AccountId: 011433970860 ContactId: 8c747a97-72f4-4444-b9d7-1cc4b9ceb840 Channel: VOICE LanguageCode: en-US Total Conversation Duration: 1327150 ms Total Talk Time (AGENT): 588250 ms Total Talk Time (CUSTOMER): 597886 ms Interruptions: 6 Overall Sentiment: AGENT=0.5, CUSTOMER=-0.6 Redaction Types: PII Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/8c747a97-72f4-4444-b9d7-1cc4b9ceb840_20250127T20:17_UTC.wav -------------------------------------------- [AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you? [CUSTOMER][NEUTRAL] Yeah, [PII], this is [PII]. I, I got a problem. I'm, I went to the doctor. I know at least twice since I've got, uh, MAU uh insurance claim. I think 22 times or 3. I'm thinking 2. [CUSTOMER][NEUTRAL] But anyway, I got a bill for 311, then I got one for 6 something. [CUSTOMER][NEUTRAL] Uh, [CUSTOMER][NEUTRAL] I'm trying to figure out what it, what, what's covered under the bill because I don't go to the doctor and get nothing done but blood work pretty much and, you know, they make sure I get my blood pressure medicine. [AGENT][NEUTRAL] OK, so you are the insured and you have a question regarding, is it claims or just your benefits? [AGENT][NEUTRAL] That you, are you [CUSTOMER][NEGATIVE] It's, it's, I mean, what I'm saying, they sending me a bill for $311 when I, you know, I, I'm trying to figure out why am I getting a bill and the only thing the insurance is paying is $58 and some cents. Uh, they're saying adjustment $217 total charges $500 and something dollars. [AGENT][NEUTRAL] OK. All right. So, uh, what I can, yes, sir, I can look at your policy and help you with some of your questions and who again am I speaking with? [CUSTOMER][NEUTRAL] [PII]. [AGENT][NEUTRAL] Thank you and Mr. [PII], what is your callback number? [CUSTOMER][NEUTRAL] [PII] [AGENT][NEUTRAL] Thank you. And your policy number, please? [CUSTOMER][NEUTRAL] My policy number? [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] Oh [CUSTOMER][NEUTRAL] Let me see if I got this you called. [CUSTOMER][NEUTRAL] Yeah, he, I guess, uh, policy number would be. [CUSTOMER][NEUTRAL] What would that be an employee ID? [AGENT][NEUTRAL] Uh, I'm not sure. It depends on the type of coverage that you have, Mr. [PII], as to how it would be worded, but do you have an ID card from American Public Life or APL? [CUSTOMER][NEUTRAL] May I? [CUSTOMER][NEUTRAL] No, I got a MAU uh card and [AGENT][NEUTRAL] OK, what is your social security number, Mr. [PII]? So I can try and look up your information. [CUSTOMER][NEUTRAL] [PII] [AGENT][NEUTRAL] Uh-huh. [AGENT][NEUTRAL] OK, thank you. One moment, please. [AGENT][NEUTRAL] OK, and Mr. [PII], I will need to verify several things with you first for security purposes and also any information that I provide for you today will be a verification of benefits and not a guarantee of payment. So first off, if you will please verify your date of birth. [CUSTOMER][NEUTRAL] [PII]. [AGENT][POSITIVE] Thank you and also your home mailing address. [CUSTOMER][NEUTRAL] [PII]. [AGENT][NEUTRAL] Mhm. [AGENT][NEUTRAL] City, state, and Zip. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] [PII]. [AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one you, I'm sorry, it is not, it is different than what you gave me. What is another phone number that we. [AGENT][NEUTRAL] Well, actually, no, I'm sorry Mr. [PII]. I read that wrong. Yes sir, the phone number we have on file is the same as the one you gave me, so that is your best contact number, is that correct? [CUSTOMER][NEUTRAL] It's the only contact you. [AGENT][POSITIVE] All right, thank you. And lastly your email address, please. [CUSTOMER][NEUTRAL] [PII]. [CUSTOMER][NEUTRAL] [PII]. [AGENT][POSITIVE] All right, thank you. [AGENT][NEUTRAL] Now on that ID card that you said you have, what is that number? [AGENT][NEUTRAL] That [CUSTOMER][NEUTRAL] E [PII]. [AGENT][NEUTRAL] OK, so no, sir, I'm. [CUSTOMER][NEUTRAL] 29. [AGENT][NEUTRAL] OK. So what I'm gonna do is I'm gonna give you the correct [CUSTOMER][NEUTRAL] Who [CUSTOMER][NEUTRAL] The group number is 943 7. [AGENT][NEUTRAL] OK, so the policy number for your coverage that you have with American Public Life, I'm gonna give you a different number. [AGENT][NEUTRAL] And I'm also going to, do you use the internet very much, Mr. [PII]? [CUSTOMER][NEGATIVE] No, I don't use it at all. [AGENT][NEUTRAL] You don't use it at all? OK. [CUSTOMER][NEUTRAL] I don't have no [CUSTOMER][NEUTRAL] Don't have no reasoning. [AGENT][NEUTRAL] OK. [AGENT][NEUTRAL] OK. [CUSTOMER][NEGATIVE] I'm kind of, I don't care for using the internet. [AGENT][NEUTRAL] Oh, that's all right. There's nothing. [CUSTOMER][NEUTRAL] You know [AGENT][NEUTRAL] Yeah, that's OK. Yeah, I, I understand. OK, and the reason I was asking that is because we do have a portal, Mr. [PII], where you could set up a profile to have access to your ID cards, um, online, but let me give you this policy number and you can just write it down. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] Mm [CUSTOMER][NEUTRAL] OK, I'm writing it down, but what good is it why is never gonna do? [AGENT][NEUTRAL] If you need to forgive it to a provider. [CUSTOMER][NEUTRAL] You know, uh, and will I be able to go to the doctor? [AGENT][NEUTRAL] OK, so under this [CUSTOMER][NEUTRAL] Would I be able to go to. [CUSTOMER][NEUTRAL] Would I be able to go to the doctor and get, you know, what I need done? [AGENT][NEUTRAL] This policy that you have with APO this limited benefit plan does not have benefits for office visits. [AGENT][NEGATIVE] This limited benefit. [CUSTOMER][NEUTRAL] Well this is this is. [CUSTOMER][NEUTRAL] This is for prompt care. I go to prompt care to a doctor, which I asked them what the doctor, the doctor that I'm under care, do they, do they, uh, [AGENT][NEUTRAL] Mhm. [CUSTOMER][POSITIVE] Work with him and they told me yes. So I'm, I thought I was good as far as they're concerned. [AGENT][NEUTRAL] Is it, well, this policy only has benefits if you were admitted as an inpatient or if you had to have some type of outpatient. [AGENT][NEUTRAL] Um, surgery. [CUSTOMER][NEGATIVE] What? That don't make sense though. I mean, why would I, why would I just do that? [AGENT][NEUTRAL] Yeah. [AGENT][NEUTRAL] I'm not sure, Mr. [PII]. I can't, I can't answer that. Now, I can make sure that you have [CUSTOMER][NEUTRAL] When it, when I need [CUSTOMER][NEUTRAL] OK [AGENT][NEUTRAL] The phone number I can also connect you with who you would need to talk to to find out about other plan options that could be available to you through your employer. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEGATIVE] So with this card I'm giving them, which I, what I gave them is, is really not nothing. [AGENT][NEUTRAL] Well, I'm not sure what. [CUSTOMER][NEGATIVE] It's just a waste of time. I'm, I'm, so you're saying I'm saying. [AGENT][NEUTRAL] I don't, I'm [CUSTOMER][NEGATIVE] I'm paying money every time they take out money, you know, every time they take out money from my check for this plan, I'm not getting nothing from it in other words, right? [AGENT][NEUTRAL] I [AGENT][NEUTRAL] I'm not sure. I don't know about the information that you were giving me on that card as far as those numbers and all of that. [CUSTOMER][NEUTRAL] Because it's, it's, it's telling me here on the card about doctor visits and all that, you know co-payment and all that. It's telling me that. [AGENT][NEUTRAL] I'm so it's, I, I didn't understand what you said. Could you say that again, Mr. [PII]? [CUSTOMER][NEUTRAL] The card is that I'm, I'm actually holding here is telling me that I got a $10 copay. [CUSTOMER][NEUTRAL] You know, my coverage is MC MEC, no deductible, no out of the pocket. [AGENT][NEUTRAL] OK, so that's a different company than who you're talking with. What number did you call to reach me on today, Mr. [PII]? [CUSTOMER][NEUTRAL] You [CUSTOMER][NEUTRAL] I, I called you on the number that they, that y'all send me on my phone. It made you send me. [AGENT][NEUTRAL] OK, well, I'm not with [PII]. What phone number did you dial to reach me today? I'm trying to make sure you have the correct information so you can talk to the correct people. [CUSTOMER][NEUTRAL] Oh. [CUSTOMER][NEUTRAL] [PII] [CUSTOMER][NEUTRAL] Oh, [CUSTOMER][NEUTRAL] I said [PII] something like that. [AGENT][NEUTRAL] Oh, I don't even, I'm, I'm not, that's on your ID card? [CUSTOMER][NEUTRAL] No, this is on my uh on the card I got it's got [PII]. [CUSTOMER][NEUTRAL] [PII] [AGENT][NEUTRAL] I'm not sure what that number is either. I've never heard of that number. [CUSTOMER][NEUTRAL] Oh it's got, and then it got. [AGENT][NEUTRAL] I'm not familiar with that, no. [CUSTOMER][NEUTRAL] It's got RX number on it too, which [CUSTOMER][NEUTRAL] It's not saying much. [CUSTOMER][NEUTRAL] And this same pay card and ID number is 64. [CUSTOMER][NEUTRAL] 556 benefits in the card. [AGENT][NEUTRAL] OK, that EDI number, that's a payer ID number that's 64, that's an electronic payer ID that a provider would use to send in a claim. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Now, you said that it, it said on there like MEC something about MEC? [CUSTOMER][NEUTRAL] Right. [CUSTOMER][NEUTRAL] Yes. [AGENT][NEUTRAL] OK, that means you, you must also have a plan with [AGENT][NEUTRAL] 90 degree benefits. [CUSTOMER][NEUTRAL] Yeah. [AGENT][NEUTRAL] OK, now their phone number is [PII]. [AGENT][NEUTRAL] [PII]. Mhm. Now when you call that number, depending on. [CUSTOMER][NEUTRAL] [PII]. [CUSTOMER][NEUTRAL] Right. [AGENT][NEUTRAL] Depending on the option that you select, Mr. [PII]. [AGENT][NEUTRAL] As to where you're transferred to. [AGENT][NEUTRAL] Option one. [AGENT][NEUTRAL] Is who you would, is what you would select to speak to someone regarding your benefit information on your wellness benefits. [AGENT][NEUTRAL] I'm with APL and the only policy that you have with us for medical is this limited benefit plan that I was telling you about a moment ago. [CUSTOMER][NEUTRAL] OK, what would that be? I mean. [AGENT][NEUTRAL] But to find out if you have. [CUSTOMER][NEUTRAL] Hello. [AGENT][NEUTRAL] That's the, yes, sir. Can you hear me? [CUSTOMER][NEGATIVE] Yeah, you keep breaking up. [AGENT][NEGATIVE] Yes, sir. I don't know. We don't have a good connection. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] But go ahead. [AGENT][NEUTRAL] So your policy number for the policy you have with us that I gave you your benefit information on a while ago is 0244. [AGENT][NEUTRAL] 3973. [AGENT][POSITIVE] Now, I will be happy to connect you over to 90 degree benefits so that you can see what your benefits are related to the coverage that you have with them as far as office visits and that type of thing. [AGENT][NEUTRAL] But again, if for some reason, Mr. [CUSTOMER][NEUTRAL] Yeah, um, [CUSTOMER][NEUTRAL] Right. [AGENT][NEUTRAL] If we were to get disconnected, call the [PII] and select option one. [CUSTOMER][NEUTRAL] For some reason [CUSTOMER][NEUTRAL] [PII] [CUSTOMER][NEUTRAL] 800 [CUSTOMER][NEUTRAL] [PII]. What? I think I got that on this card. [AGENT][NEUTRAL] Yes, sir, it should be on your card. Uh-huh, and you would select option one. [CUSTOMER][NEUTRAL] This number here you talk. [CUSTOMER][NEUTRAL] Mhm [AGENT][NEUTRAL] When it answers. [CUSTOMER][NEUTRAL] [PII]. [AGENT][NEUTRAL] Yes, sir. [CUSTOMER][NEUTRAL] It's [PII], you say, right? [AGENT][NEUTRAL] Yes. [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEUTRAL] Uh [CUSTOMER][NEUTRAL] OK, what else? [CUSTOMER][NEUTRAL] That's what I need to call and [AGENT][NEUTRAL] Now we [AGENT][POSITIVE] Now I'll be happy to transfer you if you would like so you can ask for any questions you have related to your. [CUSTOMER][NEUTRAL] I can ask the question. [CUSTOMER][NEUTRAL] Yeah, I can ask the question, but I'm, I'm headed to work at this time, so you know I ain't got a whole lot of time to, you know, talk on the phone, uh. [AGENT][NEUTRAL] Oh, OK. [AGENT][NEUTRAL] Or do you just want to call them back? [CUSTOMER][NEUTRAL] I can call back tomorrow, but I mean, I do want to look into this, uh. [CUSTOMER][NEGATIVE] This is what y'all talking about because I don't, you know, if they're not, they don't make no sense for me to be paying for insurance that I, you know, ain't doing me no good. [AGENT][NEUTRAL] So then if you're wanting to cancel this coverage or make any types of changes, you must do that, Mr. [PII], with benefits and a card or BIC, that's the company that you enrolled for your insurance through. [AGENT][NEUTRAL] And they provide the different companies with your information based on what you sign up for, so any questions about changing anything, canceling, anything related to what you're paying for your premiums, all of that would go through benefits in a card and I can give you their phone number also. [CUSTOMER][NEUTRAL] Right. [CUSTOMER][NEUTRAL] Right. [AGENT][NEUTRAL] If you don't have [CUSTOMER][NEUTRAL] I, I, I got the number though. I don't have it. [CUSTOMER][NEUTRAL] I thought this was y'all benefits in the past. [AGENT][NEUTRAL] I don't, I don't know. [AGENT][NEUTRAL] Um, no, sir. I'm not with Benefits and a card. I'm with APL. [CUSTOMER][NEGATIVE] Well, why is, why is y'all, wait, why are you calling me for MAU, uh, on the MAU because they gave me the number for me to call y'all. So, [CUSTOMER][NEUTRAL] Is it some kind of uh uh. [AGENT][NEUTRAL] OK, no, sir. So there's a third party, you and, OK, you work for MAU and all of MAU's enrollments are handled by a company called Benefits and a Card. That is the company that handles your deductions, all of that. [CUSTOMER][NEUTRAL] Right. [AGENT][NEUTRAL] You enrolled for one of our products, so they provided us your information. [CUSTOMER][NEUTRAL] Right. [CUSTOMER][NEUTRAL] would I enroll? [AGENT][NEUTRAL] For this limited benefit plan with benefits and a card, you enroll through benefits and a card. Mhm. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] OK, if that's the case, all y'all, you connecting in other ways, right? [AGENT][NEUTRAL] No, sir, not really. [CUSTOMER][NEUTRAL] And so [AGENT][NEUTRAL] I mean, we're different companies altogether. [AGENT][NEUTRAL] We are completely separate. [CUSTOMER][NEUTRAL] Yeah, but what, why do I need to, why do I need two kind of services when. [AGENT][NEUTRAL] Because that's how your employer, that's how your employer has your benefits set up. [CUSTOMER][NEUTRAL] I don't need two kinds. [CUSTOMER][NEUTRAL] That, but I'll be, so what I'll be doing, paying two payments, different payments. [AGENT][NEUTRAL] I don't, I don't have access to that information, Mr. [PII]. Again, benefits and a card would be able to answer your questions on anything related to your premium. [AGENT][NEUTRAL] And what you're paying. [CUSTOMER][NEUTRAL] OK, you gave me the money. [AGENT][NEUTRAL] Uh-huh. Well, yeah, there. [CUSTOMER][NEUTRAL] Yeah, so this is. [AGENT][NEUTRAL] OK, I know that I gave you the phone number that's on your ID card for you to call 90 Degree benefits regarding your wellness, your Mac coverage. [CUSTOMER][NEUTRAL] Right. [AGENT][NEUTRAL] And then benefits and a cords phone number is [PII]. [CUSTOMER][NEUTRAL] Right. [AGENT][NEUTRAL] 497. [AGENT][NEUTRAL] 4856. [CUSTOMER][NEUTRAL] [PII]. I got that number on the card too. [AGENT][NEUTRAL] Uh-huh. [AGENT][NEUTRAL] Yes, sir. [AGENT][NEUTRAL] Mhm. So that's who you talked to about changes, cancellations, and enrollments or your. [CUSTOMER][NEUTRAL] I got [AGENT][NEUTRAL] How much you're paying for your policies. [CUSTOMER][NEUTRAL] I think I got this pneumonia. Let me look at here for sure. [CUSTOMER][NEUTRAL] No. [CUSTOMER][NEUTRAL] I don't. [CUSTOMER][NEUTRAL] So that's what I need to do to change my policy you saying. [AGENT][NEUTRAL] Yes, sir, if you have. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEGATIVE] Because I don't understand the policy if I got the, you know, if I got this, you know, if I'm, you know, got insurance and then, you know, it ain't covering, you know, but $58 on my coverage, then something don't sound right about that, you know, I shouldn't be getting a hospital bill this big. [AGENT][NEUTRAL] Yes, sir. And unfortunately, I can't answer. Yeah, I, I understand um what you're asking. I just can't provide you any information on the coverage that you have through [CUSTOMER][NEUTRAL] You know, [AGENT][NEUTRAL] 90-degree benefits, which is that Mac coverage. [CUSTOMER][NEUTRAL] OK, well, you said I need to call, I need, I need to call bid for what my coverage is. [AGENT][NEUTRAL] You need to call back if you wanna know what you're paying, or you wanna cancel? [CUSTOMER][NEUTRAL] Yeah. [AGENT][NEUTRAL] Or you wanna change anything. If you wanna know what's covered under your 90 degree benefit policy which is the Mec wellness. [CUSTOMER][NEUTRAL] Yeah. [AGENT][NEUTRAL] You would have to call the first phone number I gave you and press option one. [CUSTOMER][NEUTRAL] OK. [CUSTOMER][NEUTRAL] The wellness benefit, that's the [PII]. [CUSTOMER][NEUTRAL] [PII]. OK, where the other one. [AGENT][NEUTRAL] [PII]. Mhm. [AGENT][NEUTRAL] Uh-huh. Option one, yes. [CUSTOMER][NEUTRAL] Yeah, I got the option one. [CUSTOMER][NEUTRAL] And the other one just to, to pick up another a whole different kind of insurance provider. [AGENT][NEUTRAL] If you wanted to find out what other, uh-huh, what, what other options are available to you, yes, sir, then you would call that last number that I gave you. [CUSTOMER][NEUTRAL] What you gave me [CUSTOMER][NEUTRAL] Options I have, yeah. [CUSTOMER][NEUTRAL] Mm [CUSTOMER][NEUTRAL] OK. [AGENT][NEUTRAL] Mhm. [CUSTOMER][NEGATIVE] All right. All right, I'll get on it as soon as I can and be part of tomorrow sometime. But thank you for that information because, because I was like, I'm not going to the, I'm not going to the doctor if I got, you know, if I got to make a bill that big, you know, I'm already struggling cause I, you know, I lost my job for 22 years and I just, ain't no way I can afford that right now. [AGENT][NEUTRAL] OK yeah [AGENT][NEUTRAL] OK, Mr. [PII]. [AGENT][POSITIVE] Well, you're, you're welcome. [CUSTOMER][NEUTRAL] You know, so [AGENT][POSITIVE] Yes, all right. I do understand. [CUSTOMER][NEGATIVE] With that being said, it just put me deeper and deeper in debt, and I can't, I can't do that much as I, you know. [CUSTOMER][NEGATIVE] I want to go to the doctor. I can't, I can't go to the doctor cause I can't afford that. So, you know, I'm, you know, I'm gonna have to talk to somebody because they're gonna have to give me some kind of, you know, information cause I know I went to the doctor twice since I've been with MAU. [CUSTOMER][NEGATIVE] And uh I'm quite 2 or 3 times. But anyways, the 3 times, 2 or 3 times I went, you know, I'm, I'm getting a bill back and I'm trying to figure out why I'm not getting a bill. [CUSTOMER][NEUTRAL] You know, [AGENT][POSITIVE] Yes, sir. I, I completely understand. [CUSTOMER][POSITIVE] So, I thank you. [CUSTOMER][POSITIVE] Yeah, I appreciate it. I, I will do, you know, my, uh, I will call them tomorrow and find out what's, what, what I, what I need to do or what's, what do I need to change anything, you know, because if I'm, you know, if I'm using this and it's not paying for, you know, me to go in the hospital, I mean, go in the doctor's office just for a physical routine checkup, you know what I'm saying? [AGENT][NEUTRAL] Yes, sir, and you may, right, you may have benefits on your other policy with the Mac policy. [CUSTOMER][NEUTRAL] You know, and they take blue. [CUSTOMER][NEUTRAL] Right. [AGENT][NEUTRAL] But this one would help you if you had to be admitted to the hospital. [AGENT][NEUTRAL] Or if you had to have some type. [CUSTOMER][NEUTRAL] Yeah, but I'm, I'm. [AGENT][NEUTRAL] And that's, yeah. [CUSTOMER][NEUTRAL] Yeah, yeah, that. [CUSTOMER][NEUTRAL] I'm not, I'm not too worried about being admitted to the hospital for what reason? I mean, [CUSTOMER][NEUTRAL] Uh, it could be any reason. I understand what you're saying, but, you know, uh, uh, that's not even a concern. I'm just concerned about making sure I get to the doctor and knowing what's going on with me. That way I won't have to be worried about being admitted to the doctor for whatever reason cause I can take care of it before we get to that point. You understand what I'm saying? [AGENT][NEUTRAL] Mhm. OK. [CUSTOMER][NEUTRAL] OK [CUSTOMER][NEUTRAL] Yeah. [CUSTOMER][NEGATIVE] So I do my, I do my due diligence to to call them and make sure, you know, what's what cause, you know, this ain't work, this ain't working for me. And I, you know, I got, I think I got a card. Y'all send the card? I don't know if you seen it, the benefits in the card. I don't know where the card is if they sent it. [CUSTOMER][NEUTRAL] You know, I think I remember seeing something like that, but I don't know where it is, to be honest. [AGENT][NEUTRAL] Yeah [AGENT][NEUTRAL] Mm [CUSTOMER][NEUTRAL] Yeah, but anyway, I'll do that, I'll call and find out what's what. [AGENT][NEUTRAL] Hello. [CUSTOMER][POSITIVE] Thank you, thank you. [AGENT][POSITIVE] OK. Well, is that all I can, yes, so you're certainly welcome. Is there anything else I can help you with today? [CUSTOMER][NEGATIVE] No, that's it. I, you know, I just got questions about, you know, why, why am I, you know, paying out of pocket so much. [AGENT][NEUTRAL] OK. [CUSTOMER][NEUTRAL] You know, uh, but anyway, that's, you know, something else I got to do. All right, thanks. [AGENT][POSITIVE] All right, Mr. [PII]. Well, thank you again for calling APL and I hope that you have a nice rest of your day today. [CUSTOMER][NEUTRAL] You too bye. [AGENT][POSITIVE] Thank you. Uh-huh. Bye-bye.