AccountId: 011433970860
ContactId: ac99616c-f107-415e-a72b-48a525b0a514
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 422369 ms
Total Talk Time (AGENT): 235389 ms
Total Talk Time (CUSTOMER): 120601 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/ac99616c-f107-415e-a72b-48a525b0a514_20250312T21:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm, I'm a new policy owner for the Middling Gap Insurance.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] And I just have a few questions. I'm trying to understand if I have.
[CUSTOMER][NEUTRAL] Um, what is the coverage provide? What, um, and what exactly do I need to do with claims if I have them and would they be covered?
[AGENT][NEUTRAL] OK, alright, I can help you with your benefits for your Medlink policy. Can you please give me your name and your, your policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] W
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and then what is your policy number, sir?
[CUSTOMER][NEUTRAL] 025.
[CUSTOMER][NEUTRAL] 83082
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[AGENT][NEUTRAL] OK, [PII], can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Thank you sir and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Um, address is [PII], that's uh [PII].
[CUSTOMER][NEUTRAL] [PII] phone number would be [PII].
[AGENT][NEUTRAL] OK and then one last verification can you give me your email address?
[CUSTOMER][NEUTRAL] Uh, yes, I just registered it it's [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And then if our call gets dropped, can I call you back at the number you just provided for me?
[CUSTOMER][NEUTRAL] Yes mhm.
[AGENT][POSITIVE] OK, thank you sir.
[AGENT][NEUTRAL] OK, so this policy is a supplemental gap insurance, and this is just to verify your benefits. It's not a guarantee of payment. The policy helps with deductible, co-pay, and co-insurance. So when you go to a facility to be seen, you give them both of your cards, your primary insurance card and this card.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So that when they file the claims they can file with both of us to help you um you have an inpatient benefit amount per calendar year and that's for 18 hours or more in the hospital.
[AGENT][NEUTRAL] Of $4050.
[AGENT][NEUTRAL] And then you also have an outpatient benefit per calendar year.
[AGENT][NEUTRAL] That is also $4050.
[AGENT][NEUTRAL] Let me make sure. I think I just read that wrong.
[AGENT][NEUTRAL] No, it's $2,025. I apologize for outpatient and $4050 for inpatient.
[AGENT][NEUTRAL] Um, your policy also
[AGENT][NEUTRAL] Helps you if you um.
[AGENT][NEUTRAL] Go to a um.
[AGENT][NEUTRAL] A lab, a diagnostic center.
[AGENT][NEUTRAL] Um, if you need to have durable medical equipment, a sleep study, speech, it also helps with surgery.
[AGENT][POSITIVE] It also helps if you um have to use an ambulance to to be ported anywhere um.
[AGENT][NEUTRAL] All of that is covered under this policy.
[AGENT][NEUTRAL] Now, did you get a copy of the policy mailed to you?
[CUSTOMER][NEUTRAL] Um, I don't know that we've had a policy mailed to us. Um, did you, would dermatology surgeries, outpatient surgery be covered?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check on that.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, I'm gonna actually pull up your policy and read it and see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What kind of facility that it covers.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] For outpatient surgery, let's look.
[AGENT][NEUTRAL] And you can also get a copy of it if you sign up for the online service center.
[AGENT][NEUTRAL] I can give you that website that you can go into um it's a direct portal to your policy.
[CUSTOMER][NEUTRAL] Yeah, I'm, I am I right, I, I did just log into that, so I'm, I'm walking through it while we're, while we're talking.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, OK, awesome.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK. So it says um that it does help with surgery in an hospital outpatient facility or a freestanding outpatient surgery center or a physician's office.
[CUSTOMER][NEUTRAL] OK, those are physician's offices I would say, yeah.
[AGENT][NEUTRAL] So, so yes, if.
[CUSTOMER][NEUTRAL] Um, and what is, what's the benefit, for, for that? What's the coverage?
[CUSTOMER][NEUTRAL] Is that 1000 and 4000 the same thing?
[AGENT][NEUTRAL] Well, it
[AGENT][NEUTRAL] It's the 2025, so that helps with only deductible, co-pay and co-insurance.
[CUSTOMER][NEUTRAL] I got you, OK.
[CUSTOMER][NEUTRAL] And so in order to get that benefit we we fill out a claim form.
[CUSTOMER][NEUTRAL] For that.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Or do OK, we give them the card and then we have to have a claim form as well filled out.
[AGENT][NEUTRAL] Well if they file the claim for you you won't have to do anything because they're filing for you yes but if you have to file for yourself um in that online service center you would choose to um to file a claim.
[CUSTOMER][POSITIVE] And then we don't have to worry about it, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you would choose the the med link.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Policy and you would need your explanation of benefits and your itemized statement from the facility.
[CUSTOMER][POSITIVE] I got you I see it, yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] To send with your claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. OK, yeah, I can see that. I can see all the information in there for that. What about dental? I noticed, uh, does it cover dental as well if you don't have primary coverage.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, it does not because this is just for medical.
[CUSTOMER][POSITIVE] OK, just for medical. I got you. OK, um, well I think anything else that we need to ask? OK, I think this has been very helpful, [PII]nk you.
[AGENT][POSITIVE] You're so welcome and you don't have any other questions or anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, ma'am, that'll take care of it for today. Thank you.
[AGENT][POSITIVE] All right. Well, you guys take care. We thank you for calling APL, Chris, and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right you too thank you.
[AGENT][NEUTRAL] Bye-bye, sir.
[CUSTOMER][NEUTRAL] Bye bye.