AccountId: 011433970860
ContactId: 5dcbd91c-8609-4918-ba00-50d6e6b24f7c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1076839 ms
Total Talk Time (AGENT): 510049 ms
Total Talk Time (CUSTOMER): 465401 ms
Interruptions: 16
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/5dcbd91c-8609-4918-ba00-50d6e6b24f7c_20250404T17:30_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII].
[CUSTOMER][NEUTRAL] Um, my company has, um.
[CUSTOMER][NEUTRAL] Gave us new insurance on [PII] and I applied for the APL coverage, the gap insurance.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I have dental and I have eyes and I don't have any information yet.
[CUSTOMER][NEGATIVE] On any of these cards that I never got in the mail yet.
[CUSTOMER][NEUTRAL] And I was wondering if you could help me or.
[CUSTOMER][NEUTRAL] How could I look at it online?
[AGENT][NEUTRAL] I can help you with that, Ms. [PII]. What is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Um, I'll give you my cell phone number [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, I can look your policies up by your social. Is that OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that number, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] What I don't have any numbers yet like I didn't get anything in the mail.
[AGENT][NEUTRAL] Yeah, what about your social? I can look it up by your social.
[CUSTOMER][NEUTRAL] Oh my social.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you mind verifying your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] I want.
[CUSTOMER][NEUTRAL] I'm gonna give you all this information.
[CUSTOMER][NEUTRAL] Like you don't have anything?
[AGENT][NEUTRAL] I just need to verify that, yeah, I just need to verify your information that we have it correct.
[CUSTOMER][NEUTRAL] In the computer?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Would that be OK?
[CUSTOMER][NEUTRAL] Not really because I just gave you my social security number, so everything should pop up.
[AGENT][NEUTRAL] OK. What about your current mailing address?
[AGENT][NEUTRAL] The reason I'm asking is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because they're gonna email uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And we go through that process to protect your information to make sure that this is in fact you to um not just someone calling in trying to get information. Not that that happens, we just wanna take every precaution.
[CUSTOMER][NEUTRAL] Yeah, usually I would usually I would just give the last 4 numbers of my number. I never gave my whole number out.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Your last name is [PII]
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now, what you have with us, Ms. [PII], is a secondary gap policy.
[AGENT][NEGATIVE] We don't have your dental or vision, that's gonna be through another company.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Beef first OK.
[AGENT][POSITIVE] Yeah, so this is gonna be a medical policy that will help assist you um with your deductibles and co-pays of your major medical.
[AGENT][NEUTRAL] Now we do have a portal if I can either email you a copy of your card or if you would prefer, now we'll have to have an email on file which I do not, but you can create an account online if I if you wanna give me your email address and I can, you can, I can give you that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you can create it.
[CUSTOMER][NEUTRAL] OK, I'll give you my personal email.
[AGENT][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] It's, it's, it's [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Would you like for me to email you a copy of your card?
[CUSTOMER][POSITIVE] Yeah, that'd be perfect and then could you help me set up the portal thing so I know what I'm doing?
[AGENT][POSITIVE] I'll be happy.
[AGENT][POSITIVE] Absolutely, absolutely, so.
[CUSTOMER][POSITIVE] Thank you so much [PII].
[AGENT][POSITIVE] Oh, it's my pleasure and if you will go to you are you at a computer now?
[CUSTOMER][NEUTRAL] Yeah, I have APL up on the screen.
[AGENT][NEUTRAL] OK, so you're gonna go into.
[CUSTOMER][NEUTRAL] And like um,
[AGENT][NEUTRAL] Log in as a new user.
[CUSTOMER][POSITIVE] Mhm good.
[CUSTOMER][NEUTRAL] And but it it it asks me, am I an individual with APO insurance employer or group?
[AGENT][NEUTRAL] You're gonna be an individual.
[CUSTOMER][NEUTRAL] Agent broker.
[AGENT][NEUTRAL] You're gonna choose the first option. Mhm.
[CUSTOMER][NEUTRAL] Individual, OK, so, OK.
[AGENT][NEUTRAL] Now it is gonna require that you put in your social.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I'm gonna put in my first name first.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I need to do.
[CUSTOMER][NEUTRAL] Is it just a big order or is it?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] From.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] How many lines is over.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] It says oops there seemed to be a problem. No user was found with information that was entered.
[AGENT][NEUTRAL] OK, let me try something. Hang on just a second.
[CUSTOMER][NEUTRAL] I OK.
[CUSTOMER][NEUTRAL] Oh, my date of birth is [PII], I guess that's why.
[CUSTOMER][NEUTRAL] I have to put in 02.
[AGENT][NEUTRAL] Yeah, we have 0802-1961 is what we have on file.
[CUSTOMER][NEUTRAL] I don't know why 21 came up.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that's what it is, but when I manually did it, it popped up.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so it says create account, so usernames could I put in as my email address? Could I do that?
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yeah, that's it.
[AGENT][NEGATIVE] It cannot, it cannot be your complete email address.
[AGENT][NEUTRAL] But it can be a portion of the email.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It could be a portion and it has to be upper character and one symbol.
[AGENT][NEUTRAL] That's the password. The, the, um sorry, that's your, yeah your username could be anything. Password will have to have.
[CUSTOMER][NEUTRAL] Oh that's the password.
[CUSTOMER][NEUTRAL] Oh my username could be anything.
[AGENT][NEUTRAL] Yeah, except it can't be your complete email like it could be the first portion of your email prior to the a symbol.
[CUSTOMER][NEGATIVE] really long
[CUSTOMER][NEUTRAL] take over.
[CUSTOMER][NEUTRAL] OK, I'll just um.
[AGENT][NEUTRAL] And then you
[CUSTOMER][NEUTRAL] And my email password I'll put in.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] That has to be one lower one upper case, one number, one symbol.
[CUSTOMER][NEUTRAL] Some of the time.
[CUSTOMER][NEUTRAL] Wearings.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Overwhelming.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] In your position.
[CUSTOMER][NEGATIVE] It's way too much.
[CUSTOMER][NEUTRAL] a
[CUSTOMER][POSITIVE] Your account has been successfully created, so I'll put log in.
[AGENT][NEUTRAL] And I just
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] So I'll put in my username now.
[CUSTOMER][NEGATIVE] do better
[CUSTOMER][NEUTRAL] Myself a cheerleader.
[CUSTOMER][NEUTRAL] Oh, you can receive claim status update text messages, OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, it looks like I'm in.
[AGENT][NEUTRAL] OK, so once they have your policy certificate completed, you'll be able to click on that policy number and view your policy benefits. It's still a new policy and it has not been completed.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, but you can click on that policy number and it will send notification that you were trying to view it.
[AGENT][NEUTRAL] So what your, what your policy is going to help cover is your deductibles and co-pays and co-insurance of your major medical. You have inpatient hospital benefits, um, outpatient hospital benefits, ambulance service benefits, durable medical equipment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, it's gonna be
[CUSTOMER][NEUTRAL] You know what.
[AGENT][NEUTRAL] Therapy
[CUSTOMER][NEUTRAL] to
[AGENT][NEUTRAL] Um, if you, now for the office visit co-pay, that is not covered, but any procedures or treatments performed in a doctor's office is covered. Emergency room, urgent care.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, outpatient surgery, MRIs, exactly. Always show your APL card with your primary insurance card when you go for medical services, and they can, the providers can file the claims for you and we can pay them direct.
[CUSTOMER][NEUTRAL] MRIs, CAT scans.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so but I don't have to pay up front, do I?
[AGENT][NEUTRAL] It will depend on the provider. Yeah, it's going to depend on the provider. Most providers will file secondary gap policies. If they don't, you may have to pay upfront. If you, if they don't.
[CUSTOMER][NEUTRAL] Like if I was to go get an MRI.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Except gap policy, it's just something that we can't control.
[AGENT][NEUTRAL] Um, then you can always file for reimbursement.
[AGENT][NEUTRAL] And benefits would come to you if you file the claim.
[CUSTOMER][NEUTRAL] OK, because yeah.
[CUSTOMER][NEUTRAL] Mhm, because when I asked the guy before I accepted this policy, he told me that I really could go anywhere to get a CAT scan and MRI.
[CUSTOMER][NEUTRAL] And I would be covered.
[AGENT][POSITIVE] Yeah, you should be.
[CUSTOMER][NEUTRAL] That's what he told me.
[AGENT][NEUTRAL] Yeah, you'll be covered by your policy. There's no network on your gap policy. Now, you do need to check with your primary insurance and make sure that the um it's covered by your major medical and they're in network.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so that it needs to be in network.
[AGENT][NEUTRAL] That's correct. Mhm. Uh, that's with your primary insurance.
[CUSTOMER][NEUTRAL] When I use this
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and also um you said it's still not set up yet? Like when is it gonna be set up?
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] It has to go through our um.
[AGENT][NEUTRAL] Compliance department to review the certificate. Now your benefits are already available, but the certificate has to go through approval before they upload the document to make sure all the benefits are correct.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, because like we already paid for this [PII] to our employer.
[AGENT][NEUTRAL] Right, you, yeah, you've got the benefits. The benefits are available to you as of [PII], just to be able to view the policy certificate document.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] In the portal, it has to go through.
[CUSTOMER][NEUTRAL] And what does that do for me? Like, mhm, what does that do certificate do for me like when it does get approved?
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure. So you would be able to click on that policy number, and you would be able to view your benefits that are covered on your plan.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And so that way you'll know best how to use this policy to your advantage. And once you understand exactly what's covered, make sure that you always, you know, provide your APL information for those services. And if you're wondering, for example, for an MRI if it's covered, you would be able to view that document and see that you have diagnostic testing.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, so when do you think this is gonna be updated?
[AGENT][NEUTRAL] Um, just depends on the compliance department when they get it, unfortunately I don't have a time frame, but it shouldn't be too much longer. I'm going to put a request in that they.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Try to get that updated quickly for you.
[CUSTOMER][NEUTRAL] Yeah, because I need to get an MRI so I have to wait until this is, I guess, get certificate and approved.
[AGENT][POSITIVE] Well, no, your benefits are approved. It's just the document is going through compliance. You've got benefits. That's not a problem.
[CUSTOMER][POSITIVE] That'd be great.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm so I but what card would I show them the card that's on here I could download this card now you said?
[AGENT][POSITIVE] Yes, ma'am, and I also emailed it to you as well.
[CUSTOMER][POSITIVE] Oh perfect, that's great.
[AGENT][NEUTRAL] And you can just print it from there.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let's see here.
[CUSTOMER][POSITIVE] OK perfect I thank you so much [PII].
[AGENT][POSITIVE] Well it's been such a pleasure. That's right. Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII], right?
[CUSTOMER][NEUTRAL] Uh uh.
[AGENT][POSITIVE] Well, it has been such a pleasure to assist you and, and you know, anytime that you have any questions or concerns, don't hesitate to give us a call.
[CUSTOMER][NEUTRAL] You have the.
[AGENT][POSITIVE] Or if the providers have questions, just ask them to call us, we'll be happy to verify your eligibility, meaning that your policy is active, and we'll be happy to verify benefits on your plan as well.
[CUSTOMER][POSITIVE] OK, that sounds great.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, that's great like I could call up before I go get the test done and tell you where I'm going to make sure I could do that.
[AGENT][NEUTRAL] Well, as far as network, as far as network, your APL policy does not participate in a network. So as far as APL goes, you can go.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, my, my, yeah, Aetna is right? I have to go to see if it's with them and then mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] That's right. So check with them.
[AGENT][POSITIVE] Mm, yeah, definitely check with them.
[CUSTOMER][NEUTRAL] Before I go
[AGENT][NEUTRAL] Yes, ma'am, because
[CUSTOMER][NEUTRAL] Before I go, so whatever's covered within you would cover my bill?
[AGENT][NEUTRAL] If it is a covered benefit on your plan, which diagnostic testing is covered.
[CUSTOMER][POSITIVE] Yes it is yeah, OK, that's perfect.
[CUSTOMER][POSITIVE] I appreciate your help in helping me get my ID card.
[AGENT][NEUTRAL] Sure. Well, it was a pleasure, [PII]. Did you did ask about your dental and vision. We do not have those policies. It's gonna be through a different company.
[CUSTOMER][NEUTRAL] Yeah, I.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll look that one up next.
[AGENT][NEUTRAL] Anything else I know insurance is just a different animal, isn't it?
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEGATIVE] I know my [PII], it's terrible. I don't know how you, uh, mhm now will I get a, will I get a physical card in the mail or I'm just gonna get this paper copy?
[AGENT][NEGATIVE] It's so hard to understand.
[AGENT][POSITIVE] But we're here for you.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] Let me see if they if that group chose to have the cards mailed. Let me check on that for you.
[CUSTOMER][POSITIVE] That'd be great.
[AGENT][NEUTRAL] Yes, you should have a card being mailed to you.
[CUSTOMER][NEGATIVE] OK great and you'll try to push through that it's certificate and approved and all that nonsense.
[AGENT][NEUTRAL] Yeah, well, and, and again they're just approving the document. Your your benefits are already approved and you've got, yeah, and that started on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Are available OK.
[CUSTOMER][NEUTRAL] OK, and it's for $6000 I think it is.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK, thank you so much [PII] I appreciate it.
[AGENT][POSITIVE] It's been such a pleasure and call us again if you have any more questions, Miss [PII]. Now if they ask for your social, you know, we are fine, we understand if you're not comfortable giving it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You know, you've got your policy number when you call us.
[CUSTOMER][NEUTRAL] Yeah, I mean, I would give the last 4 numbers. Yeah, now I have my policy number so I don't, I mean, I'll tell you my last 4 numbers, but yeah, I always give the last 4 numbers.
[AGENT][POSITIVE] Yeah, you don't have to worry about that.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And it is, it, it is, you gotta be careful these days, for sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I know, I know.
[AGENT][NEUTRAL] So, but we are here for you, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh OK, have a good weekend.
[AGENT][POSITIVE] You too, Ms. [PII], and thank you for calling APL. You take care and I hope everything goes well for you.
[CUSTOMER][POSITIVE] OK thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.