AccountId: 011433970860
ContactId: a83d0764-46cd-441d-af22-fb1d00de7d83
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372779 ms
Total Talk Time (AGENT): 190997 ms
Total Talk Time (CUSTOMER): 167365 ms
Interruptions: 1
Overall Sentiment: AGENT=2.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/a83d0764-46cd-441d-af22-fb1d00de7d83_20250221T19:24_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Um, my name is [PII], and I have APL along with my UMR insurance. And I'm going to see a chiropractor and I was just wondering if I'd be able to find out if um APL will pick up any part of um the, any part of it. Um.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] It would be my pleasure to assist you.
[CUSTOMER][NEUTRAL] So I don't know what information.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][POSITIVE] I said it would be a pleasure to assist you and we'll check on those chiropractic benefits for you. Do you happen to have your APL ID card available?
[CUSTOMER][NEUTRAL] Oh sure.
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] Do you see a policy certificate number or outpatient or inpatient benefit certificate number?
[CUSTOMER][NEUTRAL] OK, I have two numbers. I have a group number and another number. I don't know what it is because it's handwritten as 01867071.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And Miss, can you verify your date of birth and current mailing address, please, ma'am?
[CUSTOMER][NEUTRAL] [PII] and my mailing address is [PII].
[AGENT][POSITIVE] All right, thank you. And Miss [PII], what is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you. And then finally, it looks like we may have your work email on file. Do you mind verifying that for me?
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][POSITIVE] All right, thank you, ma'am. I appreciate that verification.
[CUSTOMER][POSITIVE] And you should also have my personal email because that's what I really use.
[AGENT][NEUTRAL] Would you like for us to change that to your personal email?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] It would be my pleasure. What's your personal email?
[CUSTOMER][NEUTRAL] I'm gonna say it and then I'm gonna spell it [PII] it [PII], which is [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so I'm gonna do it just letter by letter to make sure that I got it correct. So it's [PII].
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]?
[CUSTOMER][NEGATIVE] I don't know, you lost me. Hang on a second.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. You did that so well.
[AGENT][NEUTRAL] And this [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] All right, thank you. I've updated that email to your personal email, so you shouldn't have any problems. My pleasure.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] And I was checking your policy benefits, Ms. [PII]. Now, for any visits, the visit would not be covered.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] But you do have benefits for procedures or treatments.
[AGENT][NEUTRAL] In an office.
[CUSTOMER][NEUTRAL] OK, so.
[AGENT][NEUTRAL] So it could be considered.
[CUSTOMER][NEUTRAL] OK, what would be considered a treatment in the office?
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] You know, I know, OK, so I know that when I go my copay is $25 that and so that doesn't cover that, correct? That just covers I have to sign the copay, correct?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] That's right. That is right.
[AGENT][NEUTRAL] That is correct. But now, if they do any therapy,
[CUSTOMER][NEUTRAL] But anything
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] or manipulations that could be considered for benefits.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, and up to what is there, is there a limit or how does that work?
[AGENT][NEUTRAL] Mhm. Well, you have a per calendar day benefit of up to $500.
[AGENT][NEUTRAL] And that is what we can pay towards your deductible, co-pay, or co-insurance of your major medical. Now that's for those services, not for the visit.
[CUSTOMER][NEUTRAL] Right, OK, OK. All righty. So is it OK, so the question is $500 for the car, suppose I had to go for physical therapy or something else. If I make the, if I use up that $500 at the um chiropractor, would I get another $500 for uh to be used at say physical therapy or just a.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Therapy.
[AGENT][NEUTRAL] So, yes, ma'am. So your benefit is a per day benefit. So if you go to the chiropractic, say in the morning.
[AGENT][NEUTRAL] And physical therapy in the afternoon, just for an example.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] If that deductible for your chiropractic services is $500 and we paid that, then the afternoon services for physical therapy, we would not be able to pay it in the same day.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Now, if you have a chiropractor today and therapy tomorrow, that's a whole new day and that full $500 benefit is available.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh it's $500 per day. I I thought you meant for the total. OK, great, that's good to know, and I do appreciate your help. Thank you so much.
[AGENT][POSITIVE] It's my pleasure to assist you, Ms. [PII]. I will need to advise that all benefits get on the phone. It's the verification the coverage is not a guarantee of payment. And if you ever need anything, you just give us a call.
[CUSTOMER][NEUTRAL] live on you learn.
[CUSTOMER][NEUTRAL] That's fine.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] And thank you for calling [PII]. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you, Ms. [PII]. Take care.
[CUSTOMER][NEUTRAL] OK. Bye-bye.
[AGENT][NEUTRAL] Bye bye.