AccountId: 011433970860
ContactId: 9a46ab9c-1692-4af1-9e8d-dac31ee0a7fd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 369940 ms
Total Talk Time (AGENT): 143086 ms
Total Talk Time (CUSTOMER): 136540 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/9a46ab9c-1692-4af1-9e8d-dac31ee0a7fd_20250617T17:04_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, I'm trying to find out, uh, my husband just got this insurance through his job, and I need to find out about how do we get our providers and I am currently seeing a doctor.
[CUSTOMER][NEUTRAL] An eye specialist.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I wanna know if he's in in the network plan or whatever.
[AGENT][POSITIVE] OK, well, I can definitely help you with your coverage and the um network. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Uh, yes, my name is [PII].
[CUSTOMER][NEUTRAL] The policy, uh, the insured employee is [PII].
[CUSTOMER][NEUTRAL] And my number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. May I have the policy number?
[CUSTOMER][NEUTRAL] The policy number is 026376775.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[AGENT][NEUTRAL] All right, and I have you here and I just need you to verify your date of birth and the mailing address on file.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I'm not sure if it's a PO box. Is it a PO box?
[CUSTOMER][NEUTRAL] Or street address?
[AGENT][NEUTRAL] This is a PO box.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that.
[AGENT][NEUTRAL] Excuse me, and all the information provided is a verification of benefits, not a guarantee of payment. Um, so this is a
[CUSTOMER][NEUTRAL] What does that mean? What is that?
[CUSTOMER][NEUTRAL] What does that mean when that is, that phrase is stated?
[AGENT][NEUTRAL] All the information that I'm giving you is going over the benefits, but I can't guarantee payment until the claim is processed.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] So the um policy that you have is a hospital indemnity policy, so it's a limited medical policy.
[AGENT][NEUTRAL] The hospital indemnity part of your policy doesn't have a network?
[AGENT][NEUTRAL] But you do have the PPO network through multiplan?
[AGENT][NEUTRAL] Because Multiplan is a different company, we don't have access to the list of providers, but I can give you their phone number and website if you like to see if the doctors that you're seeing are in-network.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEGATIVE] They send me to you, you're sending me to them. I'm very confused.
[AGENT][NEUTRAL] You've already spoken to Multiplan?
[CUSTOMER][NEUTRAL] How do I get a dental provider?
[CUSTOMER][NEUTRAL] Yeah, and they sent me to you.
[CUSTOMER][NEUTRAL] So you all.
[AGENT][NEUTRAL] So this is for dental or medical because this policy number is for medical. You're trying to look for dental?
[CUSTOMER][NEUTRAL] This is for medical, this.
[CUSTOMER][NEUTRAL] It's, it's for medical. It's my eye specialist.
[AGENT][NEUTRAL] Oh, OK, I thought you said a dental, how do you get a dental provider? OK.
[AGENT][NEUTRAL] So I'm
[CUSTOMER][NEUTRAL] Well, I wanna know all of it, you know, who, who, who do I access?
[AGENT][NEUTRAL] Alright, so with APL you have a hospital indemnity policy, an accident policy, a critical illness policy, and a dental policy. So for your hospital indemnity policy, the only people that can confirm if you're in network with them is, or if your providers are in network is multi-plan because that's the only part of your policy that has a network. You're saying that you spoke with multi-plan or you spoke with your
[CUSTOMER][NEUTRAL] So what happened?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] I, I, I spoke with multi multi plan now they said that my eye specialist was not in network so I don't know what that means.
[AGENT][NEUTRAL] So APL doesn't provide vision insurance, so I can't, I can't assist you with the vision insurance. I can only assist you with what we have here.
[AGENT][NEUTRAL] So for vision, you would have to check with your husband. Go ahead.
[CUSTOMER][NEUTRAL] Yeah, but that
[CUSTOMER][NEUTRAL] That eye specialist.
[CUSTOMER][NEUTRAL] Usually goes under regular.
[CUSTOMER][NEUTRAL] They file regular insurance, regular medical insurance.
[CUSTOMER][NEGATIVE] They don't do vision.
[AGENT][NEUTRAL] Your vision doctor uses.
[CUSTOMER][NEUTRAL] Regular insurance.
[AGENT][NEUTRAL] OK. So on your hospital indemnity policies, but there's no vision coverage like there.
[CUSTOMER][NEUTRAL] OK, I see what you're saying, oh man.
[AGENT][NEUTRAL] So usually if you have like a major medical insurance, sometimes.
[CUSTOMER][NEGATIVE] That's gonna be a problem.
[CUSTOMER][NEGATIVE] That's gonna be a big problem.
[CUSTOMER][NEUTRAL] We do have vision.
[CUSTOMER][NEUTRAL] But I don't know if the vision plan.
[CUSTOMER][NEUTRAL] Have specialist.
[CUSTOMER][NEUTRAL] Can you tell if I
[AGENT][NEUTRAL] So I was
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Who would I have to call?
[CUSTOMER][NEUTRAL] Who would I have to call for vision?
[AGENT][NEUTRAL] You will have to reach out to your husband's HR department.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] All right. Thank you.
[AGENT][POSITIVE] You're welcome. Was there anything else I can assist you?