AccountId: 011433970860
ContactId: 942e07ab-5434-4303-9a77-3ff9c9159e90
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 498549 ms
Total Talk Time (AGENT): 200595 ms
Total Talk Time (CUSTOMER): 201518 ms
Interruptions: 4
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/942e07ab-5434-4303-9a77-3ff9c9159e90_20250402T15:14_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I was calling um
[CUSTOMER][NEUTRAL] Basically, I just called um another number and they gave me this number so I can get some more information on my insurance. They said they couldn't really answer the questions I was asking. So I wanted to just get some information, see if that my insurance covers therapy and basically just what it covers.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, um, sure, I can assist you. Do you have a policy number for us?
[CUSTOMER][NEUTRAL] Like a ID.
[AGENT][NEUTRAL] It's gonna start with a 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] Like the
[CUSTOMER][NEUTRAL] He just sent me something in my email so let me check and see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's a the benefits card, right? that you're asking for?
[AGENT][NEUTRAL] It's gonna say APL and it's gonna have um.
[AGENT][NEUTRAL] Some information about your, probably your um pharmacy in the back. It's gonna have your name and the
[CUSTOMER][NEUTRAL] I don't have that.
[AGENT][NEUTRAL] You don't have that?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any other way that we can do it?
[AGENT][NEUTRAL] OK. Let me have the spelling of your last name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and the spelling of your first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you one moment.
[AGENT][NEUTRAL] Let me have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I found the policy. Let me see if this is yours. Um, may I have your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Hm, let me look at the benefits. And you said you're looking for, is it physical therapy benefits or what type of therapy?
[CUSTOMER][NEUTRAL] Um, like therapy, like, uh,
[CUSTOMER][NEUTRAL] Like a therapist, like a, a mental, whatever.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEGATIVE] And I'm also trying to see, I talked to the man. Another question I have is I had talked to the man and I asked him, um, he said that they pay, I, I said, I've been paying for this for a couple of weeks now, but I've also, I get medicine every single week and I've been paying for it out of pocket. So I didn't know if there was some kind of back pay or something like that since I don't know why my insurance, if I'm paying for it every week, why it hasn't been covered in my um.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Prescriptions if it says that it does cover prescriptions.
[AGENT][NEUTRAL] For prescription or pharmaceuticals, it goes to another uh company. We don't handle that part. I can go ahead and tell you who handles that one, OK? Um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me, let me look at your benefits, um.
[AGENT][NEUTRAL] OK, and while I wait on that benefit, uh-huh, go ahead.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Sorry, but, um, I wanna, I know you're doing this right now and I do want this question answered, but, um, the question that you said you couldn't answer about the prescriptions, can you give me their contact information before we get off the phone?
[AGENT][POSITIVE] Yeah, I can give it to you right now if you would like um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sorry, I'm on break at work so I'm trying to make sure I get this question answered while we're on the phone.
[AGENT][NEUTRAL] gonna be one minute. Yeah, it's OK.
[AGENT][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] OK. Yes, one moment.
[AGENT][NEUTRAL] Well I'll wait on that, can you verify the email address for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. OK, so it looks like it's gonna be through Farmavale.
[AGENT][NEUTRAL] And the number to call is [PII].
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] Hold on one second.
[CUSTOMER][NEUTRAL] One second, I'm sorry, [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] OK, and then if you could just um.
[CUSTOMER][NEUTRAL] Answer the other question like to to see if it covers therapy if you can do that, please.
[AGENT][NEUTRAL] So this one, and this is not a guarantee of payment, just a verification of coverage. This one doesn't cover therapy. It will only cover a visit if you go and visit a psychiatrist.
[CUSTOMER][NEUTRAL] I'm sorry, say it again.
[AGENT][NEUTRAL] This one does not cover therapy. It will only cover if you go and visit a psychiatrist, medical doctor, a psychiatrist.
[CUSTOMER][NEUTRAL] It only cover if what?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so if I do go to, if I do go to a psychiatrist, it will cover that.
[AGENT][NEUTRAL] It will cover that visit. It will be under the um benefit office visit benefit, which is the $75 maximum of 5 visits per year for um office visit. So it's gonna be under that benefit if you go and see a psychiatrist, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Is there, mhm.
[CUSTOMER][NEUTRAL] Alright, and then, so basically, um, if I was to go see a regular therapist, I would have to like do an upgrade with my insurance, like go with a different plan.
[AGENT][NEUTRAL] Uh, you will have to check and see if um you can get any other benefits through another probably because this one doesn't have any benefits like that for this group.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] There's no therapy on this one. Thank you.
[CUSTOMER][NEUTRAL] All right. So, but you said a therapist, I mean, a psychiatrist would be covered. OK. All right.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Consider under the office basic benefit, correct. Mhm.
[CUSTOMER][POSITIVE] Right. OK. All right. Well, thank you so much. It's really all I needed.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Is there, is there anything else? Do you need the policy number or any other information?
[CUSTOMER][NEUTRAL] Um, so the policy number like my, my ID basically.
[AGENT][NEUTRAL] If you're looking at the D number, if
[CUSTOMER][NEUTRAL] You know what I mean, like my, my, my benefits card number.
[AGENT][NEUTRAL] It depends because you should have 2. If you're looking at a D number starting with a D, that's not it. Um, our policy number is a little bit different.
[AGENT][NEUTRAL] So if you don't see it there, I can give it to you.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] Do you have a number that would be on my card, like on my benefits card?
[AGENT][NEUTRAL] Um, it depends what card you have because.
[CUSTOMER][NEUTRAL] You know, like what they asked for as a doctor.
[AGENT][NEUTRAL] Mhm. I can go ahead and send the request. Um, let me see if this one goes out by mail. No, this is online.
[CUSTOMER][NEUTRAL] He said well I should be getting a physical copy since he said he sent it to my email so I guess I just gotta figure it out so it's OK. I can get it off my email or whenever the physical copy comes in the mail if I can't figure it out on the email I'll just wait.
[AGENT][NEUTRAL] Yeah, it's in your email.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, OK. Is there anything else I may help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, nope, that is it.
[AGENT][POSITIVE] OK, well thank you for calling AP have a good day.
[CUSTOMER][POSITIVE] Thank you.