AccountId: 011433970860
ContactId: b9639dbd-c581-409b-9ba5-021f324b6b2e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 407779 ms
Total Talk Time (AGENT): 180886 ms
Total Talk Time (CUSTOMER): 93293 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/b9639dbd-c581-409b-9ba5-021f324b6b2e_20250218T22:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. I just had some uh questions about the um.
[CUSTOMER][NEUTRAL] The insurance company myself. So, um I work through a uh agency that offers it.
[CUSTOMER][NEGATIVE] But they don't, they don't give me enough information on everything about it.
[AGENT][NEUTRAL] OK, um, so do you have a group number for your employer, anything like that?
[CUSTOMER][NEUTRAL] So what I do.
[AGENT][NEUTRAL] What's the group number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 70083
[AGENT][NEUTRAL] OK, let me see here.
[AGENT][NEUTRAL] OK. Um, and you don't currently have any insurance with us. You're just kind of wanting to know about the plans offered?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I do have, uh, I do have insurance with you guys.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I just, I just, I just don't know, so like co-pays and things of that nature, like they didn't really explain any of that to me, so I don't really.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, let's take a look. So what's your first and last name?
[CUSTOMER][NEUTRAL] Uh [PII]
[CUSTOMER][NEUTRAL] And last name is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have by chance your policy number there? Do you have a card or anything?
[CUSTOMER][NEUTRAL] Yeah I have the car next to me.
[AGENT][NEUTRAL] What's the member ID on there?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 025.
[CUSTOMER][NEUTRAL] 865
[CUSTOMER][NEUTRAL] 86
[AGENT][POSITIVE] All right, thank you so much, [PII]. And then if you can just verify with me your date of birth and address.
[CUSTOMER][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] My address is [PII].
[AGENT][POSITIVE] All right, thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so let me pull up your policy.
[AGENT][NEUTRAL] Well let's take a look here.
[CUSTOMER][NEUTRAL] He snowy as fuck.
[AGENT][NEUTRAL] OK. So the medical plan that you have with us is called a limited benefit plan or a hospital indemnity plan.
[AGENT][NEUTRAL] What that means is that this plan pays a set amount towards services depending on what you're having done there's not like a percentage or anything of that nature.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, if you go to like a physician's office,
[AGENT][NEUTRAL] Your plan will pay $50 per visit and you're allowed a maximum of 4 visits in a calendar year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, what that physician's office is gonna charge you for a visit, we don't have any way of knowing that. You, if you have a primary care physician or a physician you go to, um, you know, they would be able to like give you that information. Um.
[AGENT][NEUTRAL] Did you ever get a copy of the policy itself or anything like that?
[CUSTOMER][NEUTRAL] Oh man.
[AGENT][NEUTRAL] OK. If you want, I can send this to you. Um, I mean, it breaks it down. If you were admitted to the hospital, it's gonna pay $500 per day. Um, it gives surgery benefits, emergency room. Uh, it does cover also like urgent care facility. If you go to an urgent care.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] What about
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Anything on there or like what about the dental plan and stuff? What about that stuff? That's mainly what I'm looking for. I, I need that ASAP.
[AGENT][NEUTRAL] The dental?
[CUSTOMER][NEUTRAL] Yeah, like what, what does it say on that cause the hospital stuff is uh I, I'm, I'm well aware, aware on that stuff. But I just don't know how the dental plan works out for you.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, let me pull your dental and see what you have with us.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] So, the dental plan that you have is pretty basic. Um, it's gonna cover pretty much preventative and basic cost. Basic cost would be things like a filling. But if you need to have major services done, deep cleanings, root canals, crowns, things of that nature, this plan is unfortunately not gonna cover something like that.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Um, it covers 100% of all preventative cost, meaning you can go to the dentist, have your, uh, cleaning twice a year, and that would be, uh, at no cost to you. Any other expenses are covered at 80%.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can check on for you?
[CUSTOMER][NEUTRAL] Uh no, ma'am.
[AGENT][POSITIVE] OK, thanks for calling APL have a good day.
[CUSTOMER][POSITIVE] Thank you.