AccountId: 011433970860
ContactId: cfdc7cff-b89f-4133-b63e-2275dfcee80f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 399519 ms
Total Talk Time (AGENT): 164368 ms
Total Talk Time (CUSTOMER): 171432 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/cfdc7cff-b89f-4133-b63e-2275dfcee80f_20250529T14:32_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, um, I was trying to, uh, make me an appointment for a wellness check, and they said that, um, they can't find y'all company or what policy major company y'all on this so they can see if I'm eligible for an appointment.
[AGENT][NEUTRAL] I can verify eligibility. May I have your policy number?
[CUSTOMER][NEUTRAL] Um, my policy number is 02596944.
[AGENT][NEUTRAL] And may I have a good callback number along with your name?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] [PII], can you verify your date of birth, your mailing address, and your email, please?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, mailing address [PII].
[CUSTOMER][NEUTRAL] Email is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. Is this for dental or medical?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Medical.
[AGENT][NEUTRAL] OK, one moment, I'll pull up the medical policy.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] OK, this is a hospital indemnity plan. It is a limited benefit plan. What information can I provide for you today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I am trying to uh get an appointment for a wellness check. My physical every year.
[CUSTOMER][NEUTRAL] Is that covered there or no?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm just waiting on the policy to load one moment.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And under this policy, I do not show wellness.
[AGENT][NEUTRAL] I show physician's office visit, but not wellness.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] OK, can I get an understanding of how do y'all work? Do I do a.
[CUSTOMER][NEUTRAL] Like, if I want to see a doctor, what do I do? Like.
[AGENT][NEUTRAL] So with this plan, we do not have a list of providers. There is, let's see if they have.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On your ID card. I'm just pulling up your ID card. Sometimes they have a list or a network where you can utilize providers. One moment.
[AGENT][NEUTRAL] See if this one offers it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So under this one.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] It does not. Some offer on your card, there is a website that you can go to, but in this case, this one does not offer it. So it is the provider's choice if they accept this policy, but they can always call and verify your benefits as well.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, well, if I don't.
[CUSTOMER][NEUTRAL] What benefits do I have do I have? Like if I go to a doctor, what?
[AGENT][NEUTRAL] So if you go
[CUSTOMER][NEUTRAL] What am I, am I covered?
[AGENT][NEUTRAL] If you go to a physician's office, you are allowed $75 per visit and you're allowed 6 visits per calendar year. So any services rendered in the doctor's office will fall under that $75 umbrella. There is no co-pay, only a benefit amount. So anything over the $75 you will be responsible for.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] You do have urgent care. It also allows $75 per visit.
[CUSTOMER][NEUTRAL] 0 $75 per visit and then anything over that I will have to pay.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So do y'all have like a hotline, like a, like if I have to call?
[CUSTOMER][NEUTRAL] To speak to someone to get some medical attention.
[AGENT][NEGATIVE] They do not have the telehealth on this plan.
[CUSTOMER][POSITIVE] The guy was OK.
[CUSTOMER][NEGATIVE] I, I'm not understanding. I'm paying $140 a week on this plan and what, what, what, how's it all good for me?
[AGENT][NEUTRAL] Was this plan explained to you through your employer before you purchased?
[CUSTOMER][NEUTRAL] What, what,
[CUSTOMER][NEGATIVE] They told me that they told me that $75. I mean my understanding they did tell me $75 off of it, but they didn't tell me. I'm thinking, well, maybe I misunderstood.
[CUSTOMER][NEUTRAL] $75 was kinda like, I understood it was a kind of like a co-payment.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] But it's $75 knocked off the bill and then I have to pay the rest of it.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEGATIVE] So how long is this, this plan, how long does this plan affect to kill cause I don't think I'm gonna continue it after this.
[AGENT][NEUTRAL] As of right now, it doesn't have a term date.
[AGENT][NEUTRAL] But it looks like it's paid the 61 of 25.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I will reach out to your employer and ask them if they offer something that better suits your needs, because we don't actually administer the policy, we just have to interpret the benefits.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, so do, do you have the name of who I can contact?
[AGENT][NEUTRAL] Let me see. Usually it just gives.
[CUSTOMER][NEUTRAL] Cause this is a big company.
[AGENT][NEUTRAL] Let me see if it pulls up.
[AGENT][NEUTRAL] It just lists universal trucking.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the group number, that's all I get.
[CUSTOMER][NEUTRAL] OK, I'll figure it out.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], I'm sorry. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] No, I appreciate it. You have a good day.
[AGENT][POSITIVE] You're so welcome, and thank you for calling American Public Life, [PII]. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] So.