AccountId: 011433970860
ContactId: 8d2b530d-e583-4edf-b4bb-e774ff3ba758
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 401459 ms
Total Talk Time (AGENT): 176836 ms
Total Talk Time (CUSTOMER): 175195 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/8d2b530d-e583-4edf-b4bb-e774ff3ba758_20250312T15:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII], uh, my name is [PII], and um, um, I'm trying to uh get some information, uh, about, um, the, um, explanation of benefits.
[AGENT][NEUTRAL] Um, explanation of benefits regarding a claim that you submitted with us?
[CUSTOMER][NEUTRAL] Well, what it is is that I'm trying to find out if I have long term, short term disability with you guys.
[AGENT][NEUTRAL] Oh, I see. OK. So we're just needing to find out what kind of coverage this is.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Gotcha. OK. I can get that policy pulled up and we'll take a look. Um, what was your name? I'm sorry?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Are you the policy holder [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, um, and then can I get a good call back number from y'all first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And then, uh, did you have that policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me see here.
[CUSTOMER][NEUTRAL] Uh, I have a member number.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Um, we could try that.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Let's go with uh 02069161.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, I'm just gonna verify some information really quick. Um, [PII], can I get your date of birth, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], that's [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I've got a different address on file. Um, it is still on [PII], but it is different than the one that you gave me.
[CUSTOMER][NEUTRAL] Yeah, I just moved um.
[CUSTOMER][NEUTRAL] It's on uh [PII], um.
[AGENT][NEUTRAL] Yeah, that's the one that we've got. Does that need to be changed?
[CUSTOMER][NEUTRAL] Yeah I just
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, if you would, uh, could you repeat that correct address for me?
[CUSTOMER][NEUTRAL] Uh, the new one or the old one?
[AGENT][NEUTRAL] Uh, the one that it needs to be changed to.
[CUSTOMER][NEUTRAL] OK, I need to be changed to [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], that's [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I don't think he's gonna eat on the trip.
[CUSTOMER][NEUTRAL] It's just Oh, On T R I I don't think.
[AGENT][NEUTRAL] Oh yeah, OK.
[AGENT][NEUTRAL] And that was still in [PII] was that still uh [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, alrighty, I will get that updated. Um, last thing I need E is the email address we've got on file for you. Uh, looks like it is a [PII] account.
[CUSTOMER][NEUTRAL] Uh, that'll be [PII].
[AGENT][NEUTRAL] Alright, thank you so much for verifying all of that information. OK, so the only policies y'all have with us, the one that you gave me is a uh hospital indemnity medical plan. Um, the only other policy you have is a dental plan with us. So if you have uh any sort of long term, short term disability, it might be through a different carrier. Uh, I would get with your employer and see who that might be through.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, because, uh, because I do recall, um, signing some paperwork with, with, with the.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] With the long and a short term disability. So yeah. So, when you said.
[AGENT][NEUTRAL] Right. And so that might be through a different car. Sorry, go ahead.
[CUSTOMER][NEUTRAL] When you say um the medical plan, um, what all would you cover through a medical plan if if for some reason he would start to need um some type of chemotherapy, would that be?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, would you cover that type of treatment?
[AGENT][NEUTRAL] OK, so this policy, um, as it's a limited indemnity medical plan, uh, essentially what that means is there's no co-pays or deductibles. It's not like traditional major medical like, um, Blue Cross or Aetna or Cigna. It pays a set dollar amount per covered procedure or office visit. Um, as far as specific coverages, um, I'm actually unable to see that.
[CUSTOMER][NEUTRAL] Mm that's fine.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] As benefits and claim information is handled through uh they're called web TPA. I can give you their information if you'd like uh to view those benefits.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] OK, I can give you that phone number and then I can transfer you to if you'd like.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me know when you're ready for that number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] One second.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I'm gonna text it to you.
[CUSTOMER][NEUTRAL] OK, so what is it?
[CUSTOMER][POSITIVE] OK, we're ready.
[AGENT][NEUTRAL] OK, so that number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And if you call that number, uh, you would select option 3.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Option 3, OK, so we just had a hospital stay, so will, will this plan cover that hospital stay or it's gonna be at a percentage?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] This it's not a percentage unless I think the only kinds of um like for this kind of policy the only percentages might be if a surgery was required um but again I can't see the particulars of what this policy covers uh web TPA would have that information though.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Of course, do you want me to go ahead and transfer you?
[CUSTOMER][NEUTRAL] 3
[AGENT][POSITIVE] Alrighty, yeah, I'll just put you on a brief hold while I get them on the line for you. I hope you'll have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. That's what I.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to Web TPPA.
[CUSTOMER][NEGATIVE] Please not