just see if that doctor that you're seeing or that that facility you're going to participates with multi plan um and then when you present this card to them just tell them, um, it's part of the multi plan network um and is it possible that they can review it for um you know some sort of uh um.
[AGENT][NEUTRAL] Discount for that visit.
[CUSTOMER][NEUTRAL] OK, oh, OK.
[AGENT][NEUTRAL] Now, um, for that visit, like I said, there is a $75 benefit and we'll pay up to 5 visits per person per calendar year.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Now, did you have any other questions, Mr. [PII]?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh no ma'am. Oh no ma'am, no ma'am, um, then I again I got, I got, I know I got a dental car with y'all too, something like a dental.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I want, if I go to the dentist and stuff and get my tooth pulled and stuff, I could use to call a group voluntary dental.
[AGENT][POSITIVE] Yeah, you do have a dental plan with us as well, that's correct.
[AGENT][NEUTRAL] And do you have a copy of that ID card?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] Yes, and I got it right here. I got yeah I got it right here.
[AGENT][NEUTRAL] OK, now that 1 may have a little bit different just bear with me for one moment I'm gonna pull that up and look at it as well.
[AGENT][NEUTRAL] Just one moment please.
[AGENT][NEUTRAL] Now, um, with that, uh, dental plan, they, they follow that, uh, I don't know if you see at the top of that card, it does say that Carrington Solutions. So you should, uh, find, yeah, you wanna find a dentist that is part of that, uh, program, the Carrington.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] The Carrington, OK, I see it right now. Yeah, I see it.
[AGENT][NEUTRAL] And did you have any other questions?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh no, no, ma'am, no ma'am, I just want to just make sure my, um, if I go into the insurance card and they just want they just really want the insurance card, um, that I'm coming in there and that's it really basically that's it, yeah, they wanna see I got an insurance, insurance card.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, no, like I said, once you give them that card they're more than likely give us a call and just verify your coverage, um, but like I said, I want you to be aware of, you know, like I said, asking them about that multi plan, um, because this is, like I said, not a major medical insurance it's only gonna pay limited benefits, so you wanna make sure if they participate with multi plan that they can offer you a little, a little bit more savings um for that visit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, OK. Yes, ma'am. So, I, right, thank you too.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're so welcome, Mr. [PII], and good luck. I hope you feel better soon.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you for calling APL.