AccountId: 011433970860
ContactId: bea1d338-8820-4617-9a95-ca121f19ad33
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 720150 ms
Total Talk Time (AGENT): 316935 ms
Total Talk Time (CUSTOMER): 240294 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/bea1d338-8820-4617-9a95-ca121f19ad33_20250328T15:15_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah, this is [PII] calling.
[CUSTOMER][NEUTRAL] You know, I'm on you guys' insurance.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEGATIVE] I'm the doctor in the hospital in my area here won't even take this insurance card.
[CUSTOMER][NEUTRAL] So I don't know if you can bring it up on a computer.
[CUSTOMER][NEUTRAL] Who uh accept this insurance, but.
[CUSTOMER][NEGATIVE] I can't even go to the hospital even if I had to.
[AGENT][NEUTRAL] Hm, that doesn't sound right, but I can definitely help you with your um policy and um the providers, and Mr. [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] And what number is that?
[AGENT][NEUTRAL] Um, do you have an ID card with you? OK.
[CUSTOMER][NEUTRAL] 00.
[CUSTOMER][NEUTRAL] Yeah, I see it here.
[CUSTOMER][NEUTRAL] It's uh 02.
[CUSTOMER][NEUTRAL] 58
[CUSTOMER][NEUTRAL] 6238 looks like.
[AGENT][NEUTRAL] OK, so 02586208?
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] 38
[AGENT][NEUTRAL] 0, 38, OK.
[CUSTOMER][NEUTRAL] On the end.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] OK, here we go and I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] I don't think, I don't have no.
[CUSTOMER][NEUTRAL] Computer email address.
[AGENT][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] But uh my
[CUSTOMER][NEUTRAL] I don't think I have one in there with you, do I?
[AGENT][NEUTRAL] Let me see, hold on. Yes, there's a Gmail email here.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] I don't know what.
[CUSTOMER][NEUTRAL] Well, it's it's probably one that my buddy made up and I got.
[AGENT][NEUTRAL] OK, um, we can just verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] I don't know but
[CUSTOMER][NEUTRAL] [PII], that is.
[CUSTOMER][NEUTRAL] And [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So you have a hospital indemnity policy with us. It's a limited medical insurance policy, but a lot of times when the provider sees APL because it's APL or American Public Life, they're looking for Aetna, Blue Cross Blue Shield, like a major name that they know, uh, they will tell the patients that they're not familiar with it or they don't accept it, but APL isn't the.
[AGENT][NEUTRAL] Insurance product with the insurance company. So you can go for your policy itself.
[AGENT][NEUTRAL] You have the PPO network through multiplan?
[AGENT][NEUTRAL] You could go anywhere, but because of that PPO network, if the provider wants to see if they're in network with multi-plan, they can. The easiest thing to do would be to give any provider that you're wanting to go to, give them your ID card and have them give us a call, the number on the back to verify coverage.
[CUSTOMER][NEUTRAL] Number on the back, you mean the customer service number?
[AGENT][NEUTRAL] Right, the [PII], that's our number here. So I will give them that card and tell them to contact your insurance to verify benefits, but they are not to turn you away. They're not sure what the insurance is. You do have coverage for hospitals. Um, let me see what else what else is in here.
[CUSTOMER][NEUTRAL] Yeah, but which hospital is that though?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Which hospital?
[CUSTOMER][NEUTRAL] Because the one that I live near here said that they don't take this insurance.
[CUSTOMER][NEUTRAL] And I gave her the, I, I gave her my.
[CUSTOMER][NEGATIVE] Policy number and everything she run it through her computer she told me they won't even they don't take that.
[CUSTOMER][NEUTRAL] Not even the doctor's office you said.
[AGENT][NEUTRAL] OK, again, I would just at that point, I would say give my insurance a call to verify benefits because she's going off of, off of just what's in the computer. You, it's literally a hospital indemnity policy. You have hospital coverage, you have urgent care, emergency room, physician office, physical therapy, you have coverage, they need to call to get the coverage and not turn you away.
[CUSTOMER][NEUTRAL] Well yeah, but I said.
[CUSTOMER][NEUTRAL] The APL when they hear that they don't, they say they don't take this insurance card.
[AGENT][NEUTRAL] Exactly, and that's why we encourage our our insured to have them give us a call because APL isn't a company like Aetna or Blue Cross Blue Shield. They're familiar with those names. APL, they're thinking that this is right. So that's why they need to call us to verify the coverage versus telling you you don't have coverage or they don't take it.
[CUSTOMER][NEUTRAL] Well, yeah.
[AGENT][NEUTRAL] But if they, in terms of a provider network, you do have the PPO network through multi-plan, um, they can
[AGENT][NEUTRAL] Go and that's all on your card, they can go to Multiplan's website and put in their doctor's MPI number, which is like their doctor ID, and it'll let them know if they're in network or not with multi-plan, but your hospital indemnity uh policy doesn't have any network. It's just a list of coverages. If whatever you're getting is not on that list, it wouldn't be covered.
[CUSTOMER][NEUTRAL] Oh yeah, so does it cover a doctor's visit or going to the hospital? Can you see?
[AGENT][NEUTRAL] Yes, you have coverage for hospital, if you're admitted into the hospital, if you're confined to a hospital, you also have emergency room if you just
[CUSTOMER][NEUTRAL] Well, no, I'm saying if I just have to go for.
[CUSTOMER][NEUTRAL] To like the emergency room or something what I'm saying.
[AGENT][NEUTRAL] Yes, the emergency room, urgent care.
[CUSTOMER][NEUTRAL] I is that covered?
[AGENT][NEUTRAL] Yes, sir. Everything that I'm saying is covered on your policy.
[AGENT][NEUTRAL] Emergency room, urgent care, physician office, physical therapy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] So they're turning you away because she
[CUSTOMER][NEUTRAL] Well, I just
[AGENT][NEUTRAL] They're not familiar with APL.
[CUSTOMER][NEUTRAL] Yeah, because they don't, they never heard of this insurance.
[AGENT][NEUTRAL] Right, so.
[CUSTOMER][NEUTRAL] So I, so tell him just to call this number on the back of the card then when I go.
[CUSTOMER][NEUTRAL] If I ever, well, I have a doctor's appointment [PII], so.
[AGENT][NEUTRAL] So yes, sir, I will give the
[CUSTOMER][NEUTRAL] And that was rescheduled
[CUSTOMER][NEUTRAL] Yeah, have them call this number and verify the coverage, right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Oh, all right. I didn't know.
[AGENT][NEUTRAL] And just have them to let them.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Yeah, hopefully they'll take, I mean, hopefully.
[CUSTOMER][NEGATIVE] That'll work because hey I can't afford to pay for no medical or anything right now.
[CUSTOMER][NEUTRAL] And I've been having problems with my back's been hurting because I have a, well, back in the [PII], I had to have a big operation up in [PII].
[CUSTOMER][NEUTRAL] I have a big old metal plate in my back and
[CUSTOMER][NEGATIVE] Trying to go to work the has been hurting me. My legs are hurting a little bit, my side, like I'm.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] You're gonna, I'm gonna have to go to that appointment and I don't wanna have to pay for it though, that's what I'm trying to say.
[CUSTOMER][NEUTRAL] Yeah I was trying to make me pay for it though.
[AGENT][NEGATIVE] Definitely would not um
[AGENT][NEUTRAL] Pay anything, I would tell them you need to call my insurance company to verify benefits. I have coverage for whatever facility you're in. Even if you go to the emergency room, there's there's coverage for that on your policy. They need to call and verify benefits versus saying APL we don't take.
[CUSTOMER][NEUTRAL] Yeah, all right, well I'll tell them to call that knows that any.
[CUSTOMER][NEUTRAL] Questions about this insurance, and I'll just tell him to call that.
[CUSTOMER][NEUTRAL] That's the number you're talking about then.
[AGENT][POSITIVE] Yes, and we'll go over everything with them, give them your effective date, how to file a claim, we'll go over everything with them. They just need to call and not turn you away.
[CUSTOMER][NEUTRAL] Well, so a doctor's visit, does the insurance pay for the whole doctors visit or is there a copayment?
[AGENT][NEUTRAL] So for um this is.
[CUSTOMER][NEUTRAL] Or can you see in the computer?
[AGENT][NEUTRAL] Yes, sir, um, for the physician office, the policy will pay up to $50 per visit with a max of 4 visits per calendar year.
[CUSTOMER][NEUTRAL] You know I'm saying, does it pay at all or is there?
[CUSTOMER][NEUTRAL] A co-payment for me to pay.
[AGENT][NEGATIVE] No, there's no copay. There's no co-pay for your hospital indemnity policy.
[AGENT][NEUTRAL] So, um, now, if they, if they have fees, we, you know, that's based on that provider, but there's no copay for your insurance policy with APL.
[CUSTOMER][NEUTRAL] Yeah, for the doctor's visit, right?
[AGENT][NEUTRAL] Right, for the doctor's visit. Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right, well.
[CUSTOMER][NEUTRAL] I'll go ahead and
[CUSTOMER][NEUTRAL] Keep the appointment and go ahead and do that.
[AGENT][NEUTRAL] Yes, sir, and anyone.
[CUSTOMER][NEUTRAL] I guess they I just have to tell it.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][POSITIVE] Um, anyone here will be more than happy um to assist them. They just need to, we just need to get them on the phone. They just need to call us and they'll, then they'll know you do have coverage.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Well that's all I need to know today and so.
[CUSTOMER][NEUTRAL] You know, I didn't know if this car.
[CUSTOMER][NEUTRAL] Because the way they were telling me.
[CUSTOMER][NEUTRAL] When they looked it up in their computer at the hospital.
[CUSTOMER][NEGATIVE] They said that, well they don't accept this insurance. I, I, I thought to myself, well heck.
[CUSTOMER][NEGATIVE] I'm paying for this insurance every week and then I can't even use it.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] I'll, I'll go in just whenever I have to go to the hospital or when I have my doctor's appointment next month I'll just tell him to call that customer service number and.
[AGENT][POSITIVE] Yes, and then once they call us, um, we'll give them all they need to know for your policy and, and they shouldn't turn you away after that.
[CUSTOMER][NEUTRAL] I, I don't talk to you guys.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] That's all I need to know today then.
[AGENT][POSITIVE] All right, Mr. [PII]. Well, thank you so much for calling APL. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] Alright, you too.
[AGENT][POSITIVE] All right. Well, thank you so much and have a good day. Bye-bye.
[CUSTOMER][NEUTRAL] Alright bye.