AccountId: 011433970860
ContactId: 8e1470a9-0e75-49ec-b43e-30711a689ae2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1134589 ms
Total Talk Time (AGENT): 486933 ms
Total Talk Time (CUSTOMER): 402259 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/8e1470a9-0e75-49ec-b43e-30711a689ae2_20250421T19:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I, uh, I'm calling to see about, uh, my plan. Um, I want to, um,
[CUSTOMER][NEUTRAL] Walmart Healthcare, uh, virtual healthcare. Uh it's, uh, a numbers located on the back of my card. I called them. They said that they're no longer in a group with y'all.
[CUSTOMER][NEUTRAL] So, um, figure out if you don't have another option to get virtual care or if you, you actually don't get anymore.
[AGENT][NEUTRAL] OK, and let me take a look. Do you have your policy number by chance?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. Um.
[CUSTOMER][NEUTRAL] It is 0258024.
[AGENT][NEUTRAL] Alright, I missed a number there. I'm sorry, the phone cut out. It was 02580.
[CUSTOMER][NEUTRAL] 924.
[AGENT][NEUTRAL] 924.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK, great. Thank you. Sorry about that.
[CUSTOMER][NEGATIVE] Oh, no, your fault.
[AGENT][NEUTRAL] OK, and then on the policy, if I could just verify the name and date of birth?
[CUSTOMER][NEUTRAL] Uh, it's and my date of birth is [PII].
[AGENT][POSITIVE] Thank you so much. And then if you could verify to the physical address that we should have on file.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. OK.
[AGENT][NEUTRAL] Let me pull this up and see cause I know that on your cards usually.
[AGENT][NEUTRAL] It has
[AGENT][NEUTRAL] Walmart Health Virtual Care, is that who you had contacted the Walmart Health Virtual Care?
[CUSTOMER][NEUTRAL] Yes, ma'am and uh they said.
[CUSTOMER][NEGATIVE] Uh from Amazon like that Walmart it doesn't even exist anymore.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Let me go and see if I can find.
[AGENT][NEUTRAL] Another like telehealth provider.
[CUSTOMER][POSITIVE] Yes, ma'am thank you.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Are you looking for like an urgent care type situation or just like a primary care doctor?
[CUSTOMER][NEUTRAL] Uh, right now, just like a, uh, urgent care situation, and I would also like to kind of discuss a little bit more about, you know, if you're able to provide me with that type of information. Um, I am in need of a neurologist. I have ratheris currently, however, I'm not sure how much, uh, my plan would come visit it, and I just wanna kind of you know.
[CUSTOMER][NEUTRAL] Get a view of about how much that plan for those type of visits and CT scans and um like that because with my uh cause I have a traumatic brain injury so I'm needing to, you know, um
[CUSTOMER][NEUTRAL] Get these type of scans and stuff like that, not normally, but just, you know, if I'm not feeling well or you know, they usually want to give me a CT scan lumbar puncture just to check on my um.
[CUSTOMER][NEUTRAL] Levels and things like that.
[CUSTOMER][NEUTRAL] If you're able to provide me with that information if you don't mind.
[AGENT][NEUTRAL] Yeah, let's see, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] Your plan does have a diagnostic testing benefit, which includes CAT scans, MRI, CT scans.
[AGENT][NEUTRAL] The plan itself pays a set amount depending upon what you're being seen for. So, the medical imaging benefit is $100 per test. Your plan covers one a calendar year, and then it will cover one follow-up if needed, and that pays $25. Um, that's the amount it pays towards the actual um treatment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then any sort of physician's office visit you.
[CUSTOMER][NEGATIVE] So not much.
[CUSTOMER][NEUTRAL] So it doesn't really cover much.
[AGENT][NEUTRAL] I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] Uh so it doesn't cover much.
[AGENT][NEUTRAL] No, it's not. So the important thing to note about this is that it's a limited benefit plan, which means that it's just gonna pay this set amount. Um, it's not considered like a major medical. So,
[AGENT][NEUTRAL] It is different in that regards.
[CUSTOMER][POSITIVE] Got you, got you.
[CUSTOMER][NEUTRAL] So, um, and you said I would, uh, also come out of pocket for the doctor's visit?
[AGENT][NEUTRAL] Um, medication?
[AGENT][NEUTRAL] Medication is covered. It does have a
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] A prescription drug benefit of $10 a day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but it's a maximum of 15 days, and it does have a benefit to see a physician in a physician's office, um, or urgent care or emergency room if you need it. Um, the physician's office, you're allowed 4 visits a year and it'll pay $50 towards the visit. It's the same for like an urgent care facility if you had to go to an urgent care.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So about
[CUSTOMER][NEUTRAL] So I think basically is
[CUSTOMER][NEUTRAL] Well, I'm guessing, uh, I'm not really sure about the cost per visit to my neurologist. I'll say what 150 a visit you guys will pay 50 have to come out of pocket 100.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Is that just the medical part because I signed up for the, the 100%.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Plan and I was told like it covers 100%.
[AGENT][NEUTRAL] That it cover that it covers what again? I'm sorry?
[CUSTOMER][NEUTRAL] And so
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Um, 100% medical, uh, when I had first called to sign up.
[CUSTOMER][NEUTRAL] Um, they had gave me a number to sign up.
[CUSTOMER][NEUTRAL] I do my job and they were like, yeah, yeah, um, it'll be this much a week and it'll be like 100% medical.
[CUSTOMER][NEUTRAL] Um, so cover your doctor's visits and stuff like that. So I was thinking it covering my doctor's visit and it covered the whole thing.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] When they told me that.
[CUSTOMER][NEUTRAL] 100%.
[AGENT][NEUTRAL] Yeah, I mean, most, you know, um, at the very least with like major medical, um,
[AGENT][NEUTRAL] You know, um, you would just have like a co-pay or something to go to a physician or, or something like that.
[AGENT][NEUTRAL] Um, unless it's considered like preventative care, you know, like wellness, physicals, things like that, all those things that are considered preventative care when you have those types of services done, those are always covered um at 100%.
[CUSTOMER][NEUTRAL] Got you. I see what you're saying. So it's like, oh, like preventing the car.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, just going, yeah, going in for like a yearly physical or, you know, um something like that to have, you know, like.
[CUSTOMER][NEUTRAL] Like, I mean,
[AGENT][NEUTRAL] Blood work done for just like a yearly checkup. Those types of things would be covered. Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] But I still have to pay for the initial.
[AGENT][NEUTRAL] With this particular.
[CUSTOMER][NEUTRAL] Or is it like $50?
[AGENT][NEUTRAL] So, yeah, I mean, with this particular plan, it's just gonna pay that set amount. We don't have any way of knowing what your doctor would charge for like the office visit.
[CUSTOMER][NEUTRAL] Go.
[AGENT][NEGATIVE] Um, so, yeah, it would just pay that set amount towards that office visit. It's not gonna pay anything extra.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there like a way that I can
[CUSTOMER][NEUTRAL] I guess increase my plan.
[AGENT][NEUTRAL] That would be a question that you would have to ask your employer, um, because you're getting the insurance through them, so you would have to see if there's any other plans that they're offering.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, we, you know, we don't sell, uh, insurance just to individuals. We
[CUSTOMER][NEUTRAL] This is the
[CUSTOMER][NEUTRAL] Oh, OK, OK, so I can't, this is just the plan that they are, OK, cause I was thinking because like I said like like when I first initially talked to him, he said, so I was thinking like a little different, um, and I would like more coverage, you know what I'm saying, um, but.
[CUSTOMER][POSITIVE] It was top, the top tier that he offered me the top tier out of the, you know, so I'm like, and you know I'm more like a cover but um.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Well, it's OK. Um, so initially when I call I was just trying to um figure out if you guys.
[CUSTOMER][NEUTRAL] Do you have like the tele and anyone that is.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, so, so I did a search, um, give me just a second here.
[CUSTOMER][NEUTRAL] I to
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] So I did a search for some urgent cares in your area just based off of your zip code, which is [PII], correct?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Maybe.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Um, I wasn't able to find any urgent cares near you that offer any telehealth, unfortunately.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] It's uh 3 my zip code is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me search by that.
[CUSTOMER][NEUTRAL] You have to change the system, right, this is just where I'm at currently.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. Here's one that offers telehealth. Let me give you their information. Do you have something to write this down with?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] But
[AGENT][NEGATIVE] Yeah, sorry, your phone is cutting out really bad. Do you have something to write it down with?
[CUSTOMER][POSITIVE] Yeah, sorry about that.
[AGENT][NEUTRAL] That's OK. So it's it's Piedmont Urgent Care.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Their phone number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] And uh you said that um the medicine uh is covered?
[AGENT][NEUTRAL] Yeah, so the outpatient prescription drug benefit on your plan is $10 a day for a maximum of 15 days.
[CUSTOMER][NEUTRAL] What, what I'm sorry, I'm [PII]. I promise you I would. This is my first time getting my own insurance. I just had to get this myself, so I don't really understand like.
[CUSTOMER][NEUTRAL] Um, like $10 a day, like that what I pay or like.
[AGENT][NEUTRAL] Um, so it that that would be the most that it would cover for um,
[AGENT][NEUTRAL] A single day prescription for a maximum of 15 days. So when it says per day, that just means that that's the, the most that it would pay towards that. If you have a prescription that you need to fill, honestly, what my recommendation would be is you have the benefit management formal number on there, on your card.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You can have a prescription called in for you if you need to give them the BN number and group number that's on your card, and they can give you kind of what the out of pocket cost would be for something like that.
[AGENT][NEUTRAL] Um, with the prescriptions.
[CUSTOMER][NEUTRAL] Gosh, basically instead of going to like Walmart or something, just trying to do them.
[AGENT][NEUTRAL] They can do it too through there if that's your preferred um pharmacy, absolutely. Um, but yeah, they should definitely be able to run the prescription for you with the insurance based off of the information on your card and then give you kind of an idea of what that's gonna cost you, um, yeah, in the long run.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Um, if your medical needs or something where you're needing
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's say a prescription drug refill every month for a prescription that you take on the regular.
[AGENT][NEGATIVE] I don't think that this is a plan that is gonna be what you're looking for. Um, this is something that's gonna pay for a prescription, like one time that you needed to take for just a few weeks if something happened. It's not a pharmacy benefit that's gonna be paying over long term if you're on any sort of like maintenance drug.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] Right, I mean, I'm, um, I can do things, um.
[AGENT][NEUTRAL] Just
[CUSTOMER][NEUTRAL] And to me, um, uh, but it's like 10 bucks at most, um, so it's really not expensive, but, um, as far as like if I needed like, um, I get an expensive medication I only needed to take it for would be covering that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right. Yeah, yeah, I would, yeah. If it was, if it was a situation like that, then I, then I would use it for something like that. Um, that's just a one-time short term, short term kind of deal. Aside from that, if you don't have any other insurance, sometimes, um, prescription drug like discount cards and things like that, um, like, you know, can be helpful too.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you, got you.
[CUSTOMER][POSITIVE] OK, thank you so much because, uh, yeah, I think this is a whole another ball game for me, a little like I thought I had enough I'm a game, you know, I'm just gonna have to come out of pocket, you know, some type of way, which is OK, but, um, just wanted to kind of it.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] More of an ID so I you know, go to the doctor and then like they give me the receipt and I'm like uh yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You know, so, um.
[CUSTOMER][POSITIVE] Um, so basically thank you from the call and um.
[CUSTOMER][NEGATIVE] Yeah, not doing it.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Not
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Not a problem. Yeah, and if you have any other concerns or questions, you can always reach out, OK?
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] You're welcome. Have a blessed day.