AccountId: 011433970860
ContactId: 8bd928b1-42c4-4c09-9a5d-f25a6d3414a8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 522510 ms
Total Talk Time (AGENT): 279604 ms
Total Talk Time (CUSTOMER): 154765 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/8bd928b1-42c4-4c09-9a5d-f25a6d3414a8_20250602T17:10_UTC.wav
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[CUSTOMER][NEUTRAL] Aunt number.
[AGENT][NEUTRAL] Good morning, or excuse me. Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], good afternoon. I'm, uh, I'm covered under your policy, and I have a procedure coming up now and it's a $750 copay. I pay that up front and then I file for a claim with you or I could give that to the provider to file it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so you have a policy with us and you have an upcoming procedure that you're wanting to find out about how to go about filing for, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, sir. I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] OK. Thank you, Mr. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] It's [PII] again [PII].
[AGENT][NEUTRAL] OK, thank you. And your policy number, please?
[CUSTOMER][NEUTRAL] [PII], can you give it to her please? OK, I, I have that. Hi [PII], do you need group number or the cert number?
[AGENT][NEUTRAL] Hi.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] I need the cert number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So that would be outpatient because there's in hospital and outpatient. OK, outpatient cert number 01831292ML8.
[AGENT][NEUTRAL] OK, thank you. Give me just a moment please to get your information pulled up, Mr. [PII].
[CUSTOMER][POSITIVE] Not a problem.
[AGENT][NEUTRAL] OK, so first off, Mr. [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment, and I will need to verify several things with you for security. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you and your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one that you provided for me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. And then lastly we show that you do not have an email address, is that also correct?
[CUSTOMER][NEUTRAL] No, it's [PII].
[AGENT][NEUTRAL] OK, wait, give me just a moment then. Oh, I'm sorry. So it had none in here. OK. [PII].
[CUSTOMER][NEUTRAL] Uh my last name [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] No, no, [PII], my last name [PII]
[AGENT][NEUTRAL] I'm sorry. So [PII], yes, sir.
[CUSTOMER][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] The number [PII]
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, so first off, Mr. [PII], I need to give you an updated policy number because that policy number is for a policy, an older policy that you have with us.
[CUSTOMER][NEUTRAL] OK. Oh, OK, great, yeah, that might have been last year's. uh, could you email it to him because, um, or mail it to him?
[AGENT][NEUTRAL] I can what I'm gonna do, Mr. [PII] is I will email you the ID card so that you'll have it since you've got an upcoming procedure. I can request that they be mailed to you and also I'm going to include a user guide for our portal so that if you choose to set up your profile that would give you access online to your information now currently the portal website uh.
[AGENT][NEUTRAL] is down at the moment and our IT department is working on it but this user guide will give you just general information if you wanna try within, you know, maybe tomorrow or the next day to set that up um you can do that and then if you need any assistance you could call us back. But what I always recommend is because this is a supplement to your primary insurance, most providers will file.
[AGENT][NEUTRAL] Your primary and then with your supplement. In the event that they will not file your supplemental insurance, then yes, sir, you can submit the claim yourself.
[AGENT][POSITIVE] And if that need does arise, you could call us back and we would be happy to explain how to go about doing that.
[CUSTOMER][NEUTRAL] OK, but this is the $2000 gap coverage, correct?
[AGENT][NEUTRAL] Let me pull your benefit information up to take a look at that. Give me just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so on this policy you have an outpatient benefit maximum per calendar year for covered outpatient services of $1250.
[CUSTOMER][NEUTRAL] Oh, it went down I guess last year it was, we think, we think it was $2000 OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this policy, this policy that's currently active, it did go into effect as of [PII].
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the benefits, yes. So this policy is the one that's currently active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so when we go to the scan, uh, in the middle of June, we tell them here's our policy, uh, try to run.
[CUSTOMER][NEUTRAL] The co-payment through there and then if they don't do it we can call after to submit everything for you guys is that how it's gonna work?
[AGENT][NEUTRAL] That is correct. Then, because Mr. [PII], I, I know you're on the line as well. So the profile, if you choose to set up your portal, again, in addition to giving you your access to your policy information and your ID cards, you can see claims that we receive for you as well as if you have to submit your own claim, you can actually upload all of the required information directly into that portal for our review.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now if you don't have a computer or not able to do that, then you could fax it or mail it to us we just can't accept claims information via email.
[CUSTOMER][POSITIVE] OK perfect.
[CUSTOMER][POSITIVE] Got you OK that'll work OK.
[AGENT][NEUTRAL] So, so if you will give me just one second while you all are still on the phone with me, I'm gonna go ahead and send this email with your ID cards. So bear with me just a second, please.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Yeah. [PII], I guess the coverage was reduced from last year when they, when you guys renewed, you must have reduced it. Yeah, yeah. Cause it was definitely $2000.
[CUSTOMER][NEUTRAL] OK, at least we know what it is now. Yeah. No, and it'll cover the 750 so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That works.
[AGENT][NEUTRAL] OK, so the email that you're gonna be receiving from me, Mr. [PII] will come from [PII]?
[AGENT][NEUTRAL] And I did put APL and ID cards and online service center in your subject lines for that to uh be able to easily be recognized.
[CUSTOMER][POSITIVE] OK, perfect. So now we have the new ID card. Perfect. OK.
[AGENT][NEUTRAL] All right. Well, is there anything else that I can help you all with today?
[CUSTOMER][POSITIVE] No we're well thank you so much.
[AGENT][POSITIVE] Well, you're both very welcome and thank you again for calling APL. I hope you have a great afternoon.
[CUSTOMER][POSITIVE] Alrighty thank you bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.