AccountId: 011433970860
ContactId: 5b730399-00bd-45bb-aa45-911c72ff752c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 848000 ms
Total Talk Time (AGENT): 326382 ms
Total Talk Time (CUSTOMER): 242711 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/5b730399-00bd-45bb-aa45-911c72ff752c_20250404T21:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII]. I have a couple questions actually, um.
[CUSTOMER][NEUTRAL] But, uh, one, sorry, one sec.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, one of my first questions is, my wife's pregnant and I just wanna see what, um,
[CUSTOMER][NEUTRAL] I guess what you guys or what my benefits would cover.
[AGENT][NEUTRAL] OK. All right, [PII], I can help you with your benefits. Can you please give me your policy number?
[CUSTOMER][NEUTRAL] Sure, that is 02309898.
[AGENT][NEUTRAL] OK, and that's 023098-998?
[CUSTOMER][POSITIVE] Correct, yeah.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK, and [PII], can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] Thank you sir and then I'll need you to verify your policy. Can you give me your date of birth?
[CUSTOMER][NEUTRAL] Yes, it's uh [PII].
[AGENT][NEUTRAL] Thank you and is your address, phone number and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] Uh, well, I recently moved, so I, I don't know if my policy was changed through my employer, but, uh, we can try my old address which is [PII].
[AGENT][NEUTRAL] OK, and you're no longer at that address, is that correct?
[CUSTOMER][NEUTRAL] That's correct. Um, do you need my new
[AGENT][POSITIVE] What's your new address? Yeah, I'll get it updated for you.
[CUSTOMER][NEUTRAL] Yeah, it's like
[CUSTOMER][NEUTRAL] Oh, thank you. Uh, it's [PII].
[CUSTOMER][NEUTRAL] [PII], and then the zip code is [PII].
[AGENT][NEUTRAL] OK, thank you very much. I'll get that updated and then what is your email address and your phone number that we have on file?
[CUSTOMER][NEUTRAL] Email address and phone number or?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, so the, the phone number is [PII] and uh I believe the email address I used is [PII] or it could be [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you. I appreciate you verifying your policy. First, let me go ahead and get this address fixed for you.
[AGENT][NEUTRAL] It's gonna be just a sec while I fix it.
[AGENT][NEUTRAL] OK, I think I've got that address updated. Let me make sure it's stuck.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I've got you fixed on your address, [PII].
[AGENT][NEUTRAL] OK, and this.
[CUSTOMER][NEUTRAL] No, um, uh, before.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Questions, um, with the address change, am I gonna need a new card, policy card, or will, is that all internal?
[AGENT][NEUTRAL] It's all internal, um, I can mark the policy to send you a new card.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] No, it's OK. I was just kind of curious.
[AGENT][NEUTRAL] That's your new address? Oh, OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] All right. So, um, you're calling because you wanna get your benefit breakdown because your wife um is having a baby, then congratulations.
[AGENT][NEUTRAL] Uh, we have, and this is just to verify your benefits. It's not a guarantee of payment. So on the first day of hospital confinement.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, the policy pays $1500.01 time a year.
[AGENT][NEUTRAL] And then you also have a, yes, sir.
[CUSTOMER][NEUTRAL] Is
[CUSTOMER][NEUTRAL] Oh, sorry. Is there, is there prenatal care?
[AGENT][NEUTRAL] Let me, I'm gonna pull up your whole policy certificate and see what it says.
[CUSTOMER][NEUTRAL] Like all
[AGENT][NEUTRAL] It's gonna be just a minute while the computer pulls it in.
[CUSTOMER][NEUTRAL] Just me.
[AGENT][NEUTRAL] OK, let me find your schedule of benefits. Um, OK, so this policy is a hospital indemnity plan. It's a limited hospital indemnity plan. Um, you have a daily hospital benefit of $100.
[AGENT][NEUTRAL] Uh, you have, let's see, wellness and diagnostic of $250.
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] You have an outpatient.
[CUSTOMER][NEUTRAL] Is this, is this
[CUSTOMER][NEUTRAL] Is this include like, this is just general, this has nothing to do with like uh like prenatal care or, or pregnancy?
[AGENT][NEUTRAL] No, sir. I don't see that on, um, now, if she goes into the hospital to have her baby, yes, you have um hospital benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So like nothing like uh an ultrasound or?
[AGENT][NEUTRAL] I'm sorry, can you repeat the question?
[CUSTOMER][NEUTRAL] Yeah, yeah, no worries. Uh, so nothing, is there anything that would all uh like cover like ultrasounds or lab work?
[AGENT][NEUTRAL] Yes, that's diagnostic benefits.
[CUSTOMER][NEUTRAL] Oh, OK. 2.
[AGENT][NEUTRAL] That, yes, sir.
[AGENT][NEUTRAL] Yes, that's diagnostic.
[CUSTOMER][NEUTRAL] And that's 250 a day.
[AGENT][NEUTRAL] Uh, let me look and see what your policy reads.
[AGENT][NEUTRAL] OK, so, um,
[AGENT][NEUTRAL] It's a wellness, OK, it's a diagnostic testing benefit per test is $250.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That that that's how much they cover or is that how much I pay?
[AGENT][NEUTRAL] Uh, and the maximum benefit for diagnostic testing is.
[CUSTOMER][NEUTRAL] Hello? It, it sounds like you're cutting out. Are you there?
[AGENT][NEUTRAL] Sure
[AGENT][NEUTRAL] So that $250 can you hear me?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEGATIVE] No, you, you cut out. I couldn't.
[AGENT][NEUTRAL] I can't hear.
[AGENT][NEUTRAL] I'm sorry. OK, so the diagnostic testing benefit is $250 and that's per test.
[AGENT][NEUTRAL] So even if the test is less than $250 it'll still pay $250. If the test is more than $250 it only pays $250.
[CUSTOMER][NEUTRAL] OK, OK, that makes sense. OK.
[AGENT][NEUTRAL] And um so your hospital confinement benefit, that first day that um she goes into the hospital to have the baby, it will be a payment.
[AGENT][NEUTRAL] A benefit payment of $1500.
[AGENT][NEUTRAL] And that's paid one time a year for a hospital stay on that first day.
[AGENT][NEUTRAL] And then you have a daily confinement benefit that pays $100 per day while she's in the hospital.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Got you OK.
[AGENT][POSITIVE] And then, um, there's a wellness benefit.
[AGENT][NEUTRAL] That pays $25.
[AGENT][NEUTRAL] For the test, any wellness test.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes sir I can hear you.
[AGENT][NEUTRAL] Wellness exam and or test.
[CUSTOMER][NEUTRAL] Oh, OK, and what, what.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][POSITIVE] Got it OK.
[CUSTOMER][NEUTRAL] I do have one more question on that subject.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Um, does any of the, any of my benefits cover like, let's say, a home birth?
[AGENT][NEUTRAL] Uh, let me look and see.
[CUSTOMER][NEUTRAL] Or midwife.
[AGENT][NEUTRAL] I'm scrolling through to see if I can find anything that will cover for that.
[AGENT][NEUTRAL] Do you guys are you guys signed up on the online service center?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I'm not, no, my wife's on my plan, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Through the website, it's kind of.
[CUSTOMER][NEUTRAL] Typical
[AGENT][NEUTRAL] Oh, OK, got you. All right. I'm looking to see if there's any.
[AGENT][NEUTRAL] Anything in here that mentions at home.
[CUSTOMER][NEUTRAL] Or midwife services.
[AGENT][NEUTRAL] Um, so far, I'm not seeing anything that mentions home.
[AGENT][NEUTRAL] Yeah, it's just hospital.
[CUSTOMER][NEUTRAL] Gotcha. OK. Nothing on midwife?
[AGENT][NEUTRAL] No, sir. Nothing on midwife.
[AGENT][NEUTRAL] I looked for both home and midwife and I did not see anything in the policy.
[CUSTOMER][NEUTRAL] OK, um, that's OK. I just, I'm kinda curious about that, um, and it's good to know about the other stuff.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Alignment, um.
[CUSTOMER][NEUTRAL] Yeah, so I do, that brings me to my next question actually. Um, I was, I went to the urgent care back in uh [PII].
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] And I, I just got, I guess they, they finally came to conclusion on my, my bill, um, however, I, I am seeing like quite a bit of discrepancies on a lot of their line items as far as like what things cost. I'm seeing duplicates of the same item but at different prices, uh, but there's a lot of adjustments with IMA Inc and
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I'm not really too who that is and as well as provider private pay and all that stuff. I'm just kind of curious what I should do in this scenario.
[AGENT][NEUTRAL] OK, so the phone I'm sorry, the phone cut out for a moment. I can give you a phone number to call for IMA and I can go ahead and transfer you over to them so that they can check uh that claim those benefits for you um.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] The number to IMA is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you would choose
[CUSTOMER][NEUTRAL] What was the option you cut out.
[AGENT][NEUTRAL] Option one.
[CUSTOMER][NEUTRAL] OK and you said you can transfer me to?
[AGENT][POSITIVE] Yes, I can now if you would like for me to.
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEUTRAL] OK alright well I'm gonna get you on over to IMA. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] Um, no, that'll be all. Thank you very much.
[AGENT][POSITIVE] OK, well, you guys have a wonderful weekend and congratulations on your baby. Thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome, sir. Bye bye.
[CUSTOMER][POSITIVE] Thank you for calling IMA.