AccountId: 011433970860
ContactId: bafa3592-bc57-4a3e-af44-e2f4ca09d29c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 560039 ms
Total Talk Time (AGENT): 336634 ms
Total Talk Time (CUSTOMER): 81201 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/bafa3592-bc57-4a3e-af44-e2f4ca09d29c_20250106T21:13_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I just received an identification card from y'all and I'm trying to figure out what what it's for and the reason is my company recently changed over all their benefits plan and the card says this is not a major medical plan but so what is it? It says APL.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Has insured a coverage number and says med link with benefit assignment.
[AGENT][NEUTRAL] OK. So you haven't you've received an ID card from APL and you're just wanting to see exactly what that is for. Is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct, yes ma'am.
[AGENT][NEUTRAL] Yes, sir. I can, yes, sir. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And Mr. [PII], what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is that policy number that's on the ID card? It may, depending, uh, based on what you said, it may say in hospital or outpatient.
[CUSTOMER][NEUTRAL] It says there's a it is a policy number.
[AGENT][NEUTRAL] There may be
[CUSTOMER][NEUTRAL] 025.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 83068
[AGENT][NEUTRAL] OK, thank you. So, one moment please, while I get your information pulled up, Mr. [PII]. Then I will have to verify some things with you first for security. So if you could first please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thanks. What was the year again? I'm sorry, it did cut out.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you.
[AGENT][NEUTRAL] And your home mailing address, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And your zip code?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one you gave me, so again, that is your best contact number, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, thank you. And then I do need to add an email on file for you, Mr. [PII].
[CUSTOMER][NEUTRAL] OK, it's my name [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] So this plan, Mr. [PII] is through
[AGENT][NEUTRAL] Give me just one second.
[AGENT][NEUTRAL] It is a supplemental policy to your primary healthcare insurance.
[AGENT][NEUTRAL] I show that this policy went into effect on [PII]. This policy is designed to help you with your co-pays, deductibles, and co-insurance amounts of coverage services.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that's what this plan is. Now, in the information that you received, it talks about setting up your profile in the, in our portal at [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, now that will give you access to your ID cards, policy information, claim status should you ever have to file your own claim with APL you could also, you know, upload it into the portal and I do have a user guide, Mr. [PII] that I'd be happy to email you that gives you step by step instructions on setting that up if you would like for me to send that to you. I'll be happy to do that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That'd be great.
[AGENT][NEUTRAL] Alright, so give me one second and I'll go ahead while we're on our call and send that to you.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, Mr. [PII], so I have just emailed you.
[AGENT][NEUTRAL] That user guide and the email that you will receive is going to come from [PII].
[AGENT][NEUTRAL] And I did put APL and then online service center in your subject line for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So how do I use this when I go like a medical care and.
[CUSTOMER][NEUTRAL] That this is a supplement I provide them with this.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, give me just
[AGENT][NEUTRAL] Moment. Right, Medical services, you would present your APL.
[AGENT][NEUTRAL] They'll call file your supplements as well as your primary. Should they not that, can you still hear me?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes she kind of cut out there for a little bit.
[AGENT][NEUTRAL] Mr. [PII].
[CUSTOMER][NEUTRAL] Yes, go ahead.
[AGENT][NEUTRAL] OK, so I don't know what you heard, so I'll just repeat what I said. Anytime you go for medical services, always present your APL card along with your primary insurance card because most providers will file for both policies, but in the event that they don't, then you can submit your own claim with APO and if that were to.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] If that occasion were to arise, you could call us and we could explain to you how to get the claim form and all of, you know, all of that information. But this policy, um, and in your portal, once you set that up, there is a copy of your policy and it does list out your benefits that are covered under this plan. Now, office visits.
[AGENT][NEUTRAL] Uh, let's see here if they're covered or not. Give me just one second.
[AGENT][NEUTRAL] So, yes, sir. Anytime you go, whether it's to urgent care, a doctor's appointment, if you were to have some type of imaging done at an outpatient facility, if you have to go to the ER just always present this card with them because you have an outpatient benefit maximum on this policy of $500.
[AGENT][NEUTRAL] Per person, I'm sorry, yes, per covered person per occurrence.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And the definition of per recurrence is also.
[AGENT][NEUTRAL] In your policy, but it means treatment for the same or related condition unless separated by a period of 90 days.
[AGENT][NEUTRAL] And a treatment for the same or related condition that's separated by 90 days or an unrelated condition would be considered a new per occurrence.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And there is no outpatient deductible on the supplemental policy.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] If you were to be admitted inpatient.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Into the hospital, that benefit, max benefit is $2500.
[AGENT][NEUTRAL] Per covered person, per confinement.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the
[AGENT][NEUTRAL] With the confinement
[AGENT][NEUTRAL] Number of if there's a max number of days for confinement.
[AGENT][NEUTRAL] There is no deductible on that.
[AGENT][NEUTRAL] Um, either.
[AGENT][NEUTRAL] Let's
[AGENT][NEUTRAL] It just states it's per confinement.
[AGENT][NEUTRAL] On your policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And a confinement is, you know, being admitted, as I said, and then on an inpatient basis for at least 18 consecutive hours.
[AGENT][NEUTRAL] To be considered a hospital confinement.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, well I sure appreciate it. Thank you. You've been extremely helpful and uh.
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Well, you're very welcome. Well, you're very welcome. So is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] Question I have some hard.
[CUSTOMER][POSITIVE] No, no, ma'am, thank you.
[AGENT][POSITIVE] OK, Mr. [PII]. Well, thank you very much for calling APL and I hope that you have a very nice evening.
[CUSTOMER][POSITIVE] All right, you too. Thank you.
[AGENT][POSITIVE] Yes, sir. Thank you.
[AGENT][NEUTRAL] Bye bye.