AccountId: 011433970860
ContactId: c2244801-2e6e-4e20-a37b-da13a8412cfd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 557140 ms
Total Talk Time (AGENT): 257970 ms
Total Talk Time (CUSTOMER): 139668 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/12/c2244801-2e6e-4e20-a37b-da13a8412cfd_20250212T20:53_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]. My name is [PII].
[CUSTOMER][NEUTRAL] And um I have individual.
[CUSTOMER][NEUTRAL] Coverage and I have a policy number and a group number and I'd like to ask a couple of questions.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, Ms. [PII], so you have questions regarding your coverage. Is that correct?
[CUSTOMER][NEUTRAL] And I wanna know like, yeah, I have questions regarding my coverage, but I have questions regarding like, can I see any provider that I want or I forgot what I signed up for.
[AGENT][POSITIVE] OK, yes, ma'am. I can help you with this. So first off, Mrs. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] My
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and your policy number?
[CUSTOMER][NEUTRAL] Um, hold on, 02593801.
[AGENT][NEUTRAL] OK, thank you one moment while I get your information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And Ms. [PII], I will need to verify several things with you first for security purposes and then also any information that I do provide would be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that is on file for you is the same as the one you gave me, so that is the best number that we should have, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you and then lastly I do need to add an email address for you, Ms. [PII]. What email would you like to add?
[CUSTOMER][NEUTRAL] First name, last name.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, number [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, and I'm sorry, [PII] what?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. OK, thank you. So [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you and the reason that I'm adding your email in Ms. [PII] is because you will now have the ability to set up your profile in our portal online so that you can also have access to your ID cards and policy information and claims information and I will email you a user guide that has detailed instructions for setting up your profile and also the different things that you can do within the portal.
[AGENT][NEUTRAL] So this policy that you have with us is a supplemental policy.
[AGENT][NEUTRAL] To your primary health care insurance, and it's designed to help you with your co-pays and your deductibles and your co-insurance amounts of coverage services.
[AGENT][NEUTRAL] So when you go for medical services, you would present your APL card along with your primary insurance card.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, now this makes sense, OK.
[AGENT][NEUTRAL] Say yes, ma'am. Now, um,
[CUSTOMER][NEUTRAL] So I use this for only medical or dental or or pharmacy and me.
[AGENT][NEUTRAL] This is medical. This is for your medical. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, some of the things, for example, um, now, office visits or treatment that's rendered within a doctor's office, those are not covered benefits under your policy. If you were to have to go to like an urgent care, something, um, an outpatient facility, a diagnostic testing facility, for example, if you had to have like a CT or an MRI done, somewhere like that, those are things that this can help you with.
[CUSTOMER][NEUTRAL] I need to have a.
[CUSTOMER][NEUTRAL] Colonoscopy and mammogram?
[AGENT][NEUTRAL] If there's something applied to your deductible and your co-insurance and it's done at a facility that's not in your doctor's office, yes, ma'am, those are things that we could review for benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Most providers will also file with, you know, they'll file your primary insurance and then they'll also file your APL, but if for any reason your provider doesn't file your supplemental coverage, you can't, I mean, you know, your supplemental insurance with us, you can file the claim and if that need comes up then you could call us back and we could explain, you know, how to go about that as far as the claim form and you know, and all that, but if.
[CUSTOMER][NEUTRAL] Oh, I yeah.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] OK. So that, that explains a lot of what I needed because I was like, I thought I had Blue Cross Blue Shield and that
[CUSTOMER][NEUTRAL] Is this, you know, this.
[AGENT][NEUTRAL] So you
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Yes, ma'am. So you do have, you do have, well,
[AGENT][NEUTRAL] Now, um
[CUSTOMER][NEUTRAL] Uh, what do you have me down at?
[AGENT][NEUTRAL] Well, I was just gonna say this is through your employment with Questco, correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, OK. So this is a supplemental policy that goes along, you know, in addition to your primary health care insurance.
[CUSTOMER][NEUTRAL] OK, yeah, I just started, so I'm just starting to get stuff in the mail and you guys actually send me my first card. So I was like, OK I need to have, you know, some.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] Uh, work done soon, and I had just, I went to the doctor, I pay cash, and cause I was in between jobs, but then she said, oh, I want you to have this, I want you to have that. And I said, well, [PII], I gotta find out like, uh, this doesn't even sound like any insurance I've ever even heard of.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Well, you're welcome, Ms. [PII], and I'm gonna send you that email that I was talking about in just a moment, and I, the email that you will receive will come from [PII].
[AGENT][NEUTRAL] And I will put APL in the subject line for you so that that's easy for you to recognize as not being junk or spam mail.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, you could put, yeah, yeah, put APL or supplemental insurance.
[AGENT][NEUTRAL] Yeah, I will. I'm gonna put APL in the subject line along with the online service center.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] User guide and again it will come from [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] Well, you're very welcome, Ms. [PII]. Is there anything else I can help you with at the moment?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, well then, thank you so much for calling APL and I hope you have a very nice evening.
[CUSTOMER][POSITIVE] Yeah thank you bye bye.
[AGENT][POSITIVE] Yes ma'am. You're welcome. Bye bye.
[AGENT][NEUTRAL] Really?
[AGENT][NEUTRAL] Really?
[AGENT][NEUTRAL] Yeah, what I'm not doing that.