AccountId: 011433970860
ContactId: 7db7e632-8094-418f-9894-e93eda4e6469
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 643940 ms
Total Talk Time (AGENT): 279341 ms
Total Talk Time (CUSTOMER): 138685 ms
Interruptions: 4
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/7db7e632-8094-418f-9894-e93eda4e6469_20250423T22:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII], and I called, um, I'm needing my insurance cards and to also make sure that my daughter's birth control is covered.
[AGENT][NEUTRAL] OK, Ms. [PII], I can hear you. I can help you with your benefits and your cards, ma'am. Can I please get your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And then what is your policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um, I don't know. That's what I, I need my card, ID cards.
[AGENT][NEUTRAL] OK, I can look it up with your social if you'd give that to me it'll pull it in for us.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, Miss [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Address is [PII], um, phone number [PII] and [PII].
[AGENT][POSITIVE] OK thank you I appreciate you verifying that information for me let me look up your policy real quick.
[AGENT][NEUTRAL] OK, Ms. [PII]. I do show that you do have an hospital indemnity plan with us. Um, and let me check to see about birth control if it has any kind of pharmacy benefits on it.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] OK, you do have, and this is just to verify your benefits, it's not a guarantee of payment. You have an outpatient prescription drug benefit that pays $10 towards drugs.
[AGENT][NEUTRAL] And you get 15 a year.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] But no, she gets the bar in her arm.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] That um.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] She, you do have um for.
[CUSTOMER][NEUTRAL] Yeah, it's the next one on and.
[AGENT][NEUTRAL] OK. You do have um a physician office visits. You get 4 of those a year?
[AGENT][NEUTRAL] To go to the doctor's office and that pays $50.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 4 times a year.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I don't, I don't know if that's gonna work.
[CUSTOMER][NEUTRAL] I don't know how much that they actually like.
[CUSTOMER][NEUTRAL] Put something in her arm.
[AGENT][NEUTRAL] Is it considered surgery?
[AGENT][NEUTRAL] In a physician's office?
[CUSTOMER][NEUTRAL] I mean,
[CUSTOMER][NEUTRAL] It's in the office, they do it.
[CUSTOMER][NEUTRAL] But they have to remove her old one and reinsert a new one.
[AGENT][NEUTRAL] OK, so you do.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] You do have a surgical benefit.
[AGENT][NEUTRAL] a year for accident or sickness.
[AGENT][NEUTRAL] ' s office.
[AGENT][NEUTRAL] That pays $125.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Well, what should I do to know that it's covered?
[AGENT][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Like she can't go without it.
[AGENT][NEUTRAL] Um, the
[AGENT][NEUTRAL] Right, so the best way to do it is just to file the claim, um, see if the physician's office can file the claim they can call.
[AGENT][NEUTRAL] Verify your benefits with us with the same number that you called and we can go over the benefits with them and then if they can file the claim for you.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] We'll need the itemized statement with the diagnosis and procedure codes and then the claims would just have to be uh.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Go through the claims process with the claims specialist.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I will do that. I will um take the.
[AGENT][NEUTRAL] Now
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, no, you go ahead and finish. I was getting ready to move on to the card with you, but if you have more questions, I can answer them.
[CUSTOMER][NEUTRAL] Oh, no, I was too. I was gonna say I will take the card to them tomorrow uh along with the phone number and so they can call because her appointment is on [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's something that she has done every 5 years.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, ma'am, um, just take the card in, let them call us and we can go over the benefits with them.
[CUSTOMER][NEUTRAL] She's just [PII], so she needs her.
[CUSTOMER][NEUTRAL] Uh, so what if it's not covered? Can I call and have it upgraded or something so it does?
[AGENT][NEUTRAL] If um if you need to change your benefits, you'll have to do that through your employer because your benefits are um through your focus workforce management.
[CUSTOMER][NEUTRAL] Uh-huh. How long will that take?
[AGENT][NEUTRAL] I am unsure about that. You'd have to go to human resources director and let them know that you wanna change your benefits and see what the process is that they use.
[CUSTOMER][NEUTRAL] OK, so I don't have to wait till like the open enrollment or anything, is that correct?
[AGENT][NEUTRAL] I am unsure of what kind of procedures they have for you if they have you wait until open enrollment unless.
[AGENT][NEUTRAL] It's a qualifying event. I'm, I'm not sure what what their plans are as far as that goes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK if you could just send the cards to me that.
[AGENT][NEUTRAL] Um, now,
[AGENT][NEUTRAL] OK I can send them by email or if you want to go to the online service center and sign up for it you can it's a direct portal to your policy you can get your.
[AGENT][NEUTRAL] Cards you can see your policy you can file claims there.
[AGENT][NEUTRAL] If you wanted me to give you that address so that you could, yeah.
[CUSTOMER][NEUTRAL] OK. Can you do both? I'll do.
[AGENT][NEUTRAL] Yes, um, that, um, address to the portal is [PII] I'm sorry, is secured, [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then you'll go in there and you'll sign up as a new user that'll be the first step and then the second step you're gonna choose is you're an individual.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] With an APL policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm getting this card ready to send to you now um at the address that you.
[CUSTOMER][POSITIVE] OK perfect thank you very much.
[AGENT][NEUTRAL] Verified for me so I'm gonna put you on a quick hold while I get.
[AGENT][POSITIVE] This email ready for you and as soon as I push send I'll come right back, OK?
[CUSTOMER][POSITIVE] Perfect. Thank you.
[AGENT][NEUTRAL] All right. It's gonna be a brief hold. You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, Ms. [PII], I have that email on its way to you and in the subject line I put your policy number so that you would have it.
[CUSTOMER][POSITIVE] Perfect thank you so much.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can do to help you today?
[CUSTOMER][NEUTRAL] I think that's it.
[AGENT][POSITIVE] OK, well, you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][NEUTRAL] Bye-bye, Miss [PII].