AccountId: 011433970860
ContactId: 5f6a1079-07f7-402d-8de1-49783811a0c8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 844130 ms
Total Talk Time (AGENT): 205006 ms
Total Talk Time (CUSTOMER): 377192 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/5f6a1079-07f7-402d-8de1-49783811a0c8_20250124T19:38_UTC.wav
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[AGENT][POSITIVE] Good afternoon, thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Um, hi, my name is [PII], and I'm with Doctor Margaret Elizabeth Raines dental office, and I'm the office manager, and we have a group policy for our employees, and I want to find out.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Where I can find the policy details for our for our employees, especially with the change of the [PII], I don't believe I've seen anything yet and um we have questions about what our coverage entails.
[AGENT][NEUTRAL] So you need the master policy for the whole group.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. All right, sure.
[CUSTOMER][NEUTRAL] Yes, for each like each employee each employee is the same, correct.
[AGENT][NEUTRAL] Um, more than likely they are, yes, Miss [PII]. Um, may I have the group number?
[CUSTOMER][NEUTRAL] Yes it is um.
[CUSTOMER][NEUTRAL] Um, let's see here.
[CUSTOMER][NEUTRAL] Gosh, let me get back to my billing.
[CUSTOMER][NEUTRAL] Payment account um.
[CUSTOMER][NEUTRAL] I'm on the website and.
[CUSTOMER][NEUTRAL] OK, get back to the.
[CUSTOMER][NEGATIVE] I don't want the guide.
[CUSTOMER][NEGATIVE] Website's a little confusing.
[CUSTOMER][NEUTRAL] Like to
[AGENT][NEUTRAL] If you don't see it right away, you can always open a um an invoice or something like that and they will give you that number.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] That's what I'm trying to get to here we go, the invoices.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, but to OCS account, uh.
[CUSTOMER][NEUTRAL] OK, let me see manage users if they'll take me all the users, no, it doesn't.
[CUSTOMER][NEUTRAL] Let me just log out and log back in.
[CUSTOMER][NEUTRAL] It's just easier. Oh, here's an invoice.
[CUSTOMER][NEUTRAL] Because if I, I have all my invoices paid up to date.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Print invoice that makes it easier.
[CUSTOMER][NEUTRAL] I'll just do this. I got my ID card right here myself.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Group number is 251-777.
[CUSTOMER][NEUTRAL] And I have the policy certification number.
[AGENT][NEUTRAL] OK, let me try just the group number for now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you have a policy number with us as well, Miss [PII].
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, H 00 P E R, right.
[AGENT][POSITIVE] Super. OK.
[AGENT][POSITIVE] Yes, I see that. I've been saying Cooper and is super.
[CUSTOMER][NEUTRAL] OK, it's OK. um, it's, I get it a lot it's OK. I, I can't always say my name.
[CUSTOMER][NEUTRAL] I can't say my name, especially with allergies and so.
[AGENT][NEUTRAL] All right. OK, um, let me have a callback number just in case we get disconnected and I need to verify the mailing address and the group name.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, it's um [PII] is our callback number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And our main uh.
[CUSTOMER][NEUTRAL] Mailing address is [PII]. That's for our office. Do you need my individual mailing address?
[AGENT][POSITIVE] No, it's fine. That's the one I needed. Thank you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, OK, um.
[CUSTOMER][NEUTRAL] It's still showing med link having the card effective date [PII].
[CUSTOMER][NEUTRAL] And the, the card I just reprinted my card.
[AGENT][NEUTRAL] Yeah, it doesn't look like it has changed, um.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Let's see, so it's gonna be the same card, yes, for everybody's same thing. So it looks like the benefits has not changed from last year. It's gonna be the same one, so the cards are gonna be the same one we're not sending new cards because they didn't change.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, yeah, to view, uh, your benefits, either you can go either two routes. Um, if you have registered the account under the group, you will go to, um.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] So, um.
[CUSTOMER][NEUTRAL] I, I need to see if, see, I have the main account though because I'm on the term pay the bills but.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I don't know if I registered one for myself. Let me check and sign in on a different tab.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Like a personal one.
[AGENT][NEUTRAL] And I
[AGENT][NEUTRAL] Yeah, and I can also check, um, let me check on my end.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh yeah I think I have one it's just it's.
[AGENT][NEUTRAL] Or maybe if I type it on the right spot. OK.
[AGENT][NEUTRAL] Yeah, you do have an account, a personal account, um.
[AGENT][NEUTRAL] Your username is um [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] Right now which website would I because I mine keeps defaulting to the pub pub provider portal APL insurance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can go either to routes, either you can go to [PII] or you can go to [PII] and sign in.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Uh let me try [PII] and [PII]. oh, it's still opening to the one I have opened already.
[AGENT][NEUTRAL] Um, you might wanna get out of that one and see if he will let you put the signing information for your individuals.
[CUSTOMER][NEUTRAL] Oh OK
[CUSTOMER][NEUTRAL] OK, there we go. Let me try it now. OK, 731-92.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Let me make sure I have my.
[CUSTOMER][NEUTRAL] I get my
[CUSTOMER][NEUTRAL] Password for my private.
[CUSTOMER][NEUTRAL] I haven't changed it in a while.
[CUSTOMER][NEGATIVE] it's expired. Password's expired.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's gonna send me a verification code.
[CUSTOMER][NEUTRAL] OK, then I gotta put a new password in.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] I find one that I can remember.
[CUSTOMER][NEUTRAL] OK, so now I got there just one second.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so now I'm in my portal and.
[AGENT][NEUTRAL] OK, so you're gonna click on your policy number, it should be blue.
[AGENT][NEUTRAL] Color blue.
[CUSTOMER][NEUTRAL] OK, policy number and that's the one for 2024.
[CUSTOMER][NEUTRAL] Yeah, because we started this back in [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's see here.
[CUSTOMER][POSITIVE] OK wonderful because I'm gonna print this out everyone's is the same for all employees.
[AGENT][NEUTRAL] Got it. Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, from what I see here, all the policies are the same, the same product. Mhm.
[CUSTOMER][NEUTRAL] It just has my
[CUSTOMER][NEUTRAL] OK, so I know like.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I got a certificate of insurance.
[CUSTOMER][NEUTRAL] So when I get to.
[CUSTOMER][NEUTRAL] Like the outpatient benefit writers med link at 6 policy.
[CUSTOMER][NEUTRAL] It shows outpatient writer, office treatment writer, cancer outpatient independent lab facility writer, durable medical equipment writer shows those independent child maternity amendment writer which we don't have any kids we're not paying for that.
[CUSTOMER][NEUTRAL] No, nobody has dependents eligible.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Section 3 definitions OK.
[CUSTOMER][NEUTRAL] Eligible dependence.
[CUSTOMER][NEUTRAL] It's one question is they don't pay for office visits that they don't cover like the gap insurance doesn't cover between what your insurance like our primary paid.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And what
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] For like an office visit.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] No, not for the co-payment, the co-payment, uh, yeah, it's members responsibility for the office visit for the co-payment. Mhm.
[CUSTOMER][NEUTRAL] OK, co-payments you do not cover so um.
[AGENT][NEUTRAL] No, not for an office visit. Only if it's like for a testing, like diagnostic testing um independent facility, um, but for an office itself, no, we do not cover the co-payment for the visit for an office.
[CUSTOMER][NEUTRAL] So for like here it says in hospital benefit we will pay the out of pocket amount for treatment incurred while combined in the hospital as an as an inpatient.
[CUSTOMER][NEUTRAL] And treatment of uh that's mental illness.
[CUSTOMER][NEUTRAL] OK, ambulance benefit.
[CUSTOMER][NEUTRAL] You'll pay for the out of pocket amount for ground or air transportation.
[CUSTOMER][NEUTRAL] From a medical to another where a covered person is confined as an inpatient.
[CUSTOMER][NEUTRAL] So you have to be confined as an inpatient, right, OK, um, we'll thank you very much, we'll read through these and.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] See what other.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Questions we come up with.
[AGENT][POSITIVE] OK, maybe, yeah, whenever you have a question, just feel free to call us back. We'll go ahead and go over any questions you have about the policy, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now if an employee say she has questions about her her claims and like um.
[CUSTOMER][NEUTRAL] Things that weren't paid she can call the same number and what what um selection should she choose like I chose [PII] and then 4.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, 4 is fine, um, because we handle basically whenever there's a question about a claim, um, if we have the information available, we can go ahead and assist her in this line. If it's something that we need to do a research, more than likely we either, um, we'll send out a request for a call back for a research if we need to, but yeah, more than likely we can answer the questions, um, in the in this line, same line you paid, OK?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Fantastic, thank you very much. I appreciate your help.
[AGENT][POSITIVE] You're welcome, Ms. [PII]. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] No, I'm good you just have a good day.
[AGENT][NEUTRAL] OK. Uh-huh.
[AGENT][POSITIVE] You too. Have a good afternoon. Thank you for calling APM. Goodbye. You're welcome.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][POSITIVE] Thank you bye bye bye.