AccountId: 011433970860
ContactId: b5bdba8b-12de-411c-9024-4623da84f64c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 514808 ms
Total Talk Time (AGENT): 246905 ms
Total Talk Time (CUSTOMER): 208192 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/b5bdba8b-12de-411c-9024-4623da84f64c_20250217T21:27_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], um, I'm just a little confused. I've been, I believe I'm a member. I just received my card and, um, is this the same thing as as a multi plan benefits in a card?
[AGENT][NEUTRAL] Yes, um, I'll have to, uh, we do associate with them, but I'll have to look up your policy in order to find out for sure. Can you please give me your um name and your policy number?
[CUSTOMER][NEUTRAL] Absolutely. Uh my name is [PII]. [PII] [PII]
[CUSTOMER][NEUTRAL] [PII] [PII]
[CUSTOMER][POSITIVE] And I can give you the policy number when you're ready.
[AGENT][POSITIVE] Yes ma'am, I'm ready for you.
[CUSTOMER][NEUTRAL] Right. It's 02490697.
[AGENT][NEUTRAL] OK, let me look up your policy, Ms. [PII].
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] OK. Can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] Mhm. [PII].
[AGENT][NEUTRAL] OK, and then for security reasons, um, can you please verify your address, phone number and email address?
[CUSTOMER][NEUTRAL] Mhm. Uh [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] My email is my name is [PII] and my phone number.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK thank you so much and just in case our call is disconnected is this a good number to call you back on?
[CUSTOMER][POSITIVE] Yeah, thank you.
[AGENT][POSITIVE] OK. All right. Thank you, Ms. [PII]. I appreciate that.
[AGENT][NEUTRAL] Alright, let's look at your policy.
[AGENT][NEUTRAL] Yes, you would be through multi-plan for your hospital indemnity plan.
[CUSTOMER][NEUTRAL] OK, so this is just for hospital indemnity?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, uh, sorry, I'm so sorry. I'm just pretty confused by what's happening, um.
[AGENT][NEUTRAL] No, that's OK.
[CUSTOMER][NEUTRAL] Thank you. So I was with benefits and a card. Um, I mistakenly thought that I automatically re-enrolled and it seems as though I didn't and I was rolled over into Medicaid, but I'm getting hospital indemnity as still, even though I didn't enroll in that. Can you explain how that happened?
[AGENT][NEUTRAL] OK, so you are through benefits and a card.
[AGENT][NEUTRAL] Um, through our company through your employer creative circle.
[AGENT][NEUTRAL] And your hospital indemnity plan, um, the first effective date was [PII] and it's payroll deducted.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you're paid to [PII].
[CUSTOMER][NEUTRAL] OK, so did it just restart in [PII] is what you're telling me?
[AGENT][NEUTRAL] Uh, it, it doesn't look like, let me see if you've been.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Yeah, you've been with us since [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And your your payroll deducted weekly, it's a weekly amount of $9.19 that hasn't, there's not been a gap in the insurance, so it's been deducted from your paycheck through your employer.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We wouldn't send you a bill.
[CUSTOMER][NEUTRAL] Right, you're saying until.
[CUSTOMER][NEUTRAL] You're right, you were saying though until [PII], which was last month, so did it stop last month?
[AGENT][NEUTRAL] No ma'am, it's payroll deducted and so what happens with benefits in a card, um, they can put pay retroactively so they'll um they'll deduct it from your paycheck and then send your premium in.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I just received these two cards from APL, and that's just for limited benefit hospital indemnity, so that's what I've been receiving information about, which is what exactly?
[AGENT][NEUTRAL] So your hospital indemnity plan and this is just to verify your coverage it's not a guarantee of payment actually helps if you go into the hospital you have a hospital.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Daily confinement benefit of $50 if you go into the hospital. Um, you have an outpatient sickness and benefit rider of $75.
[CUSTOMER][NEUTRAL] Got it. OK, so
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it helps with, um, and, and again, if you go in the hospital, that first time you go in the hospital, that first day per year, it pays $500.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I understand. So the information I've been receiving is purely about hospital indemnity, which is if I get admitted to a hospital and that's when this comes into play.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, I'm not sure if you're able to answer this, but you can see that I am enrolled in benefits in a card. Is that active?
[AGENT][NEUTRAL] Yes, yes, it's through your employer benefits and a card.
[CUSTOMER][NEUTRAL] OK, because
[CUSTOMER][NEUTRAL] I'm not, and again I'm not sure if you're the correct person to ask about this, but I saw a doctor two months ago on benefits and a card, and I tried to see her again over the weekend, and they said that it no longer looked like I was enrolled in that and that I had been rolled over into Medicaid. So I'm just trying to backtrack to figure out where that had occurred and how I can stay enrolled, even though you're saying that I am enrolled.
[AGENT][NEUTRAL] Yes, you are enrolled through the hospital indemnity plan with us. Um, we have no association with Medicaid, so that's billed completely separate than what this is, um.
[AGENT][NEUTRAL] And it
[AGENT][NEUTRAL] But there's no coordination of benefits there. So this is a whole separate different kind of insurance apart from that.
[CUSTOMER][NEUTRAL] Right, right, so I understand you're talking about hospital indemnity, but there are other aspects to benefits in a card, um, right, there's medical and dental as well, not just the hospital aspect. Do you deal with those or you just purely hospital indemnity?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Let me tell you, um, what policies you have with us through benefits in a card.
[AGENT][NEUTRAL] You have the hospital indemnity, you have your group accident policy with us. You have your group term life insurance with us, and and you have your dental policy through us.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I don't have medical.
[CUSTOMER][NEUTRAL] Meaning like the doctor I went to.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Like your major medical, your major medical may be with another company.
[CUSTOMER][NEUTRAL] OK, do you know
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you know why those were rolled over, but medical was not?
[AGENT][NEUTRAL] We have never done major medical. We've always had limited plans. So your major medical plan.
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] Um, could be with another company.
[CUSTOMER][NEGATIVE] That, um, I don't think that makes sense. I'm pretty sure I signed up all through one.
[CUSTOMER][NEUTRAL] Um, but you're saying basically everything you're seeing is the same that I've had, nothing has been dropped or added.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so then it sounds like that doctor was through something else that I need to look into, so not.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] APL.
[AGENT][POSITIVE] And if they need to call and verify your benefits for your hospital indemnity plan, you do have some outpatient benefits that pay $75 if they need to call and verify that information with us, we'll be more than happy to go over your benefits with them.
[CUSTOMER][NEUTRAL] OK, um, it sounds like I need to call someone else first, but thank you for verifying all that.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You're very welcome, Ms. [PII].
[CUSTOMER][NEUTRAL] But
[CUSTOMER][POSITIVE] All right, thanks [PII]. Have a good day.
[AGENT][POSITIVE] Is You're welcome. You have a good day too, and thanks for calling APL.
[CUSTOMER][POSITIVE] OK thanks bye bye.
[AGENT][NEUTRAL] Bye bye.