AccountId: 011433970860
ContactId: 9735e33a-fbf3-402f-be63-3b6e96fc9368
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 614250 ms
Total Talk Time (AGENT): 281937 ms
Total Talk Time (CUSTOMER): 313378 ms
Interruptions: 10
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/9735e33a-fbf3-402f-be63-3b6e96fc9368_20250514T15:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. Uh, my name is [PII], and I'm calling to get some information about American Public Life. Um, I called.
[CUSTOMER][NEUTRAL] The um third party administrator, what is it my benefits card.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is that right? Yeah, I called and got eligibility from them, but the questions I was asking, he couldn't answer. Um, so is American Public Life, is it, uh, like a private healthcare system or just a basic commercial coverage?
[AGENT][NEUTRAL] OK, so, um, [PII], I'm so sorry just so that I understand, um, are you looking to get coverage with us or are you a provider?
[CUSTOMER][NEUTRAL] No, I'm a pro I work with provider, Nationwide Children's Hospital.
[AGENT][NEUTRAL] OK, got you, um, before.
[CUSTOMER][NEUTRAL] So I just want to register the coverage correctly.
[AGENT][POSITIVE] Absolutely, yes, um, can I first get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, did you have a specific policy we were looking at or did you just want the general information?
[CUSTOMER][NEUTRAL] Um, no, you could, um, actually look at this this policy, um.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] Maybe you could um let's see it is let me find this number again.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] D as in [PII].
[AGENT][NEUTRAL] OK, I'm sorry to add to the confusion, [PII], but that's actually not one of our policy numbers. So as you mentioned benefit and the card I had a feeling, um, so that's they're part of a multi plan so that one is through um 90 degree benefits. So if you have, do you have their social it's very possible they have a policy with us, um, it would just be a different policy number do you have their social by chance I could search for them that way.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I have the subscribers social, yes.
[AGENT][POSITIVE] OK, yeah, let's try that.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, one moment please.
[AGENT][NEUTRAL] And what was their name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, was this for, uh, a dependent under this policy?
[CUSTOMER][NEUTRAL] It is for 2 dependents under that policy. Just wanna make sure both of them are covered.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, if you have their names and date of birth, please.
[CUSTOMER][NEUTRAL] Yes. The first one is [PII].
[CUSTOMER][NEUTRAL] Or she goes by Ava, they have that in print, uh, question marks or parenthesis um date of birth [PII].
[CUSTOMER][NEUTRAL] And I need to pull up the other one. Hold on here.
[AGENT][NEUTRAL] Mhm. Sure.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Let's see, then we've got [PII] His date of birth is [PII].
[AGENT][POSITIVE] Perfect. Alrighty, thank you so much for verifying all of that, [PII]. OK, so I was able to find a policy, um, this is a limited indemnity medical plan. It is currently active. Um, I can go ahead and give you that policy number whenever you're ready and then I can give you more information.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Please hold on a minute here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so it is going, is this a, like I asked you before, is this a private healthcare system or uh
[AGENT][NEUTRAL] Oh right, sorry, yes, so as this is a part of a multi plan.
[CUSTOMER][NEUTRAL] Um, that's OK. Reference based or anything like that?
[AGENT][NEUTRAL] Right, so this is part of a multi plan it is through uh his provider or I'm sorry um his um employer excuse me, um, and this one again as it's a multi plan he probably has multiple different kinds of coverages it is very confusing um through different providers um this one that he has with us is the limited indemnity medical plan so um and again whenever you're ready I can go over those specific benefits in short, um.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let me.
[AGENT][NEUTRAL] It's different than traditional major medical, um, but it's, uh, pays a set dollar amount per covered procedure or office visit um you would send the claim information directly to us it's not affiliated with any sort of networks or anything like that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so just, OK, um.
[CUSTOMER][NEUTRAL] Go ahead with the ID.
[AGENT][NEUTRAL] Yes, that is 02.
[AGENT][NEUTRAL] 55
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 7107.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 7. OK.
[AGENT][NEUTRAL] And that effective date was [PII] and again it is currently active.
[CUSTOMER][NEUTRAL] And to current.
[CUSTOMER][NEUTRAL] OK, garlic.
[CUSTOMER][NEUTRAL] OK, so 10:14. 0, OK, so it did not stop on [PII].
[AGENT][NEUTRAL] It did not stop. No, it is currently active, um, that whatever you what may I ask where you saw that on the website?
[CUSTOMER][NEUTRAL] Uh, no, that's what, um, the rep from the other company gave me.
[AGENT][NEUTRAL] OK, yes, so a lot of the time, I'm sorry.
[CUSTOMER][MIXED] He gave me the correct start date, but he gave me the correct start date, but he told me that it turned [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's not termed um it is again very confusing but as this is being paid through his emp[PII] um that information may not have registered when we received that information but I'm showing active across the board.
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK. So [PII]can Public Life is where we send our claims, and the address is [PII], is that [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] So that is actually um IMA or 90 degree benefit again I'm so sorry for the confusion um if that's the information they gave you, you can absolutely send the claim information there.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] I, they didn't, I did not go over that with the other rep, so.
[AGENT][NEUTRAL] Oh, I see. Is that what's on their card?
[CUSTOMER][NEUTRAL] Um, I don't even have that. I'm sorry, that's what they have. They put it in our system like that, but if it's not 90 degrees because see 90 degrees for us is reference based.
[AGENT][POSITIVE] Oh, OK. No, no, no, you're right.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] That's the one that's the, the policy number um that begins with a D, that's 90 degrees from what I understand with them, that's going to be more along the lines of uh wellness uh benefits and such, whereas this one is going to be much more regarding um hospital stay, intensive care, uh accident sickness, uh, surgical, things like that.
[CUSTOMER][NEUTRAL] Is that what this coverage is?
[CUSTOMER][NEUTRAL] 19.
[CUSTOMER][NEUTRAL] Coverage, OK, not um not hospital, so the, the DID would not cover any hospital, OK, not.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Not, I'm not 100% because again I'm not really familiar with 90 Degrees. Just from what I'm aware of is that's going to be more wellness. This policy they have with us does have the hospital benefits and um again, like diagnostic testing, ambulatory, things like that.
[CUSTOMER][NEUTRAL] Uh-huh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Benefits etc. OK.
[CUSTOMER][POSITIVE] Getting a lot of information here, so OK, effective, yeah.
[AGENT][NEGATIVE] It's a lot. It's a lot. I know. I wish they had a clear, um, here's this, here's that kind of thing, but it does seem to be a game of tag most of the time. It's even worse explaining it to the actual insured.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh gosh, I can only imagine.
[AGENT][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, OK, so do we need to do we need to worry about putting in group number or anything like that?
[AGENT][NEUTRAL] You shouldn't have to, but I can give you that information if you need it.
[CUSTOMER][NEUTRAL] Can I read to you what I got and see if that's correct?
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] IMA 9476-G.
[AGENT][NEUTRAL] OK, so that's gonna be through again IMA or 90 degrees, um, I can give you the um group number we have.
[AGENT][NEUTRAL] If you, but that again, that's if you need that.
[CUSTOMER][NEUTRAL] OK, hold on here let me.
[CUSTOMER][NEGATIVE] I don't think we will.
[CUSTOMER][NEUTRAL] Group number.
[CUSTOMER][NEUTRAL] Is 90.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Number.
[CUSTOMER][NEUTRAL] OK, yeah, I don't think we'll need that. You guys don't, I mean, if you guys don't, um, when on your claims and stuff like that, that's not one of your clicks to, to make sure it is correct, is it?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] No, you're perfectly fine. Um.
[CUSTOMER][NEUTRAL] Just so that we got our claims, OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, so I think I have all my information put that in there, yep, and
[CUSTOMER][NEUTRAL] Then is there a call reference number?
[AGENT][NEUTRAL] Yes, ma'am, that would be my first name, last initial, and today's date. And so my name is spelled [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You didn't have any other questions for me at the moment?
[CUSTOMER][NEUTRAL] OK, and today's date.
[AGENT][NEUTRAL] I know that was a lot of information.
[CUSTOMER][POSITIVE] Nope, I'm good. Thank you very much, yeah, yeah, it was, but I think I got it all.
[AGENT][POSITIVE] You are very welcome. Yes, ma'am.
[AGENT][POSITIVE] All right sounds good well I hope you have a great rest of your day [PII] thank you bye bye.
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye.