AccountId: 011433970860
ContactId: a85d6a37-fb9a-4dd1-afb2-0d2e379ed09b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 657770 ms
Total Talk Time (AGENT): 311337 ms
Total Talk Time (CUSTOMER): 191467 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/a85d6a37-fb9a-4dd1-afb2-0d2e379ed09b_20250529T13:43_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] May I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm calling um I have um enrolled with your medical insurance and I need um copies of um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My medical card.
[AGENT][NEUTRAL] OK, and your name is?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And do you happen to have that policy number or no?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK, uh, give me one moment, Ms. [PII].
[CUSTOMER][NEUTRAL] But
[CUSTOMER][POSITIVE] Thank you
[AGENT][NEUTRAL] OK, and verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] [PII] mailing address is [PII].
[CUSTOMER][NEUTRAL] Email address is um [PII].
[AGENT][NEUTRAL] OK, thank you ma'am, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Uh-huh, [PII].
[AGENT][NEUTRAL] Is this a cell number?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And you say you want a copy of your medical card?
[CUSTOMER][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] Uh, I, I have, I have enrolled the beginning of the year, but I have not, um, I need to, I, I got a question too, um, with my insurance, does it cover me getting like a physical for like the OBGYN in my area?
[AGENT][NEUTRAL] Uh, let me see, give me one moment.
[AGENT][POSITIVE] So like for a wellness visit.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, let me pull up your policy. Give me one moment and while I'm pulling up your information, uh, just to let you know we do have an online service center uh where you can set up an account to view your policy, print out any temporary card, and uh also when claims are received, you can check claim status from there as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK, uh, that site is at [PII].
[CUSTOMER][NEUTRAL] The kids, I on me right now, my notes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Hi.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] That's, that's two words, right? AM [PII] together?
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] At
[CUSTOMER][NEUTRAL] I got it.
[AGENT][NEUTRAL] OK, and they just um updated it to.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Well, um, I don't show any wellness benefits under the plan. You do have office visit benefits, um, but not for wellness screening.
[AGENT][NEUTRAL] And let me see because you do have other policies because it looks like the.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like you have a dental.
[AGENT][NEUTRAL] Critical illness and disability. Uh, let me check the critical illness and see if there's a wellness benefit.
[AGENT][NEUTRAL] And also, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you file a wellness claim, we have it uh to where you can uh file a claim through the site once you set up.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] But I don't, I'm trying to pull up your plan.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I'm trying to figure out how do y'all work.
[CUSTOMER][NEGATIVE] I'll figure out how y'all work um cause my daughter tried to use it, um, use your services at an urgent care and they wouldn't, it wouldn't take.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So do I get a local doctor or your, your doctors?
[AGENT][POSITIVE] Wow
[AGENT][NEUTRAL] Well, we don't have a, like a network of providers, meaning that your policy is open to where you can go to any medical provider and they can submit the claim or you can submit the claim for your daughter. And what's her name?
[CUSTOMER][NEUTRAL] How do y'all work like.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So prior to an appointment, submit a claim first. That's what you're saying?
[AGENT][NEUTRAL] That's
[AGENT][NEUTRAL] Uh, you can, well, most times what you could do is give them our information and what they would do is contact our office to verify benefits and eligibility. Like I said, we don't have a network, so it's open. Uh, if you or your daughter go to the doctor and they for some reason don't want to file a claim, you can file that claim yourself to be reimbursed any payable benefit. But for the most part, most providers just call our office to verify benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, OK, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, I was trying to pull.
[CUSTOMER][NEUTRAL] So if I was gonna do like I
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] I have an appointment. I have an appointment. This is my first appointment, um, using our services, so, um.
[CUSTOMER][NEUTRAL] Will I just pay out of pocket first and that's what you're saying they file a claim to be reimbursed?
[AGENT][NEUTRAL] Uh, you can or you can give them our information, uh, that way they can call verify benefits and eligibility.
[CUSTOMER][NEUTRAL] Oh what?
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] But like I said, if it's for a wellness visit, it's not covered since you don't have wellness benefits on your plan, but you do have benefits for a regular office visit or like a sick visit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And urgent care, uh, for your daughter, was it for a sickness or an injury?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, it doesn't matter if it covers for sickness or accident for our visits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But I will send a request to have those cards, ma'am. Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] But are there a policy that
[CUSTOMER][NEUTRAL] Yeah, are, are there, are there any benefits that y'all have to offer the wellness so next time, next year I know which one to choose.
[AGENT][NEUTRAL] Uh, we do have some, but it depends on what is offered through your group.
[AGENT][NEUTRAL] Um, I don't know if they gave you like a brochure or like a printout of possible cover benefits.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But, um, anytime you see anything, um, I guess it says diagnostic or wellness screening or wellness diagnostic, those are the benefits that will cover for like a wellness screening.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But, but it all depends on what's offered through your group though, through your employer, they offer any policies that have wellness benefits. And I was trying to pull up your critical illness cause I know some of those plans do you have a wellness component on them?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] If you don't mind, give me one moment I'm trying to see if I can pull up that information, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Universal oh, so you're with um.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Universal Trucking.
[AGENT][NEUTRAL] Or contracted with him.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, you can definitely contact, uh, UTBA and they can verify if they have any other policies that cover, uh, wellness cause I know.
[AGENT][NEUTRAL] That some of the groups with UTCA do have uh benefits to where it covers wellness. This is more of a newer policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] RPI
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That that's
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Uh, I don't show necessarily for a wellness visit, but on your, uh, critical illness policy, I do show where it covers like for vaccines.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, I don't show anything as far as any wellness though.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I'm sorry. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, does, do you have the.
[CUSTOMER][NEUTRAL] I would try to, I would try to um set that appointment up with um.
[CUSTOMER][NEUTRAL] I will still need my card so I can at least let them call you all to verify some benefits, I guess.
[AGENT][NEUTRAL] Yes, ma'am, but, um, I'll send that request and I'll say give it 3 to 5 business days, uh, to receive. But like I said, also, if you set up on the online service center, you will be able to view your policy or print out a temporary one until you receive your hard copy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, OK, thank you so much.
[AGENT][POSITIVE] Uh, yes, ma'am. Thank you for calling APL. Have a great day, Ms. [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah