AccountId: 011433970860
ContactId: 80ca3b7c-8457-4a1a-a4fb-263b62126e18
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 291880 ms
Total Talk Time (AGENT): 108257 ms
Total Talk Time (CUSTOMER): 128516 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/80ca3b7c-8457-4a1a-a4fb-263b62126e18_20250402T13:22_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]
[CUSTOMER][NEUTRAL] And I'm calling uh with an individual coverage with group 23,350 and I'm wondering what my benefits are.
[AGENT][NEUTRAL] OK. Do you have a callback number in case we get disconnected, I can call you back.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][POSITIVE] You got it.
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Uh, let's see, I have a payer ID.
[CUSTOMER][NEUTRAL] I have, I'm not holding a card from APL right now uh I have a group number um.
[CUSTOMER][NEUTRAL] I have in hospital benefits certification number.
[AGENT][POSITIVE] Yes, sir. Well, that number will work.
[CUSTOMER][NEUTRAL] Outpatient benefit
[CUSTOMER][NEUTRAL] Which one do you want?
[AGENT][NEUTRAL] Either one's fine.
[CUSTOMER][NEUTRAL] 02592991, M as in Michael, L as in llama, 7.
[AGENT][NEUTRAL] Thank you, hold on one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can I verify your date of birth, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And can I verify your address?
[CUSTOMER][NEUTRAL] It should be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And I'm sorry, how did you pronounce your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, Mr. [PII].
[AGENT][NEUTRAL] And do you have an email address you would like to give us?
[CUSTOMER][NEUTRAL] Sure, so I don't think I need more email in my life. [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That was [PII].
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] Thank you. And you were calling for the benefits on this policy?
[CUSTOMER][NEUTRAL] Yeah, I, I, I think it's gap policy, but I'm not sure.
[AGENT][NEUTRAL] Yes, sir. I can help you with that. It is a gap policy. It coordinates with your primary insurance. Whatever your primary applies to your deductible co-pays or co-insurance only for certain procedures depending on what procedures.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You're having done now it does cover outpatient.
[AGENT][NEUTRAL] 1000 per calendar day and any benefits given over the phone is not a guarantee of payment for inpatient.
[CUSTOMER][NEUTRAL] Obviously.
[AGENT][NEUTRAL] It will pay up to 5000 per calendar year.
[CUSTOMER][NEUTRAL] Got you. So is this something I should present every time I use my insurance card?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, that's pretty much all I need to know. Uh, does it also pay for the copays on drugs or does it just only handle basically hospital inpatient and inpatient stays?
[AGENT][NEUTRAL] It does not cover prescriptions, no, sir. It, it does not cover office visits, but it does cover if you have any services done in a doctor's office like injections, X-rays, it covers that. It just doesn't cover the office visit itself.
[CUSTOMER][POSITIVE] OK, that's, that's just great.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Oh, so if I have to get a special X-ray, it covers that. And if I, of course, go to a hospital, then it covers the initial, uh, out of pocket expense. OK, thank you. That's, that's all I really needed to know. Thank you so much.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][POSITIVE] Thank you, Mr. [PII] for.
[CUSTOMER][NEUTRAL] Oh, actually one more question before we go. Uh, it just occurred to me. Uh, when my wife gets her Social Security number, I can add her to this plan along with my primary insurance, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK. Thank you so much. Have a great day.
[AGENT][POSITIVE] Thank you for calling APA. You have a good day, Mr. [PII].