AccountId: 011433970860
ContactId: b5af2b11-46ec-494d-ba12-be7b980363c9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 251100 ms
Total Talk Time (AGENT): 109092 ms
Total Talk Time (CUSTOMER): 111760 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/b5af2b11-46ec-494d-ba12-be7b980363c9_20250211T21:56_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] I need to clarify um what exactly my policy covers because I put in two claims and they were rejected saying it wasn't covered. I don't know if I was misinformed or what's going on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, your name is?
[CUSTOMER][NEUTRAL] Sorry, [PII].
[AGENT][NEUTRAL] And Ms. [PII], do you have your policy number or the policy number?
[CUSTOMER][NEUTRAL] Let me, let me grab it because I printed out like.
[CUSTOMER][NEUTRAL] What she hold on a second.
[CUSTOMER][NEUTRAL] It would be in my welcome information, correct?
[AGENT][NEUTRAL] Uh, yes, ma'am. It should say probably policy or certificate number, start with 01 or 02.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] 0257.
[CUSTOMER][NEUTRAL] 3253.
[CUSTOMER][NEUTRAL] I think.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It is. And verify your date of birth, mail address and email address for me, please.
[CUSTOMER][NEUTRAL] 52181 mailing address [PII]. Email is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, that's a unique. Well, that's cool email address. I like the show.
[AGENT][NEUTRAL] Let's see. And Ms. [PII], do you have a callback number in case the call drops?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And I show the type of policy you have is a secondary supplemental plan. Uh, what it does, it helps with your primary insurance deductible, co-pay or co-insurance for services in an outpatient facility or if you're confined inpatient in the hospital.
[AGENT][NEUTRAL] Um, outpatient being ER, urgent care, ambulatory surgery center, MRI or imaging center, and inpatient is if you're confined 18 hours or more in a hospital.
[CUSTOMER][NEUTRAL] OK, so if it, I re render services at a doctor's office, it's not covered?
[AGENT][NEUTRAL] Correct, yes ma'am. Office, um, visits or procedures in office are not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's where I got confused.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Yes, ma'am. Do you have a copy of your policy?
[CUSTOMER][NEGATIVE] I do, and I read through it, but I'm not really an insurance person, and I, I have a high deductible on my insurance. I haven't been, I'm not gonna, I don't plan on being hospitalized or anything like that. So how do I cancel this policy cause it's costing me a lot. I have to go through my HR.
[AGENT][NEUTRAL] Oh no, I understand.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh, you
[AGENT][NEUTRAL] Yes, ma'am, since it's a group plan, you have to go to your group employer and just um speak to them, letting you know you want to cancel the policy and then they'll send over an email to cancel it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Most time.
[CUSTOMER][NEUTRAL] OK, cause I thought this was gonna like pick up my high deductibles and part of my
[CUSTOMER][NEGATIVE] Like out of pocket cost, it's not worth it because I, I do everything outpatient so if it's not covered outpatient then.
[AGENT][NEUTRAL] Well, outpatient is covered, but it's
[CUSTOMER][NEGATIVE] Not gonna work for me.
[AGENT][NEUTRAL] Specific places, like I said, the ER, urgent care, um, ambulatory surgery center or imaging center, those are considered outpatient on the policy, but not for like office.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's what I was looking for was kind of like a, a gap plan for outpatient things because I'm not gonna be inpatient or have imaging or anything like that and so, OK, um.
[CUSTOMER][NEUTRAL] I'll let them know. I just wanted to clarify before I did that.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and it's
[CUSTOMER][POSITIVE] I appreciate your time thank you.
[AGENT][POSITIVE] You're welcome, Ms. [PII], and thanks for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye.