AccountId: 011433970860
ContactId: 6d0845dc-f25b-4e5f-a69c-8ace91bbe327
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 376470 ms
Total Talk Time (AGENT): 204855 ms
Total Talk Time (CUSTOMER): 125907 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/6d0845dc-f25b-4e5f-a69c-8ace91bbe327_20250306T18:03_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was just calling that I had a question um regarding my benefits.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And I, I wanted to find out, I don't think it is, but I wanted to find out um if co-pays are reimbursed for specialty doctor visits.
[AGENT][NEUTRAL] OK. So you have a question. You're the insured and you have a question regarding your benefits on your policy, regarding an office visit?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] This is [PII].
[AGENT][POSITIVE] Thank you. And Miss [PII], what is a good callback number for you in case we're disconnected?
[CUSTOMER][NEUTRAL] Area code [PII].
[AGENT][NEUTRAL] OK, what was your area code again, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you. And your policy number, please?
[CUSTOMER][NEUTRAL] 1 462-849
[AGENT][NEUTRAL] OK, I'm sorry, can you repeat that again?
[CUSTOMER][NEUTRAL] Sure, 246-2849.
[AGENT][NEUTRAL] OK, thank you. One moment please while I get your information pulled up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And Ms. [PII], I will have to verify several things with you for security purposes and also any information that I provide for you would be a verification of benefits and not a guarantee of payment. What is, first off, your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And your home mailing address, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have for you is also the same as the one that you gave me. So again, that is your best contact number. Is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. And the last piece of information to verify with Miss [PII] will be your email address.
[CUSTOMER][NEUTRAL] Um, I, mm, I'm not sure if I have it under [PII] or on a [PII].
[AGENT][NEUTRAL] OK, so do you only have one Gmail address?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And you said that it was [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] [PII]. OK, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. So, on this supplemental policy, let me check to see about office benefits. No, ma'am. Office visits are not covered. Now, if you were to receive some type of treatment, you know, done at the doctor, then the treatment could be reviewed under your outpatient benefits, but the office visit fee itself is not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so if I had, uh, I've just, um,
[CUSTOMER][NEUTRAL] I've just finished um uh quite a number of weeks of physical therapy. And so, um, I did, so the co-pays for those visits for physical therapy are not covered for the visit itself.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now, the therapy, yes, ma'am. We could review for the therapy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you did you present your APL ID card along with your primary insurance to your provider?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] I did not there and I don't, I think I'm OK. I, but so far the in my primary insurance has covered the visit itself. I was just curious about the co-pay at this time.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, oh, OK, for the visit. OK. So, yes, and we could review the treatment itself, the therapy, but if there's a separate charge for an office visit, sometimes there is, sometimes there isn't. That, that part of it would not be covered under this policy, but we could review the treatment. So, um, I would just recommend, you know, maybe providing them with your APO information. You can file your own claims.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] But if a provider will do it for you it's typically a lot easier.
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] And then it's a lot easier and a lot less um legwork for you to have to do. But again, should that need arise and you need to file it, you can and you could call us and we'd be more than happy to to give you the information on how to do that. Now, have you ever set up your profile, Ms. [PII] in our portal called the online service center?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I, I believe I have, um, I'm on like I'm on the main page that I come to when I log in, so I'm not sure if there's something additional for me to set up.
[AGENT][NEUTRAL] Are you familiar with that?
[AGENT][NEUTRAL] Uh-huh. OK.
[AGENT][NEUTRAL] No, let me just, I can check to make sure if not I if you're not, I was going to email you the user guide for how to do that but if you're already set up, then we won't need to do that. Let's see. OK, I can check that for you. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think I am. Yeah.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And, yes, ma'am, you are. Mhm. You're already set up.
[CUSTOMER][POSITIVE] Perfect. OK, good.
[AGENT][NEUTRAL] OK. Well, is there anything else, Ms. [PII] that I could help you with at the moment?
[CUSTOMER][NEUTRAL] All right, well.
[CUSTOMER][POSITIVE] Uh, not for today. I think I'm, I'm good for now.
[AGENT][POSITIVE] OK, then. Well, thank you again for calling APL and I hope that you have a very nice afternoon.
[CUSTOMER][POSITIVE] Thank you so much. Have a good day.
[AGENT][POSITIVE] Yes, ma'am. You too. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye-bye.