AccountId: 011433970860
ContactId: 5f6fae01-99f6-4ddc-a045-f23d6dbb7352
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 254479 ms
Total Talk Time (AGENT): 124362 ms
Total Talk Time (CUSTOMER): 109713 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/5f6fae01-99f6-4ddc-a045-f23d6dbb7352_20250206T20:00_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] I'm calling to verify um the insurance that I have, um, what my outpatient benefit is.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the outpatient benefits and [PII], may I have a good contact number in case we're disconnected and your policy number?
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] [PII] and my policy number is 02505772M as in Mary L as in Larry 8.
[AGENT][NEUTRAL] Thank you for that. And can you verify um your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] Uh, date of birth [PII] uh uh mailing address is [PII] and my email is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So for outpatient, I'm showing your policy will pay up to $2500 per calendar year.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] OK, who do I need to speak to about these, um, about this policy? When I signed up at work it was supposed to be 7900. I've already gone to my work, uh, benefits department. They said that they were gonna call you guys to fix the issue, and I see it hasn't been fixed. Is there anything on my end?
[AGENT][NEUTRAL] So you have to
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] You have two sets of benefits. You have inpatient benefits, so if like someone gets admitted to the hospital and they're confined, and then you have outpatient benefits. So for your inpatient benefits, yes, the benefit amount is $7900. For your outpatient though, it's $2500. So, yes.
[CUSTOMER][NEUTRAL] Right, it's, it's supposed to be 79 volts.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's what it's supposed to be.
[AGENT][NEUTRAL] And your, um, you said you have talked to your benefits department?
[CUSTOMER][NEGATIVE] Correct, and it's been about a week and a half. They said that they had contacted you guys and they were in the process of fixing it, but as of now it hasn't been fixed and I'm wondering if there's anything or anybody that I could speak to because I'm getting bills and being sent to collection because those payments, you know, have, uh, they're not being made.
[AGENT][NEUTRAL] So, this is the only thing that we can do. Let me look through your notes. Hold on one second.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so because all of our all of our policies come from the employer,
[AGENT][NEUTRAL] All they have to do because they haven't, they haven't, I'm looking through the notes, they haven't reached out to us, um.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] They haven't? OK, alright, that's what exactly what I wanted to know.
[AGENT][NEUTRAL] So let, OK, so let them know that they just
[CUSTOMER][NEUTRAL] I think they're
[CUSTOMER][NEGATIVE] Uh, they're telling me the wrong information, right? Who do I'm sorry, can we keep breaking up? What did you say?
[AGENT][NEUTRAL] They just need to email us, um, the group most likely has our email address because that's how they send like the enrollments and terminations and things. Just let them, um, tell them to email us and let them know that they, they sent the wrong enrollment information. This is the policy that you wanted to enroll under, and then we'll go ahead and make the um corrections for you. Um, but yeah, I'm just looking through the note. I I don't see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I mean, providers have called to like verify your benefits, but not like your group to say something's wrong, but we wouldn't have been able to do it over the phone anyway, they would have had to send it through the email, so it was right in writing.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect thank you very much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's it thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL [PII]. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you