AccountId: 011433970860
ContactId: 8d0621a6-dfe2-4801-89f0-65b0f930bcc6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 387399 ms
Total Talk Time (AGENT): 188952 ms
Total Talk Time (CUSTOMER): 124733 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/8d0621a6-dfe2-4801-89f0-65b0f930bcc6_20250310T15:34_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]. My name is [PII]. Um, I am covered by American Public Life, I believe, for, um, um, for mental health, and, um, I would just like to know what my coverage is for finding a, um, psychiatrist for medication management.
[AGENT][NEUTRAL] OK, and what's your name again, ma'am?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK. And what's your policy number?
[CUSTOMER][NEUTRAL] It is, give me 1 2nd.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is 02596755.
[AGENT][NEUTRAL] And what's a good call back number calling in case we're disconnected?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And if you can verify your date of birth and your mailing address for me?
[CUSTOMER][NEUTRAL] It is [PII], and it should be [PII].
[AGENT][NEUTRAL] And your email address please.
[CUSTOMER][NEUTRAL] Um, it is [PII].
[AGENT][NEUTRAL] Thank you for [PII] for verifying that for me. All right, so the PPO network of contracted providers for your medical policy is multi-plan. Now we don't have a list of their contracted providers, but I do have a phone number for them.
[CUSTOMER][NEUTRAL] OK, yeah, that would be great. Um, so, um, I just have a question, so it would be, so technically, um, the provider would be covered, it would be under the multi-pla network, correct?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I mean I I don't have a list of their providers but yeah it would be under the multipla network correct.
[CUSTOMER][NEUTRAL] OK, and I, I am covered for um for uh psychiatric medication, correct?
[AGENT][NEUTRAL] And so this is for like a specialist office visit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. You do have the office visit benefit under your policy?
[CUSTOMER][NEUTRAL] OK, alright, great, and, and what was the number again? Sorry.
[AGENT][NEUTRAL] OK, and so that phone number. One moment.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. They also have a website address if you would like that as well.
[CUSTOMER][NEUTRAL] Um, OK, it, it would be like a [PII] essentially.
[AGENT][NEUTRAL] It's yeah, [PII].
[CUSTOMER][NEUTRAL] OK, um, I just wanted to call and make sure because I, I had called a specialist through the multi-plan network and they, um, contacted APL and they told me I'm not covered for, um, psychiatric medication, um, medication management, so.
[AGENT][NEUTRAL] OK, so, OK, so, OK, so for, for medication, give me a second. Do you have a copy of your identification card?
[CUSTOMER][POSITIVE] I do, yes.
[AGENT][NEUTRAL] Uh, let's see. Let me look at your policy again. There is an outpatient prescription drug benefit under your policy. Um, let's see.
[AGENT][NEUTRAL] Let me pull up your policy real quick.
[AGENT][NEUTRAL] And then when you say man, are you meaning just a prescription for the condition?
[CUSTOMER][NEUTRAL] Yes, I'm, I'm, yes, I'm just looking for refills on my prescription essentially.
[AGENT][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so on the back of your card?
[AGENT][NEUTRAL] Um, it should, uh, list the pharmacy carrier. It's Farmmavale.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that number on the back should be [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and they'll need all of that information underneath that number like the VIN number, group number and the PCN number, so that's your prescription carrier, but you also have a prescription benefit under your policy as well and so like when um.
[AGENT][NEUTRAL] I'm thinking that maybe you can provide us with a copy of your prescription receipt when you go to the pharmacy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we could reimburse you based on that, but Farmervale is your carrier, so they should also provide a benefit, uh, a prescription benefit for you as well.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, yes, that'd be good because I, I keep going, I keep, you know, trying to get refills my prescription and they keep saying it's not covered, so I, yeah, OK.
[AGENT][NEUTRAL] At the pharmacy?
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] Did, did you show him your ID card?
[CUSTOMER][NEUTRAL] I did, yes.
[AGENT][NEUTRAL] I wonder if it's a type of um drug.
[AGENT][NEUTRAL] That you're trying to get.
[CUSTOMER][NEUTRAL] It, it probably
[CUSTOMER][NEUTRAL] It might be, yes, it might just be the drug itself that's not covered.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] I got it I got it. And so then you can also get their um like an itemized statement from them if you should have to pay out of pocket and then you could send that to um American Public Life, and let me get into your policy specifically. I know it's a $15 reimbursement, but let me see the frequency.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What the frequency is.
[AGENT][NEUTRAL] So it says that the outpatient prescription drug benefit is 10, it's here it says $10 per day, a maximum of 15 days per calendar year per covered person.
[AGENT][NEUTRAL] Yeah, it's $10 yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. All right. Thank you so much.
[AGENT][NEUTRAL] OK, any other questions, [PII]?
[CUSTOMER][POSITIVE] Um, not at this moment. I will go back if there is any, but thank you so much for your help.
[AGENT][POSITIVE] You're welcome thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Uh, bye-bye.