AccountId: 011433970860
ContactId: c8665b38-1555-4211-9b30-b86fe80298bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 644919 ms
Total Talk Time (AGENT): 144816 ms
Total Talk Time (CUSTOMER): 235075 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/c8665b38-1555-4211-9b30-b86fe80298bf_20250207T19:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello [PII].
[AGENT][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I worked for MAU over here in [PII].
[CUSTOMER][NEUTRAL] For 18 months on an assignment.
[CUSTOMER][NEUTRAL] And I had uh
[CUSTOMER][NEUTRAL] The uh
[CUSTOMER][NEUTRAL] Multi-plan or whatever it is.
[CUSTOMER][NEUTRAL] You're representing with MAU.
[CUSTOMER][NEUTRAL] I don't know where the group would be, but um.
[CUSTOMER][NEUTRAL] How can you look up my.
[CUSTOMER][NEUTRAL] I got the card here.
[CUSTOMER][NEUTRAL] How can you which number do you need off this card to find the policy or what uh what I was wondering.
[AGENT][NEUTRAL] Um, the policy certificate number if there's one on there.
[CUSTOMER][NEUTRAL] Uh, is that payer ID?
[AGENT][NEUTRAL] No sorry, it will say policy certificate number. If not, I can look you up by name. May I have your last name?
[CUSTOMER][NEUTRAL] Medical claim
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you Mr. [PII], and your first name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is that [PII]?
[CUSTOMER][NEUTRAL] It was [PII] on the card.
[AGENT][POSITIVE] Oh [PII] on the card, OK, thank you.
[CUSTOMER][NEUTRAL] Yeah, but they, they had [PII] on the card, I believe.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, employee ID I can give you that is that what you need?
[AGENT][NEUTRAL] No sir, no sir, um, what state do you live in please?
[CUSTOMER][NEUTRAL] MIU
[CUSTOMER][NEUTRAL] I live in [PII].
[AGENT][POSITIVE] That one. OK, thank you. I think I have you here.
[CUSTOMER][NEUTRAL] Now I
[CUSTOMER][NEGATIVE] I changed coverage after about 6 months and I got a little supposedly a better coverage which tell you honest truth, I never could collect anything from you. They, they paid a little bit of dental one time they paid some of that and they did pay an eye exam.
[CUSTOMER][NEGATIVE] And on some glasses, but every time I went to the doctor, they never did pay it. So, you know, I paid probably 40, I forgot how much a month or a week on this thing and
[CUSTOMER][NEGATIVE] You know, it was terrible insurance, terrible.
[CUSTOMER][NEUTRAL] So I just, I, I got.
[CUSTOMER][NEUTRAL] I got uh
[CUSTOMER][NEUTRAL] One's still pending that I'm fighting over.
[CUSTOMER][NEGATIVE] Where they went ahead and rebuild and sent sent it back in and you didn't pay it again either on.
[CUSTOMER][NEUTRAL] On kind of physical or or blood test.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] I just wonder why it didn't pay it. I did I read something in? I thought it was supposed to pay for.
[CUSTOMER][NEUTRAL] For wellness physicals.
[AGENT][NEUTRAL] OK, I'm sorry. Simply, before we get to that, I'm sorry, what is your date of birth just to make sure I have the correct policy.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Verify your complete mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your email address?
[CUSTOMER][NEUTRAL] My email is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Are you calling for the medical policy. OK, blood work.
[AGENT][NEUTRAL] Or physical.
[AGENT][NEUTRAL] Do you remember the date of service?
[CUSTOMER][NEUTRAL] And they turned it in they they went.
[CUSTOMER][NEUTRAL] I think one of them was in [PII] and the other might have been in [PII].
[CUSTOMER][NEUTRAL] They turned it in and they went back in and rebuild it and send it back to you.
[CUSTOMER][NEUTRAL] It was with a medical group of the Carolinas with uh Spartanburg Regional Hospital.
[CUSTOMER][NEUTRAL] Well they
[CUSTOMER][NEUTRAL] For their offices.
[AGENT][NEUTRAL] OK, Spartan Medical Center.
[CUSTOMER][NEUTRAL] And by the way, can you tell me exactly what I was paying for that a week?
[CUSTOMER][NEUTRAL] Back when I I had this insurance.
[AGENT][NEUTRAL] OK, yes, it's
[CUSTOMER][NEUTRAL] I could go back and look it up.
[AGENT][NEUTRAL] OK, so for the medical, um, one moment, sir.
[CUSTOMER][NEGATIVE] And, and pharmacy too was terrible. I mean, the pharmacy I went to, they could use benefits in a car, boy, I mean not, excuse me, Good RX, and it was.
[AGENT][NEUTRAL] And
[CUSTOMER][POSITIVE] It was way cheaper with good RX than it was with insurance but.
[AGENT][NEUTRAL] The medical was $7.02.
[CUSTOMER][NEUTRAL] a week
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I thought it was more than that.
[AGENT][NEUTRAL] What is Spartanburg.
[CUSTOMER][NEUTRAL] The medical was $7 a week.
[AGENT][NEUTRAL] OK, let me, I'm sorry, let me go back to that. Sorry, give me, I was trying to look for the, uh, hospital bill that you were asking about. OK, so for the premium, it shows $7.02.
[AGENT][NEUTRAL] It showed dental was 3, yes.
[CUSTOMER][NEUTRAL] A week.
[CUSTOMER][NEUTRAL] OK, so that was about $40 a month?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me get back.
[CUSTOMER][NEUTRAL] All right, I thought it was more than that.
[AGENT][NEUTRAL] OK, so let me get back to this here.
[AGENT][NEUTRAL] OK, now [PII], Sparkburg.
[AGENT][NEUTRAL] 128 covered.
[AGENT][NEUTRAL] OK, so that was a PSA test you had done on the [PII] of last year.
[AGENT][NEUTRAL] The surgery.
[AGENT][NEUTRAL] Almost there.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, sir, the policy you had did not pay for wellness.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I upgraded that from the 1st 6 months I think I was there upgraded it to a different.
[CUSTOMER][NEUTRAL] Policy but
[CUSTOMER][NEUTRAL] It never did OK, but and you sure that was just $7 a week.
[AGENT][NEUTRAL] That was for medical, you had other policies with us, so that may have added up to $40 a month what you stated, but that was just for medical.
[CUSTOMER][NEUTRAL] Oh a week
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So I, so the only thing I ever paid was went to the dentist it paid that one time.
[CUSTOMER][NEUTRAL] And it paid the eye.
[CUSTOMER][NEUTRAL] There
[CUSTOMER][NEUTRAL] And the glasses so it paid that.
[CUSTOMER][MIXED] So that that was good but the medical is not very good so I'm sorry to tell you that.
[AGENT][POSITIVE] Yes sir, you'll have to apologize.
[CUSTOMER][NEUTRAL] But uh alright so they're not, did they send you the rebill on that on those.
[AGENT][NEUTRAL] The last
[CUSTOMER][NEUTRAL] Well I
[AGENT][NEUTRAL] The only thing that the last claim that was that we received was on.
[AGENT][NEGATIVE] [PII] we have not received anything else.
[AGENT][NEUTRAL] From sport
[CUSTOMER][NEUTRAL] Oh OK all right
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][POSITIVE] OK, thank you so.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] So you don't pay for physical, you don't pay for physicals.
[AGENT][NEUTRAL] No, sir.
[AGENT][NEUTRAL] No sir.
[CUSTOMER][NEUTRAL] OK, was that
[CUSTOMER][NEUTRAL] Where could I have seen that in the policy? Or would you have told me that in something somewhere?
[AGENT][NEUTRAL] It would, it would have been in the policy, yes sir, uh, your policy certificate, um, it has a list of covered benefits, um.
[AGENT][NEUTRAL] Or, or
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Of course, or of course, um, the insurer could have called in and, and asked for physicals covered.
[AGENT][NEUTRAL] And of course at that time we would have said no.
[CUSTOMER][NEUTRAL] OK, alright, well.
[CUSTOMER][NEGATIVE] I'll just if I'll talk to him about I'll tell him it's not very good.
[CUSTOMER][POSITIVE] That's all I can say I'm sorry.
[AGENT][NEUTRAL] OK, no need to apologize.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][MIXED] Really wasn't worth the paper, really I'm worth the paper is written on. I could have been better off about it. All right, but thank you.
[AGENT][POSITIVE] You're welcome, sir. Thank you so much and have a good day.