AccountId: 011433970860
ContactId: 658bb625-d669-45e8-af05-db7adbf7a71c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 576640 ms
Total Talk Time (AGENT): 204995 ms
Total Talk Time (CUSTOMER): 77601 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/658bb625-d669-45e8-af05-db7adbf7a71c_20250108T19:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi. Um, I have a question about my insurance covers.
[AGENT][NEUTRAL] OK, you have a question regarding benefits?
[CUSTOMER][NEUTRAL] Um, I think so. I'm trying to figure out if it, uh, so like it, the last insurance I was on covered Botox, so I'm trying to figure out if this insurance is likely to cover it as well.
[AGENT][NEUTRAL] OK, so you do have a question as to far as your coverage, your benefits on this plan. Is that correct?
[AGENT][NEUTRAL] Sounds like.
[CUSTOMER][POSITIVE] Uh yes, I hope so.
[AGENT][NEUTRAL] OK, yes, ma'am. OK, yes, ma'am. I can help you. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Ms. [PII], what is a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And what is your policy number, please?
[CUSTOMER][NEUTRAL] Uh, one second.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I just received it, so.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, it is 258456-2.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Excuse me, Ms. [PII], if you can hear that. I apologize.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] OK, so first off, Ms. [PII], I will have to verify several things with you for security purposes. So give me just one moment to get your information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And your the whole mailing address, please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so just one moment.
[AGENT][NEUTRAL] OK, and the zip code?
[CUSTOMER][NEUTRAL] I'm sorry, what?
[AGENT][NEUTRAL] What is your zip code?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one that you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you and lastly your email address please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] So because your policy was literally just issued yesterday, I, give me just a moment to um
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] To see if I can pull another policy that's exactly like yours so that I can look at your information but I can tell you this is not major medical insurance.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You said that you were wanting to find out if Botox was covered?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, it's under a pain management clinic.
[AGENT][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] I'm sorry, what?
[AGENT][NEUTRAL] OK, I don't believe that it is. Yes, ma'am. I do not believe that it is, but I'm going to try and see if I can, again, locate another policy that I can verify that on.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Even if I get a letter from them saying it's medically necessary.
[AGENT][NEUTRAL] This is not, yes, ma'am, because this is not major medical insurance. This is a limited benefit plan that only pays for certain services.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh boy, OK.
[AGENT][NEUTRAL] It's gonna take just a moment for me to, to locate a policy to be able to, to look out for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you for your patience and while I'm
[AGENT][NEUTRAL] Trying to pull some information for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So yes, ma'am, that is not covered under this policy.
[CUSTOMER][NEUTRAL] OK. Um, is there anything that I could possibly do to get any parts of it covered?
[AGENT][NEUTRAL] Again, that is, that is just not one of the covered benefits under this policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, it's because it's, it is a very limited benefit plan. Now,
[AGENT][NEUTRAL] An office visit, you know, if you go to be seeing my physician for a sickness-related, you know, issue, the benefit that this would pay would be $75.
[AGENT][NEUTRAL] The maximum it would pay would be $75 per visit with a maximum of 5 visits per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, got it, thank you.
[AGENT][NEUTRAL] Yes, ma'am. You're welcome. And when you received your information, Ms. [PII], it talked about setting up your profile in the APL online service center. That's where you can have access to your policy information and ID cards online. Now your policy is not there yet. Like I said, this policy was just issued, um, but it will be, but do you have that website for our portal?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I haven't received that email yet.
[AGENT][NEUTRAL] OK, so the email, um, actually I can email you the user guy. Give me one moment and I can do that and then you will have it. OK, so just one second please.
[CUSTOMER][POSITIVE] OK, that'd be great.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] I do have to run to a meeting though, so will I just be able to do everything from that email you're sending?
[AGENT][POSITIVE] Sure, and the email that you will receive and you're gonna receive it in just a couple of minutes. It's gonna come from [PII], and I did put where I will put APL in your subject line so that you'll be able to recognize that.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] OK, well, you're welcome and if that's all I can help you with, thank you again for calling APL and I hope that you have a nice afternoon.
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you, Ms. [PII]. Bye bye.