AccountId: 011433970860
ContactId: befa101d-f8de-4245-bc89-66708493c1bb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 517840 ms
Total Talk Time (AGENT): 326072 ms
Total Talk Time (CUSTOMER): 108497 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/befa101d-f8de-4245-bc89-66708493c1bb_20250408T17:13_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] Hi, [PII], we were disconnected. I was in the process of trying to get a description of my benefits.
[AGENT][NEUTRAL] OK, so you were speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, Mr. [PII], so you were speaking with someone that you got disconnected or lost connection?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, and you're needing benefit information, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, sir. I can try and help you with that. And what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 886
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And your policy number, please, Mr. [PII].
[CUSTOMER][NEUTRAL] 02456799
[AGENT][NEUTRAL] OK, thank you, so give me a moment please to get your information pulled up.
[AGENT][NEUTRAL] OK, and Mr. [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. I will have to verify several things with you first for security purposes. So first off, if you will please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Your zip code?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, the phone number that we have on file for you is the same as the one that you gave me, so that is your best contact number, is that correct?
[CUSTOMER][POSITIVE] That's also correct.
[AGENT][POSITIVE] Thank you and lastly your email address please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, Mr. [PII], thank you for verifying all of your information. Now one question for you, have you ever set up your profile in our portal here at APL called the online service center where you can also have access to your ID cards and policy information online.
[CUSTOMER][NEUTRAL] I don't know that I have. It's been so long. I'm actually trying to figure out if this is like, is this my medical insurance?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] This is the supplemental insurance. This is your supplement to your primary health care insurance.
[AGENT][NEUTRAL] So this plan is the one that helps you with your co-pays, deductibles, and co-insurance amounts of covered services.
[CUSTOMER][NEUTRAL] Helps me with my co-pays. OK, so let me ask you this. If I was to, if.
[AGENT][NEUTRAL] Uh-huh, I covered services. Now all
[AGENT][NEUTRAL] Uh-huh. Sorry. Go ahead.
[CUSTOMER][NEUTRAL] Huh?
[CUSTOMER][NEUTRAL] I'm sorry. I need a physical. I need a DOT physical.
[CUSTOMER][NEUTRAL] Is that when I present this card?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, you would always present this card along with your primary healthcare insurance card when you go for medical services.
[AGENT][NEUTRAL] Now on this on this supplemental policy, office visits are not covered under this policy. However, if you receive treatment within a clinic or an office setting rather, we can review that under your outpatient benefits, but the office visit fee itself is not covered.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Office visits.
[AGENT][NEUTRAL] That is correct, yes sir. They are not covered.
[CUSTOMER][NEGATIVE] Prescriptions are not covered.
[AGENT][NEUTRAL] And there is no prescription coverage. That is correct.
[CUSTOMER][NEUTRAL] OK, so let me make sure that I understand the usage of this.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let's just say uh Oklahoma City.
[CUSTOMER][NEUTRAL] That you calling me back?
[CUSTOMER][POSITIVE] Yeah, that's you, that's the other lady calling me back. I, I won't worry about it.
[AGENT][NEUTRAL] No, sir. Well, I mean, that may be, that may be someone else. Yes, sir.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] That you were speaking to.
[CUSTOMER][NEUTRAL] OK, so let's just say for giggles, I get into an accident.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And they reach into my wallet and they pull out this card.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What do you guys potentially covering?
[AGENT][NEUTRAL] OK, so if you, OK, so for example, if you were admitted as an inpatient into a hospital.
[CUSTOMER][NEUTRAL] Potentially.
[AGENT][NEUTRAL] You have a calendar year maximum benefit on this plan of $4000.
[AGENT][NEUTRAL] That this policy could help you with on covered in hospital benefits, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If it's an outpatient coverage service, you have an outpatient benefit maximum of $2400.
[AGENT][NEUTRAL] Per covered person per calendar year for covered outpatient services.
[AGENT][NEUTRAL] There is a $100 outpatient deductible.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Per covered person per calendar you're on the supplemental policy.
[AGENT][NEUTRAL] So the outpatient deductible would have to be met and then the maximum benefits per calendar year is $2400. So if you went to the emergency room, that's something that could be reviewed under your outpatient benefit. If you were to have, if you went to an urgent care facility, if you had outpatient surgery or some type of diagnostic testing, you know, like an MRI, CT, that type of thing.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Um, if you had to go to physical therapy, that's something that we could review.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh, if you had an ambulance.
[AGENT][NEUTRAL] Service
[AGENT][NEUTRAL] You know, say you were in an accident like you said, and you were transported via ambulance to the hospital. That is something that could be reviewed under your outpatient benefit. Or as I first mentioned to you, treatment in your office, if they had, you had to have lab work that was sent to an outside lab facility, somewhere like, you know, lab core quest, a free-standing lab like that.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] If you had to have some form of durable medical equipment.
[AGENT][NEUTRAL] Now, supplies on durable medical equipment is not covered. Anything that's disposable or implantable is not covered.
[AGENT][NEUTRAL] Or if you were to have some form of home health, those are the types of things that this policy can help you with.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So that's why it's always important for you to give this card to your health, you know, always put this with your primary health care insurance card.
[CUSTOMER][NEUTRAL] Got you. Do you have any?
[AGENT][NEUTRAL] To give to the providers when you go for medical services.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, um, real quick.
[CUSTOMER][NEUTRAL] Any idea what I'm paying?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Does it show up in my records?
[AGENT][NEUTRAL] Uh, this, I can, well, you would need to verify with your employer as far as that goes. I, I can see it looks like 6907.
[CUSTOMER][NEUTRAL] E
[CUSTOMER][NEUTRAL] 6907.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is that per pay period or is that per what?
[AGENT][NEUTRAL] Yeah, that is something you would really need to speak to your employer about. I'm not able to get that in depth into the how it's.
[AGENT][NEUTRAL] Paid.
[AGENT][NEUTRAL] How they're deducting it, but they would be able to answer that for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Not a problem appreciate it.
[AGENT][POSITIVE] Well, you're certainly welcome. Oh absolutely and then one last thing, Mr. [PII], I am going to send you an email with the user guide for our portal that explains how to set it up and then it also gives you the information on the different things you can do in the portal.
[CUSTOMER][POSITIVE] Thank you for your help.
[CUSTOMER][POSITIVE] I appreciate it.
[CUSTOMER][POSITIVE] Thank you ma'am.
[AGENT][POSITIVE] All right. Well, you're very welcome. So, can I help you with anything else?
[CUSTOMER][POSITIVE] No ma'am I'm good appreciate it.
[AGENT][POSITIVE] All right. Well, you're very welcome. And again, thank you for calling APL and I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] Yes ma'am, I know.