AccountId: 011433970860
ContactId: 7d1b8184-4caf-42bb-99e4-589c7af0296b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 334299 ms
Total Talk Time (AGENT): 157976 ms
Total Talk Time (CUSTOMER): 126520 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/7d1b8184-4caf-42bb-99e4-589c7af0296b_20250606T14:51_UTC.wav
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[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, good morning, um, this is [PII], uh.
[CUSTOMER][NEUTRAL] I'm working with the PRC department. Um, I have uh health insurance with you guys, but I want to know how much my health insurance paid out.
[AGENT][NEUTRAL] You submitted a claim, so you need to know how much we have paid on the claim is, is that what you're calling for?
[CUSTOMER][NEUTRAL] Yeah, I, no, I, I, I submit a claim cause I went to the doctor the other day, but when I give them my insurance card.
[CUSTOMER][NEGATIVE] They said something is wrong. I need to contact my insurance.
[CUSTOMER][NEUTRAL] So I want to know how much um.
[CUSTOMER][NEUTRAL] If I went to the doctor and something happened, how much the claim would I get from my insurance?
[CUSTOMER][NEUTRAL] You have to cover that bill.
[AGENT][NEUTRAL] OK, let's see what we can do. Um, may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Thank you. And do you have the policy number?
[CUSTOMER][NEUTRAL] The policy number for my car.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, hold on, I got it in my.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, it's 0255.
[CUSTOMER][NEUTRAL] 8899.
[AGENT][NEUTRAL] Thank you, Mr. [PII], um, may I have your date of birth, mailing address and email address for verification?
[CUSTOMER][NEUTRAL] [PII] mailing address is [PII].
[AGENT][NEUTRAL] The email address on file?
[CUSTOMER][NEUTRAL] My email uh [PII].
[AGENT][NEUTRAL] Hm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, let me go ahead and pull your benefits. Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And let's see, so, um, for an office visit, what we cover is $50 per visit, maximum of 4 visits per cover person per calendar year.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So how much $50?
[AGENT][NEUTRAL] $50 yes.
[CUSTOMER][NEUTRAL] That that's my coverage.
[AGENT][NEUTRAL] For an office visit, that is your coverage. You have separate benefits. So you have office visit benefits, you have urgent care visit benefits, um, physical therapy benefits.
[CUSTOMER][NEUTRAL] So how, how much is the house?
[CUSTOMER][NEUTRAL] How much is the hyggen tier?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] The urgent care is also $50 but that's a separate benefit. So you have uh 4 visits for urgent care for $50 each, and then you have 4 visits for a regular doctor like a specialist or a PCP, which is your regular doctor, or $50 each for visits per year.
[CUSTOMER][NEUTRAL] So it's only just $50 a year I would get from my benefits.
[AGENT][NEUTRAL] $50 per visit up to 4 visits per year.
[CUSTOMER][NEUTRAL] Yes, yes, I understand. So I'm just saying it's only if something happens and then I go to the doctor, just, uh, insurance is only gonna cover $50.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][POSITIVE] Correct, that's the benefit amount.
[CUSTOMER][NEUTRAL] So what?
[CUSTOMER][NEGATIVE] Why am I paying for insurance and that's my benefit $50.50 dollars didn't cover nothing.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, um, well, I do apologize. You, you feel like that, but I, I don't see any other benefits. Um, that's the only benefits I see under your benefits.
[CUSTOMER][NEUTRAL] So, so.
[CUSTOMER][NEGATIVE] So, so we can't go up to no more? What would I have to pay more to get more?
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] You will have to check with um your employer. Your employer is working with benefits and a card.
[AGENT][NEUTRAL] They're the ones that make any changes or any updates or you know, you, you get the policy through them. So you can call Benefits in a card and see if they offer anything different, but right now the policy you have through them is this one which is a limited policy and those are the benefits under this one.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, I'm gonna call them thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm. You're welcome. Do you need their number or you need any other information?
[CUSTOMER][NEUTRAL] Yeah, you have the number?
[AGENT][NEUTRAL] I do. Let me go ahead and get that for you one moment.
[AGENT][NEUTRAL] OK, so the number two benefits in a card is 1800.
[AGENT][NEUTRAL] 497. OK, sure, let me know when you're ready.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] On a
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] 6497.
[AGENT][NEUTRAL] 4856.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] 485 6.
[CUSTOMER][NEUTRAL] For a
[CUSTOMER][NEUTRAL] 56.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] Alright thank you.
[CUSTOMER][NEUTRAL] No, nothing else.
[AGENT][POSITIVE] You're welcome. OK, well, thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] Mm thank you