AccountId: 011433970860
ContactId: 85450922-fd3a-4b17-97e4-c6b9cfdbd182
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 901780 ms
Total Talk Time (AGENT): 379522 ms
Total Talk Time (CUSTOMER): 328959 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/85450922-fd3a-4b17-97e4-c6b9cfdbd182_20250307T17:33_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I was just on the phone with somebody and we got disconnected, um.
[CUSTOMER][NEUTRAL] I am needing.
[CUSTOMER][NEUTRAL] The plan that I that I purchased was back in um [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it's supposed to be a PHCS PPO plan.
[CUSTOMER][NEUTRAL] With a $25 primary care, $50 specialist, 3 to $10 prescriptions, um, no deductibles to be met, and I'm paying $291.90 a month for that.
[CUSTOMER][NEUTRAL] Um, the card that I have, um, it's accepted at my doctor's office, but when I take it to the pharmacy, they tell me that I don't have, it's not for any prescription.
[CUSTOMER][NEGATIVE] So I've been paying full price for my prescriptions um since November, and I can't get [PII], um.
[CUSTOMER][NEUTRAL] To answer her phone. So I don't know who to call, um, but I've just got, I've got to get my prescription card or
[CUSTOMER][NEUTRAL] Uh, something done very soon because I do take numerous prescriptions. And the other day when I walked in the pharmacy for a name brand prescription that was supposed to be 300, I'm sorry, 3 to $10 they told me was $700.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] OK. So you are trying to find out who you would need to speak to regarding the coverage that you have related to your pharmacy?
[CUSTOMER][NEUTRAL] Uh, it, well, I know the coverage is what it's supposed to be is what I was, what I was told because I have it all written down. I just don't have a
[CUSTOMER][NEUTRAL] A card or anything for my prescription, the card that I have is just for the doctor's office.
[AGENT][NEUTRAL] OK. So yes, ma'am. What I can try and help you as far as um
[AGENT][NEUTRAL] Answering some of your questions, but first I'll have to locate your information and verify some things with you for security, and then we can go from there, OK? So who am I speaking with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], will you spell your last name, please?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you. And a good callback number for you, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And do you have your policy number?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] What would that be my member ID?
[AGENT][POSITIVE] I can try and look it up with that. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. It is um M.
[CUSTOMER][NEUTRAL] 5
[CUSTOMER][NEUTRAL] 28.
[CUSTOMER][NEUTRAL] 0.
[CUSTOMER][NEUTRAL] 222.
[CUSTOMER][NEUTRAL] Oh, I apologize. After the M there's a 7, ma'am.
[AGENT][NEUTRAL] OK, so let me see if I can.
[AGENT][NEUTRAL] Because I'm not familiar with that number, so just one moment.
[CUSTOMER][NEUTRAL] OK, let me, I'm gonna get you my card. I'm sure the policy numbers on this card, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It says, OK, oh my goodness, I can't see.
[CUSTOMER][NEUTRAL] OK, um, I have a group ID, uh, benefit level member number.
[CUSTOMER][NEUTRAL] And that's it.
[CUSTOMER][NEUTRAL] On this card and on the back it says it's just got a customer service phone number.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And a provider and a submit claims to phone number.
[AGENT][NEUTRAL] OK, Ms. [PII]. So I may have located it by looking at it for it differently. Give me just one moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so let's, um, let me verify some information with you first for security purposes. So Ms. [PII], what is a, what is your date of birth first off?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And your home mailing address, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. The phone number that I have for you is the same as the one that you provided for me, so that is your best contact number, is that correct?
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] OK, thank you and then the last piece of information to verify is your email address?
[CUSTOMER][NEUTRAL] It's my first and last name [PII].
[AGENT][NEUTRAL] OK, thank you. So just a moment please.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so this is you enrolled for the hospital indemnity plan that you have with APL through your association with the Business Workers of America, is that correct?
[CUSTOMER][NEUTRAL] Uh, I have no idea.
[CUSTOMER][NEUTRAL] I believe it's BW BWA is what my card.
[AGENT][NEUTRAL] BWA yes, ma'am. OK, so the Business Workers of America Association, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So just a moment.
[AGENT][NEUTRAL] OK, so now the ID card that you're provided that those do not come directly from APL so on your ID card that you did receive, does that have information related to pharmacy on the front like where your name and stuff is located?
[CUSTOMER][NEUTRAL] No, ma'am, no ma'am, it just says a $25 office visit or primary and then uh.
[CUSTOMER][NEUTRAL] Hold on, I'm getting it again.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And the bottom right hand corner.
[CUSTOMER][NEUTRAL] It has primary care office visit 25 and then specialty uh 50.
[AGENT][NEUTRAL] OK, so on the other side of your card, does it have?
[AGENT][NEUTRAL] A phone number for members to call?
[AGENT][NEGATIVE] For general customer service concerns.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, yes, it does.
[AGENT][NEUTRAL] OK, is that an 8 by chance? Is that an [PII] number?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. And have you tried to contact that number?
[CUSTOMER][NEUTRAL] Uh, no, I have not.
[AGENT][NEUTRAL] OK. So that would be who you would need to reach out to. I'll be more than happy to connect you, but related to any of your questions on your pharmacy, as far as, you know, if you have that coverage, that type of thing, um, that's the phone number that you would, would call.
[AGENT][NEUTRAL] Because that is something that's not affiliated with this policy that you have with APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What do I have with APL?
[AGENT][NEUTRAL] This is the hospital indemnity plan.
[CUSTOMER][NEUTRAL] Oh, OK, the.
[AGENT][NEUTRAL] Yes, ma'am. That's what you have with us.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] It
[CUSTOMER][NEUTRAL] They don't give, OK, so they sent me was the card, the card and then I have the APL stuff. I apologize.
[AGENT][NEUTRAL] No, you're fine. No, ma'am, that's perfectly fine and I'm going to actually email you a user guide for our portal and I'm going to request that your policy information, um, I think I can do that for your association. Give me just one second.
[AGENT][NEUTRAL] Now you should have received from a link an email like from.
[AGENT][NEUTRAL] The enrollment company that you enrolled through with a link to your portal and your signing information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that would not come from us. That would come from member services, I believe.
[AGENT][NEUTRAL] Which is
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Also, you know, where you like would talk to them about enrollments or changes or anything like that?
[AGENT][NEUTRAL] That's member services, and I can provide you their phone number because I don't believe that number is on your ID card.
[AGENT][NEUTRAL] But member services phone number would be [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, um, what's the difference, the member service number on the back and then this member service number?
[AGENT][NEUTRAL] And they
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] I'm honestly not sure, to be very, to be very honest with you. I'm not sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right honey, I.
[AGENT][NEUTRAL] I can just, we have a copy of your ID card, you know, I mean, a copy, like a generic copy of the ID card. That's where I saw that first number that you said is on your card, and then the other number that we give out to members who have any questions, you know, related to changes or cancellations or their premiums is that phone number that I just gave you.
[CUSTOMER][POSITIVE] Got it OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and you transfer me over to um.
[AGENT][NEUTRAL] I will. I'm gonna transfer you to that number that's on your card.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let them know that you have some um inquiries about.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Yes, because that states for according to what I can see, it says for general customer service concerns.
[AGENT][NEUTRAL] Members may receive care from any licensed provider.
[AGENT][NEUTRAL] I don't wanna transfer you to the wrong place, but I'm honestly not sure with you having a question related to that, you know, your pharmacy coverage, if you have pharmacy coverage.
[AGENT][NEUTRAL] I they should let me connect you first off to the 2nd phone number that I gave you to member services so that they can verify with you what benefits you're enrolled for.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, they also have an email address for member services, Ms. [PII], and would you like that?
[CUSTOMER][NEUTRAL] No, I, I, yeah, if you could do.
[CUSTOMER][NEUTRAL] Me
[AGENT][NEUTRAL] OK. Now, I don't know what time zone they're on, so for some reason, if.
[AGENT][NEUTRAL] It goes to voicemail. Would you like for me to release you to their voicemail to leave a message for someone to return your call?
[CUSTOMER][NEUTRAL] Uh, no, I'll just, I'll just call the numbers back.
[AGENT][NEUTRAL] OK, OK, well, I will try and transfer you if it does go to voicemail then I'll just get back on the line and let you know that, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Well, you're very welcome. And is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][POSITIVE] OK, well, thank you so much, Ms. [PII], for calling APL and I hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you.
[CUSTOMER][NEUTRAL] Thank you for calling member services. All calls are recorded for quality assurance. Our hours of operation are Monday through Friday [PII] Central Standard Time. If you know your party's extension, please dial it now.
[CUSTOMER][NEUTRAL] For customer support, press 2. For agent support, press 3. For claim support, press 4. For provider support, press 5. Thank you.
[CUSTOMER][NEUTRAL] You are currently caller number 19, waiting to speak with a representative. The estimated hold time is currently 15 minutes. Thank you for your patience.
[AGENT][NEUTRAL] OK, Ms. [PII], this is still [PII]. So the, um,
[AGENT][NEUTRAL] It's option 2 that you would choose, but the message um has changed from the last time I transferred a call there. It does give you the number of, it said that you would be 19 in line.
[AGENT][NEUTRAL] For the next available attendant, and approximate hold time is 15 minutes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ah
[AGENT][NEGATIVE] It did not give the option of leaving a message.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So would you like for me to transfer you back over and just release the calls?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][POSITIVE] OK, well, I'll be happy to do that. So give me one moment, please.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][POSITIVE] OK thank you ma'am.
[AGENT][POSITIVE] Yes, ma'am. You're welcome.
[CUSTOMER][NEUTRAL] Thank you for calling member services. You are currently