AccountId: 011433970860
ContactId: aba9290e-e9a0-4cfa-a421-9a27ba595711
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 403309 ms
Total Talk Time (AGENT): 223448 ms
Total Talk Time (CUSTOMER): 156343 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/aba9290e-e9a0-4cfa-a421-9a27ba595711_20250218T15:03_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] But I'm trying to call about my um how would I just do with my card with about my benefits.
[AGENT][NEUTRAL] OK, I can help you with your benefits. Can I please get your name, your callback number, and your policy number please?
[CUSTOMER][NEUTRAL] Sure. My name's [PII]
[CUSTOMER][NEUTRAL] And um our policy number is 145.
[CUSTOMER][NEUTRAL] 1720
[CUSTOMER][NEUTRAL] And it's under my husband's name, [PII]. He's the policyholder.
[AGENT][NEUTRAL] OK, and then Miss [PII], what is your callback number just in case our call is disconnected we'll be able to call you back?
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Oh sorry, it's [PII].
[AGENT][NEUTRAL] OK, let me look up that policy real quick.
[AGENT][NEUTRAL] OK, Ms. [PII], can you verify your date of birth for me?
[CUSTOMER][NEUTRAL] Oh sure, it's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then also for security reasons, I'm going to need for you to give me your address and email address that's on the policy.
[CUSTOMER][NEUTRAL] So it's uh [PII], and I'm not sure if it's to [PII]'s email at [PII] or [PII].
[AGENT][NEUTRAL] Yes, ma'am. I have the [PII] family.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you very much for verifying that for me. OK, so you need a little help with your benefits. What is it that I can help you with?
[CUSTOMER][NEUTRAL] So I'm having like an in-office, um, like a vein procedure tomorrow. And I'm just wondering, they're saying that like I was under the understanding that this secondary insurance helps cover costs of
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Of what United Healthcare doesn't cover.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] But they told me that the, this insurance only like covers like hospital stays.
[AGENT][NEUTRAL] Right, um, looking at the policy and this is just to verify your coverage, it's not a guarantee of payment. You do not have office visits, but you can go to an ER urgent care center, MRI imaging center, or an ambulatory center.
[AGENT][NEUTRAL] For your outpatient benefits. Um, this policy only helps with deductible, co-pay, and co-insurance. So if you were to go to, uh,
[AGENT][NEUTRAL] Outpatient facility that um you know, is allowed per your policy you've got a $6000 calendar year benefit amount to help towards the deductible co-pay or co-insurance.
[CUSTOMER][POSITIVE] OK, so like when I went to have my colonoscopy done in an outpatient center that was covered, that helped cover, you guys would cover that.
[AGENT][NEUTRAL] Right. If it was done in an ER urgent care center, MRI imaging center or an ambulatory center.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK and then does it cover like doesn't it cover a certain amount of like co-pays for um like the office visits that we have or no?
[AGENT][NEUTRAL] Not the visit itself, but the it will help with the physician fee up to $6000.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] OK, and then after you meet the $6000 then what happens?
[AGENT][NEUTRAL] Then you're maxed out for the calendar year for your outpatient services, um, benefit. But you do have, if you go into the hospital and you have to be admitted to the hospital, you do have a, a, a benefit for that also, which is $6500.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] And that's, that's for 18 hours or more.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then our other United Healthcare then covers the other part of that, I assume.
[AGENT][NEUTRAL] Right, so your United Healthcare would be billed first.
[AGENT][NEUTRAL] And then after their bill, then we come in 2nd and they send us their EOB with um the procedures that they did, the explanation of benefits, and we pay based on what they paid because if it's not covered by your major medical, then it's not gonna be covered with us either because they have to pay first.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] have pets.
[CUSTOMER][NEUTRAL] Oh, OK, I got it. OK, I understand now. OK, that makes sense. OK, and then I have another question. We don't have any new cards like is there any way to resend us out new cards because my husband, um.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] Yeah, because we have like the old cards from like a few years ago, so I was wondering if you could send us out two new cards.
[AGENT][POSITIVE] Yes ma'am, I will, I'm taking care of that right now while we're on the phone together.
[AGENT][NEUTRAL] It's gonna be just a second. It's only gonna take me 2 minutes to get it done, probably not even 2 minutes. I'm already working on the 2nd card for you.
[CUSTOMER][POSITIVE] Oh perfect.
[CUSTOMER][POSITIVE] Well, that's quick. Lucky we have technology, click the buttons.
[AGENT][NEUTRAL] Yes, ma'am. OK, so I have requested 2 cards be mailed to your home address.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][POSITIVE] Oh thank you so much. I appreciate it.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] You're welcome. And then also um.
[AGENT][NEUTRAL] It might be beneficial for you guys to sign up for our online service center. It's a direct portal to your policy. You can file claims there if you ever need to file your own claims you could see a copy of your policy, you can see your cards, get copies of those if you want to, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, so what is the
[AGENT][POSITIVE] It's really cool.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And then let me give you the website. It's secured, S E C U R E D.
[CUSTOMER][NEUTRAL] What is that
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK perfect all right then we'll sign up for that.
[AGENT][NEUTRAL] OK. Is there anything else, Ms. [PII], I can help you with?
[CUSTOMER][POSITIVE] No thank you so much for all your help I appreciate it so much.
[AGENT][POSITIVE] You're very welcome. I hope you have a good procedure and everything goes well for you.
[CUSTOMER][POSITIVE] Uh, OK, thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL Ms. [PII]. You have a good rest of your week.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK you too now bye bye.
[AGENT][NEUTRAL] Bye-bye.