AccountId: 011433970860
ContactId: 72c028e0-b157-43ec-8100-b57e9c49d329
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 509220 ms
Total Talk Time (AGENT): 187577 ms
Total Talk Time (CUSTOMER): 188279 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/72c028e0-b157-43ec-8100-b57e9c49d329_20250415T14:57_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] How you doing, [PII]?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][NEUTRAL] Oh wonderful. Uh, this is [PII]. I have you guys' insurance and I was wondering, do I have a pharmacy? Is there, do I have a pharmacy insurance, uh.
[CUSTOMER][NEUTRAL] Insurance or code?
[AGENT][NEUTRAL] Um, uh, let me look up your policy. Do you have that policy number handy?
[CUSTOMER][NEUTRAL] Hold on one sec.
[CUSTOMER][NEUTRAL] Hold on one second uh.
[CUSTOMER][NEUTRAL] Policy number is 02569352.
[AGENT][NEUTRAL] OK, thank you. Um, let's see. And what is your birthday?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you [PII] do you have a um good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And just need two more pieces of information. What's your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then lastly your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Um, let's see
[AGENT][NEUTRAL] Um, let me pull up your policy.
[AGENT][NEUTRAL] And it's just for pharmacy, that's what you're checking on?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And then I have another question after that.
[AGENT][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] Um, let's see, so I don't see a pharmacy benefit on here. No, there's not one.
[CUSTOMER][NEGATIVE] So I don't have, so there's no pharmacy benefit. Y'all don't offer any of that?
[AGENT][NEUTRAL] Not under this policy.
[AGENT][NEUTRAL] Um, this pays for like hospital admission, hospital confinement, intensive care, rehab unit, um, emergency room, urgent care, physician's office, and then like physical therapy, speech therapy, occupational therapy.
[CUSTOMER][NEUTRAL] What's up?
[CUSTOMER][NEUTRAL] Occupational therapy, what's that?
[AGENT][NEUTRAL] Um, that's like when you learn, uh, so physical therapy, like it, it's like modalities for your body if you get hurt, but occupational is like how to
[AGENT][NEUTRAL] Like open, like if you got, if you had a severe like catastrophic stroke, for example, it would teach you how to get in and out of bed and um you know, open jars, like the daily things that you need to do.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] Oh OK, OK, um.
[CUSTOMER][NEUTRAL] Is there a policy, do y'all offer a policy with that?
[AGENT][NEUTRAL] Um, I don't, we don't really have any like major medical policies.
[AGENT][NEUTRAL] Um, so, let me see.
[CUSTOMER][NEUTRAL] Because here's the thing, I, I have to have Manjaro and it's like $1100 right now. I have a discount coupon, the manufacturer discount coupon, and they're telling me I need uh the insurance to connect it to.
[CUSTOMER][NEUTRAL] And I, you know.
[AGENT][NEUTRAL] Let me see if you have any other calls.
[CUSTOMER][NEUTRAL] I don't have a
[CUSTOMER][NEGATIVE] So that mean I'm paying for all my medication out of pocket for whatever price that is given.
[AGENT][NEUTRAL] Yeah, um, you could check with your employer and see if they offer any type of like major medical coverage, but I just show that you have this plan.
[AGENT][NEUTRAL] A critical illness policy, um, which that pays for very specific illnesses, and then your dental plan. Um, but you could check with your employers to see if they offer any kind of major medical that has prescription coverage, or you can give this information to the pharmacy and see if that
[AGENT][POSITIVE] That works for them.
[CUSTOMER][NEUTRAL] What information?
[AGENT][NEUTRAL] Uh, the card information. Do you have a card?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And and see if, if that will work for them as proof of like your insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We just give basically your policy number and everything.
[AGENT][NEUTRAL] Yes, yeah.
[CUSTOMER][NEUTRAL] OK, uh, yeah, on my dental plan.
[CUSTOMER][NEUTRAL] What's the uh waiting period on the deep cleaning?
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] Because I went to the dentist yesterday and the dentist said it's like a 6 to 12 month we plan for me, for me to even do a deep cleaning cause that's what I need. I need a deep cleaning. OK, here's the thing, they said I need deep cleaning and extraction, uh, two fillings.
[CUSTOMER][NEUTRAL] And a bridge
[CUSTOMER][NEGATIVE] They're saying you guys won't cover any of it. The only thing y'all cover right now is, is the two fillings. And then I still have to come out of pocket 80 $80 with it, but then I have to come out of pocket 52 $200. And I'm trying to see if either
[CUSTOMER][NEUTRAL] Can I get reimbursed for that after the waiting period or what?
[AGENT][NEUTRAL] So the
[CUSTOMER][NEUTRAL] And they're saying I need to go ahead.
[AGENT][NEUTRAL] Yeah, so for the bridge, that's considered major and there is a 12 month waiting period. So basically like if you want to wait for those benefits, you would have to wait till [PII].
[AGENT][NEUTRAL] Um, let me pull up your policy real quick. Hold on one moment.
[CUSTOMER][NEUTRAL] [PII] when I started in December. Oh well, my, my, my uh what you call that? I can't, well, they say I can wait on the bridge, but as far as the deep cleaning, I need to I can't wait for for deep cleaning.
[CUSTOMER][NEUTRAL] I need to do cleaning now.
[AGENT][NEUTRAL] OK. Hold on one moment.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, let me pull up your policy and see what's.
[AGENT][NEUTRAL] covers
[AGENT][NEUTRAL] Um, anything I say it's not a guarantee of payment, just a basic outline of your policy. Um, let me see.
[AGENT][NEUTRAL] OK, so you're saying for the deep cleaning, let me see what that's under.
[AGENT][NEUTRAL] OK, so yeah, so deep cleaning falls under periodontic expenses, and that is the 12-month waiting period, unfortunately.
[CUSTOMER][NEUTRAL] OK, the question is, uh, if I had to, if I go ahead and pay for it, will y'all reimburse me later once that is active?
[AGENT][NEUTRAL] No, it's based on when, yeah, it's based on when the actual services are rendered, so, or when they take place, so we wouldn't be able to reimburse you.
[CUSTOMER][NEUTRAL] Oh, the waiting period is over.
[CUSTOMER][NEGATIVE] So basically I'm out of here. So basically the insurance ain't no good until the 12 months is a year later. That's crazy.
[AGENT][NEUTRAL] Yeah, they have, they have preventative and then basic, but that that particular service does fall under major with the waiting period, yeah.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Yeah, I might, I might have $6000.
[CUSTOMER][NEUTRAL] And I got insurance. That's crazy. OK, alright, thanks.
[AGENT][POSITIVE] OK, thank you for calling APL. Hope you have a good day.
[CUSTOMER][NEUTRAL] Me too.