AccountId: 011433970860
ContactId: 9cdb4483-0269-4020-af2e-6c8e9dc2793e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 404720 ms
Total Talk Time (AGENT): 231887 ms
Total Talk Time (CUSTOMER): 88080 ms
Interruptions: 3
Overall Sentiment: AGENT=1.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/9cdb4483-0269-4020-af2e-6c8e9dc2793e_20250603T20:59_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. I just need to know how much um
[CUSTOMER][NEUTRAL] Coverage I have left as far as funds for emergency because I need to go to the ER and I just want to know if I have any left.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Any funds left to for that.
[AGENT][NEUTRAL] OK. So you're just wanting to see what your what benefits have been used thus far for this period. Is that correct? Yes, sir, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you. And Mr. [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have your policy number?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] It's in my wallet.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][POSITIVE] Yes, I have it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is 02025.
[CUSTOMER][NEUTRAL] 53585.
[AGENT][NEUTRAL] OK, Mr. [PII], thank you. Give me a moment to get your information pulled up. Once I do, I will have to verify several things with you first for security and also any information that is provided would be a verification of benefits and not a guarantee of payment. So give me just a moment please.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and Mr. [PII], if you could first please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. I, I'm sorry, what was the month again? I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], OK, thank you and your home mailing address?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one that you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes, yes, ma'am.
[AGENT][POSITIVE] Thank you and lastly your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and Mr. [PII], I can see that you had previously set up your profile in our portal, the online service center.
[AGENT][NEUTRAL] Where you can log in to have access to your information online and there was an update to our portal over this past weekend.
[AGENT][NEUTRAL] So when you go out to that website the next time you will need to create a new profile and you will see the button that says um so instead of logging in with your username and password that you have previously set right below where it says log in it says create your OSC account so do select that to set up a new profile OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Sounds good. OK.
[AGENT][POSITIVE] And if you have any issues with that, obviously, please call us and we'll be more than happy to help you.
[AGENT][NEUTRAL] All right. You're welcome. All right. So let me, uh, and you said that you're going to the emergency room, you're wanting to know about, for the emergency room, is that correct?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. All right, one moment.
[AGENT][NEUTRAL] It's just taking a moment, Mr. [PII] to load a piece of information for me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on this supplemental policy that you have with APL, your outpatient benefit maximum is $500 per covered person per occurrence for covered outpatient services.
[AGENT][NEUTRAL] And I can see that uh um percurrence, if you're not familiar with what that definition means on your policy, that means for treatment for the same or related condition.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Conditions unless separated by a period of, OK.
[CUSTOMER][NEUTRAL] Yeah, this one was totally this is my this is my this is my yeah this is my shoulder so it's not the same as anything I've had done before.
[AGENT][POSITIVE] I got you. OK. OK. Because uh since it's a per occurrence benefit, I am able to see that as of now, we have paid $350.
[AGENT][NEUTRAL] Of that $500 benefit, but if this is for a separate occurrence or something completely unrelated to the other.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Then you know your benefits it would be the $500. Again, I can't guarantee payment, but that would be the benefit. Outpatient is $500 per occurrence for covered services.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Right, right, that.
[AGENT][NEUTRAL] So just make sure that you present your APL card along with your primary insurance. Yes, sir, because most of the providers facilities especially will take care of filing both of your insurances, but in the event that they don't, you can file your own claim and you could call us back if that need arises and we'd be happy to tell you how to go about doing that.
[CUSTOMER][POSITIVE] OK, well that's wonderful.
[CUSTOMER][NEUTRAL] The card.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK great well thank you very much, man. I appreciate your help.
[AGENT][POSITIVE] OK. Well, you're certainly very welcome. And is there anything else that I can help you with, Mr. [PII]?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, well then thank you very much for calling APL and I hope you feel better.
[CUSTOMER][POSITIVE] Oh, thank you. You take care.
[AGENT][POSITIVE] Yes, sir, you too. Thank you.
[CUSTOMER][NEUTRAL] Bye bye
[AGENT][NEUTRAL] Bye bye.