AccountId: 011433970860
ContactId: a2fe9e4e-3980-4e1d-9bcd-d717cf95cec0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 454570 ms
Total Talk Time (AGENT): 233192 ms
Total Talk Time (CUSTOMER): 222707 ms
Interruptions: 5
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/a2fe9e4e-3980-4e1d-9bcd-d717cf95cec0_20250508T13:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Yeah this is my first time in my entire life having a a gap like medical insurance policy, and I have to have a surgery unfortunately and I'm trying to find out because my insurance unfortunately sucks so I'm trying to find out exactly how much my gap will pay because right now my out of pocket costs. I can't even have the surgery and I kind of unfortunately desperately need it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you are, you have a policy with APL and you're just gonna want, you wanna find out what the benefits are on this plan?
[CUSTOMER][NEUTRAL] Yeah, because I didn't understand when I looked at the benefits. It looks like it only pays 500 for outpatient maximum, but I'm not 100% I'm reading it correctly because I've never had gap insurance for medical like I said, so I'm just trying to figure it out.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, sure. I can help you with this. And who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] Um, [PII] is my personal cell phone.
[AGENT][POSITIVE] Thank
[AGENT][NEUTRAL] OK, thank you. And your policy number?
[CUSTOMER][NEUTRAL] Um, let's see, group number effective date. I have an in-hospital benefit certificate number and an outpatient certificate number, two different numbers. Which one did, which one?
[AGENT][NEUTRAL] You may see an in-hospital and out.
[AGENT][NEUTRAL] OK. Yes, ma'am. So you're having an outpatient surgery?
[CUSTOMER][NEUTRAL] Uh, it's considered an outpatient surgery, yeah, unless something happens, God forbid, then that.
[AGENT][NEUTRAL] Yes, ma'am. So just give me that number.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's 02480457 M as in Michael L as in Larry, the number 8.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, thank you. Give me a couple of moments later to get your policy 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 just one moment.
[CUSTOMER][NEUTRAL] Of course mhm.
[CUSTOMER][POSITIVE] You got it.
[CUSTOMER][NEUTRAL] Been in healthcare 30 years. I've heard those words more than you could imagine.
[AGENT][NEUTRAL] I'm sure. OK, so first off, Ada, uh, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. Also your home mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And the phone number that we have on file for you is the same as your cell number that you gave me, so that is your best contact number, is that correct?
[CUSTOMER][POSITIVE] Correct, yep.
[AGENT][NEUTRAL] Thank you and then the last piece of information to verify is your email address.
[CUSTOMER][NEUTRAL] Uh, my personal email address is [PII]. I think they registered me initially under my work email, which I don't use obviously for personal things.
[AGENT][POSITIVE] OK, thank you. Yes.
[AGENT][NEGATIVE] Well, no.
[AGENT][NEUTRAL] Yes, we do have your personal email on file. Yes, ma'am. OK.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Yeah, OK, good, because I was gonna say when I logged in for the first time as a new user I put in my personal and it wouldn't take it. I had to change it to my work so.
[AGENT][NEUTRAL] Right. And now it looks like it has been changed to your personal.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Now Ada, have you ever set up your profile in our portal called the online service center?
[CUSTOMER][NEUTRAL] I just went on and created a username and password today.
[AGENT][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] And I printed out my ID cards, which is why I had my ID for you.
[AGENT][NEUTRAL] OK. Well, now, OK, so on that, on the ID number that you gave me, that is the older policy that you had with us. The policy number you gave me was active from 51 of 24 to 81 of 24, and you should see in your portal, well, that shows it's lapsed and there is another policy number.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] That's the one that said active. Hold on one second.
[AGENT][NEUTRAL] Ends in a 24. The one that's active ends in a 24. Mhm.
[CUSTOMER][NEUTRAL] Secure there it is, hold on.
[CUSTOMER][NEUTRAL] Hang on, let me go back in.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] My computer has 2 step verification, so give me a second.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] I totally understand. No worries.
[CUSTOMER][NEUTRAL] Hold on, it wants to verify my cell phone again because apparently I didn't do that the first time.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, thank you. OK, so yeah, I hit on the [PII] that's the one I hit on.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, you know what, the cards were just in the middle there. That's why it didn't specify which card was the good one and which one was the, it just says Medlink select group, and then it has two cards attached. That's it. It doesn't specify. Hang on one second, let me grab it.
[AGENT][NEUTRAL] Uh, OK.
[AGENT][NEUTRAL] So yes, she's
[AGENT][NEUTRAL] Yeah. The one ending in 24 is, that is the one that you're gonna need to give to your provider.
[CUSTOMER][NEUTRAL] Starting download.
[CUSTOMER][NEUTRAL] OK, hang on one second, so this one says effective date [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Yes, ma'am, that is correct. Uh-huh.
[CUSTOMER][NEUTRAL] Right, OK, alright, so I'll shred this one.
[AGENT][NEUTRAL] OK, so on this supplemental policy, yes ma'am, for outpatient, the outpatient benefit max per calendar day for covered outpatient services is $500 and there is no outpatient deductible per covered person per calendar day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So again,
[CUSTOMER][NEUTRAL] So the most it will pay is $500 towards everything.
[AGENT][POSITIVE] Correct. Correct, per calendar day.
[CUSTOMER][NEGATIVE] That's useless. I don't know why I bothered getting it.
[CUSTOMER][NEGATIVE] OK, well, I'm only planning on being in there for one day so that doesn't even help me cover my deductible which is 1,77819, so I guess I won't be getting surgery, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] I'm sorry that that's, that that is the, and again, some of these, you know, this is a per calendar day benefit which
[CUSTOMER][NEUTRAL] I'm gonna
[CUSTOMER][NEUTRAL] It's not your fault.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] It's not a per calendar year, but that is a $500 you know, helpful benefit for you at least, um, on here. And the way this plan.
[CUSTOMER][NEGATIVE] Yeah, that's not gonna help me even a little.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEGATIVE] My surgery is gonna my out of pocket is 6,0003 something so and there's no way I can afford to pay $8000 for a surgery.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you anyway though.
[AGENT][NEUTRAL] Well, I am so sorry. Um, is there, but if you decide that you do move forward or with any other, you know, whether it's
[CUSTOMER][POSITIVE] It's right.
[AGENT][NEUTRAL] any type of service, medical service, always present your APL card along with your primary healthcare insurance because most providers they will file both insurances for you in the event that they tell you they would not file your supplemental, then you could call us back because you can do that and we could give you all of that information if that need arises.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK thank you appreciate it.
[AGENT][POSITIVE] Well, you're welcome. Yes, ma'am. Can I help you with anything else today?
[CUSTOMER][POSITIVE] No, we're good thank you.
[AGENT][POSITIVE] OK. Well, thank you so much then for calling ATL and I hope you do have a very nice day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye bye.