AccountId: 011433970860
ContactId: b29e34ee-fecd-4593-955d-44aade897fbd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 376089 ms
Total Talk Time (AGENT): 206700 ms
Total Talk Time (CUSTOMER): 195225 ms
Interruptions: 6
Overall Sentiment: AGENT=1.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/b29e34ee-fecd-4593-955d-44aade897fbd_20250318T13:46_UTC.wav
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[AGENT][POSITIVE] Morning thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning. I have a couple of questions. I wanna, I kinda gotta get an understanding of how the gap insurance works. Is this the right number to call?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] It is the right number and it would be a pleasure to assist you with that. Do, do you have your policy number available?
[CUSTOMER][NEUTRAL] I do. My policy number is 025.
[CUSTOMER][NEUTRAL] 21734.
[AGENT][POSITIVE] Thank you. And what is your name please, ma'am?
[CUSTOMER][NEUTRAL] Sit your sellers.
[AGENT][NEUTRAL] Thank you, Ms. [PII]. Can you verify your date of birth and current mailing address, please, ma'am?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Alright, thank you and we do have an email on file can you verify that and a callback number?
[CUSTOMER][NEUTRAL] First two trip at Yahoo [PII].
[AGENT][POSITIVE] Perfect. Thank you. I appreciate that. Yes, ma'am. So this gap policy is going to help cover your deductibles, co-pays, and co-insurance for the covered benefits listed on your policy.
[CUSTOMER][NEUTRAL] OK, well, I have a question. I have a um ultrasound scheduled for the [PII] because I had a mammogram, so they wanted to do some additional testing on one of my um breasts. So what I mean, can I use this gap insurance for that? Like how would that work?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You certainly can. You do have diagnostic testing benefit under your plan?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and that benefit amount is $200 per calendar day. Now that is a verification of coverage on your policy, not a guarantee of payment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] So just be sure to give them your APL card along with your primary insurance card. They can file the claim for you, we can pay them any benefits payable. And also, yeah, they can, um, if they won't file the claim for you, then you can certainly call, uh, file for reimbursement.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so they file a claim, OK.
[AGENT][NEUTRAL] So make sure you get, if they don't file the claim for you, ask them for a document with the procedure codes and diagnosis codes. Most places will file for you though.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then we'll send them the money. Now if it's payable. Now I do see you have an active portal account. If you ever want to view your policy benefits, just click on your policy number.
[AGENT][NEUTRAL] And it will download your certificate. Uh-huh.
[CUSTOMER][NEUTRAL] OK, but let me ask you another. OK, let me ask you another question. So when I go there, I, I, I don't wanna pay the copay. I'm gonna tell them to bill me. Would that, would that make a difference to y'all?
[AGENT][NEUTRAL] It would not make a difference to us now your office visit co-pay is not covered, of course, but um, any procedures or treatments in the office, such as diagnostic testing is covered.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so it wouldn't matter if I don't, yeah, OK, so it matter if I bill if I get billed. OK, that's all I need to know because I'm gonna get billed.
[AGENT][NEUTRAL] Mhm. Now, and the policy, yeah, the policy only pays for sickness or injury so like a well wellness mammogram would not be covered. But sounds like they wanna check, yeah, they wanna check something, so.
[CUSTOMER][NEUTRAL] No, it's an additional one.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, OK, so that one would, so that would technically would be covered, right?
[AGENT][NEUTRAL] Yeah. And it's
[AGENT][NEUTRAL] That's correct. That would be diagnostic.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][POSITIVE] OK, well thank you.
[AGENT][NEUTRAL] Anything else I can help you with, Mr. [PII]?
[CUSTOMER][NEUTRAL] That's it, um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Let me ask you a question. I, um, who, who all do I have covered on because I see I got my card say family. Let me just list out the people who I think I want. So me, myself, my [PII] and [PII].
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So that's all I have covered, correct?
[AGENT][NEUTRAL] Journey.
[CUSTOMER][NEUTRAL] And journey, OK, and journey harder, yeah, OK.
[AGENT][POSITIVE] Yeah, that's right.
[CUSTOMER][POSITIVE] Alrighty, thank you so much.
[AGENT][POSITIVE] Mm, and it has been such a pleasure, and if you ever have time, just go on that portal and click on that, uh, policy number, and you can view the benefits and that way you kinda understand what's covered and because we want you to get your full benefits. So, and your policy has been active since [PII], so if you see any of those benefits that you have, uh, services that you've used, you can go back and file for reimbursement.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Well, let me tell you, I had, I had a little experience, but it wasn't with y'all, it wasn't with the gap part, it was with the um.
[CUSTOMER][NEUTRAL] It was the cancel one, because I canceled that one. It was a cancel one and the, the accident one. So, the, the coverage that we had before we went with, what, what was your company?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Any kind of claim that you could submit, like you go to a doctor for anything, you get the reimbursement, right? But when I try to do with, with y'all group or whatever, it was like, oh no, you have to be, it have to be an injury or illness. So my thing is, that what was the purpose? Cause like, like, you don't want to, you ain't always have an injury or illness to get your reimbursement. You understand what I'm saying? So I actually canceled that part of it, but I did keep the gap because the
[AGENT][NEUTRAL] Uh, probably that was under your accident policy. Yeah, so.
[CUSTOMER][NEUTRAL] Yeah, I think it was my yeah, I think it was my accident one, yeah.
[AGENT][NEUTRAL] Yeah, your accident does pay with for injury due to an accident.
[CUSTOMER][POSITIVE] Which I think is kind of funny because the one we have, the one we had before our um the city went with y'all, it was any clean. It was any clean, anything you went to the doctor for. Mhm mhm. Yes, ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Any claim under an accident policy? Interesting.
[CUSTOMER][NEUTRAL] We'll get $50. Mhm. And so we were told that we could do it was y'all pretty much the same thing as the other one we had. So yeah.
[AGENT][NEUTRAL] Now,
[CUSTOMER][NEGATIVE] So we had a lot of angry people. I, I can tell you no lies, so probably mhm.
[AGENT][NEUTRAL] I am so sorry. Yeah, that's, that's tough when you go from a benefit like that.
[CUSTOMER][NEUTRAL] Thank you, thank you. So, so I actually, so I actually canceled my accident one with y'all and I cancel one. I went back to the previous company.
[AGENT][NEUTRAL] I hear you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But I kept the gap, so yeah.
[AGENT][NEUTRAL] Well, good. I think you'll like this gap policy. It, it, and that benefit is a per calendar day, so there's no cap on it per year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, that's good. OK.
[AGENT][POSITIVE] Yeah, but if you need anything at any time, Mr. [PII], never hesitate to give us a call. We're here to assist you any way we can, OK? And I hope everything goes well.
[CUSTOMER][POSITIVE] Well, thank you.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Alrighty thank you.
[AGENT][POSITIVE] Thank you for calling APL. Take care. Bye-bye.
[CUSTOMER][NEUTRAL] OK bye.
[CUSTOMER][POSITIVE] Alrighty bye.