AccountId: 011433970860
ContactId: 5c0fad42-0e2b-4718-9ec5-54eed0b451de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 213880 ms
Total Talk Time (AGENT): 100280 ms
Total Talk Time (CUSTOMER): 96574 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/5c0fad42-0e2b-4718-9ec5-54eed0b451de_20250121T23:01_UTC.wav
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[AGENT][NEUTRAL] Contacting. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] that it was.
[CUSTOMER][NEUTRAL] Hi, good afternoon. I wanna get some information about this policy that we supposedly got. Um, I didn't know we had signed up for it in the open enrollment.
[CUSTOMER][NEUTRAL] Um, can you explain to me how it works and how we, um, apply online, uh, this, we got supplemental medical expense certificate of insurance.
[AGENT][POSITIVE] Yes, I can certainly help with that. And do you have your policy there with you?
[CUSTOMER][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] And what is that policy number, please?
[CUSTOMER][NEUTRAL] Um, not sure what kind of number is it? I have, it's just says group issue and then a number, then it says med links.
[CUSTOMER][NEUTRAL] FM Florida and then a P.
[CUSTOMER][NEUTRAL] 20563. I'm not sure.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK, there should be a number uh down at the bottom that says uh either um inpatient or outpatient. It may begin with a 01 or 02.
[CUSTOMER][NEUTRAL] I have a 025822777.
[AGENT][NEUTRAL] 77. Thank you. If I could verify your name, uh date of birth, and a phone number, please.
[CUSTOMER][NEUTRAL] Yeah, this account is under my husband's name. I'm on it also. My name is [PII]. His name is [PII].
[AGENT][NEUTRAL] And your, if I could just verify your date of birth and a phone number, please?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you. It looks like
[CUSTOMER][NEUTRAL] I did apply online.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh, actually I got a, uh, I got a, oh, I see, uh, the card, the card.
[CUSTOMER][NEUTRAL] Yeah, I see that in hospital not patient benefit I downloaded the card.
[AGENT][NEUTRAL] Yes, that's, that's fine. Um, and, uh, your policy looks like it went into effect on [PII], and what this is is it's a secondary or gap insurance and it's meant to pick up the deductible, co-payment or co-insurance for in and out of hospital. And the way that this policy works is that if you have any sort of inpatient or outpatient hospital um services, if you go to the urgent care or the ER.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] What it will do is that, or if you have an in-hospital stay, what it does is it picks up the deductible co-payment or co-insurance that you would normally have out of pocket um for outpatient services up to $500 per calendar day.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] For inpatient services that's anytime you're in the hospital for 18 hours or more, up to $2500. But that is what the, the policy does. It's, is for inpatient or outpatient services.
[AGENT][POSITIVE] And it picks up that deductible co-payment or co-insurance that you would normally have out of pocket.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][MIXED] OK, but it doesn't cover um pharmacy and it does not cover copays like when you go to the doctor.
[AGENT][NEUTRAL] No, no, this is strictly for inpatient and outpatient hospital only.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, is there, is there any
[CUSTOMER][POSITIVE] Well, I appreciate your help.
[AGENT][NEUTRAL] Is there anything else at all that I can help you with with your policy?
[CUSTOMER][POSITIVE] No, no, that'll be all. Thank you for your time, ma'am. Have a good day.
[AGENT][POSITIVE] OK, thanks for contacting APL. Have a good day.