AccountId: 011433970860
ContactId: a9a5dd56-d3eb-4df1-a201-d2bfa26bbaaa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 643580 ms
Total Talk Time (AGENT): 318107 ms
Total Talk Time (CUSTOMER): 200813 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/a9a5dd56-d3eb-4df1-a201-d2bfa26bbaaa_20250310T17:13_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Hi [PII], how you doing? My name is. I want your client, I guess. I'm trying to fill out the um the the claim form and not the claim form they they asked for APL number and I'm not sure what what that number is.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] OK, so you're the insured and you're trying to submit a claim to APL and you're needing your policy number?
[CUSTOMER][NEUTRAL] Is that what it is? AP the policy number?
[AGENT][NEUTRAL] Well, I'm not sure. It depends on the type of claim. I'm gonna have to pull your information up and verify some things with you first for security, but I can help you with this. And who am I speaking with again?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEGATIVE] First name is [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Last night we went [PII]
[AGENT][NEUTRAL] OK, Ms. [PII], thank you. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have your policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, uh, no, I, I'm asking for a policy number.
[AGENT][NEUTRAL] First, I need to pull up your policy information, Mr. [PII] and verify some things with you for security.
[AGENT][NEUTRAL] So do you have that number?
[CUSTOMER][NEUTRAL] Right, I don't, I, no, I don't. That's why I'm asking.
[AGENT][NEUTRAL] OK, what is your full social security number so that I can look up your information?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] OK, Mr. [PII], so first off, any information that I provide for you would be a verification of benefits and not a guarantee of payment. Please verify your date of birth for me.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and also your home mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the phone number that we have on file for you is the same as the uh information you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yeah, is that [PII]?
[AGENT][NEUTRAL] Thank you and the last piece of information to verify Mr. [PII] is your email address?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you so much. All right, so your policy number, Mr. [PII], with APL?
[AGENT][NEUTRAL] It's going to be 248.
[AGENT][NEUTRAL] 0688.
[CUSTOMER][NEUTRAL] OK. 2248-0688.
[AGENT][NEUTRAL] Yes sir, that is correct. Now Mr. [PII], have you ever set up your profile in our portal here at APL so that you can.
[AGENT][NEUTRAL] Uh, have access to your information with APL and also you can submit your claims forms and documents to us through this portal.
[CUSTOMER][NEUTRAL] Not yet.
[AGENT][POSITIVE] OK, um, I do have a user guide that I would be happy to email to you that explains how to set up your profile if you would like for me to do that. OK, alright, just one moment.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, Mr. [PII], so I will send that to you. The email that you will receive will come from [PII].
[AGENT][NEUTRAL] And I will put APL online service center portal in the use in the subject line rather so if that's easy for you to recognize.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is there anything else that I could help you with today?
[CUSTOMER][NEUTRAL] Yes, yes, OK, uh, I, I haven't, I, I have to have, how to share with you guys.
[CUSTOMER][NEUTRAL] Um, I was really confused at my, at my policy. Um, if I, when I go to a doctor, might understand I paid $25 copay, which I, I pay, and you guys supposed to pay the rest, but the last one of the last, the last couple of bill I got is basically you get paid 20% and 80% of the office visit, is that correct? Or that's something I I missing?
[AGENT][NEUTRAL] OK, so your copay amount, that does not have anything to do with your policy that you have with APL that is.
[CUSTOMER][NEUTRAL] OK, what is, OK.
[AGENT][NEUTRAL] Um, give me just a moment.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] I'm getting some additional information to pull up on your policy. So bear with me just a moment please, Mr. [PII].
[CUSTOMER][POSITIVE] No problem, I appreciate it.
[AGENT][POSITIVE] All right. You're welcome.
[AGENT][NEUTRAL] OK, so Mr. Way, on your policy that you have with APL this limited benefit plan for accident and sickness treatment, this plan pays a specific amount, OK. Um, it's a limited benefit plan. So this policy provides a $50 per day benefit.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And a maximum of 3 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] OK. That hat will stay correct?
[AGENT][NEUTRAL] This is for office visits.
[AGENT][NEUTRAL] Under this plan that you have with APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, OK, they, I, I guess I, I'm little bit confused. OK, they sent me the information PHCCS that is to my doctor group, right?
[CUSTOMER][NEUTRAL] You, you know anything?
[AGENT][NEUTRAL] Now for other questions that you have related to that office co-pay amount that's on your ID card, um, I have another phone number, let's see.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Um, for general customer service, that should also be on your ID card. It's an [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK, go ahead. I'm sorry, go ahead.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, so you guys only take care of anything that was hospitalized, correct? You don't.
[AGENT][NEUTRAL] No, sir, again, as I just stated, this policy is called a hospital indemnity limited benefit plan, but you do have benefits on here for certain things outpatient. And an office visit, again, the maximum benefit that this plan would pay would be $50 per day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And only for a maximum of 3 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I guess I had to call a general place because I what what they told me what I might understand what they cover it's not the same so I I just want under alright.
[AGENT][NEUTRAL] Now, you can also, I can provide you the phone number for the member services if you have questions on actually what you enrolled for, um, Mr. [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This number that I'm gonna give you would be for them, for member services, and that's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And if you would like for me to try and connect you with them, I would be more than happy to do that. Now, I can also
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I, I will appreciate.
[AGENT][NEUTRAL] Yes, sir. And if you would like, I do have an email address for them as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Which you can send an email to.
[CUSTOMER][NEUTRAL] Yep.
[AGENT][NEUTRAL] And that email address is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm so that travel OK.
[AGENT][NEUTRAL] Now when I transfer you to member services Mr. [PII], if it goes to voicemail, uh, would you like to for me to release the call so that you can leave them a message to have someone call you back?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] OK. Well, I'll be happy to do that. So is there anything else that I could help you with first?
[CUSTOMER][POSITIVE] No, that's it. That's all I need right now. Thank you.
[AGENT][POSITIVE] OK. Well, you're very welcome and thank you again for calling APL. I hope you have a nice rest of your day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Yes, sir, thank you very much. So one moment, please.
[CUSTOMER][NEUTRAL] Thank you for calling member services. All calls are recorded for quality assurance. You are currently caller number 23, waiting to speak with a representative. The estimated hold time is currently 10 minutes. Thank you for your patience.
[CUSTOMER][NEUTRAL] You are currently