AccountId: 011433970860
ContactId: d62df4e0-9116-4545-89dd-a74af065cdc4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 741179 ms
Total Talk Time (AGENT): 334422 ms
Total Talk Time (CUSTOMER): 274386 ms
Interruptions: 8
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/30/d62df4e0-9116-4545-89dd-a74af065cdc4_20250430T14:35_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling AP APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII] and I was just calling um from Parkersburg Pediatrics today to see what is covered on a member's plan.
[AGENT][POSITIVE] OK, I can help you with that.
[CUSTOMER][NEUTRAL] We've just never heard of this insurance and unsure if there's any coverage.
[AGENT][NEUTRAL] OK, I can help you with that, Ms. [PII]. Do you have a policy number?
[CUSTOMER][NEUTRAL] Um, I don't, I have a social for a patient. Um, I actually just called and spoke with.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, benefit wizard and they said the insurance would be through American Public Life and to call you guys to see if anything would be covered.
[AGENT][NEUTRAL] OK. All right, can I have that social please, ma'am, and we'll search and see if we can find them in our system.
[CUSTOMER][NEUTRAL] OK, social is going to be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. Give me just a moment.
[AGENT][NEUTRAL] Excuse me, and I will see if I can find that for you.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] It may take just a moment for it to search by social.
[CUSTOMER][NEUTRAL] He said they're still waiting on it to come through completely like.
[CUSTOMER][NEUTRAL] Um, sir staffing is where they work and they have already sent the information over to Benefit Wizard, um, but they haven't received first payment out of their paycheck yet so I don't know if that makes a difference.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Oh, so we may, they may not even, OK, yeah, it didn't pull anybody in yet 70084.
[AGENT][NEUTRAL] Uh, search staffing.
[AGENT][POSITIVE] OK, I like that what is the name of the, the person? Maybe I can try that way.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The person is [PII]. It's [PII]
[CUSTOMER][NEUTRAL] Last name [PII], [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you. Just a moment, please.
[AGENT][NEUTRAL] So he's they're not real sure if he is enrolled if he showed up as an as being newly enrolled, correct?
[CUSTOMER][NEUTRAL] Well, he is enrolled um they said that they're just waiting on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He just started with staffing so he has to have his first paycheck in order for money to come out to start funding it, but he is enrolled.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Alright, so we just may not have received the information here yet. Give me just a second and we'll see.
[AGENT][NEUTRAL] I may have to ask somebody else if my system's acting up, that may be.
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] Alright, that did not. OK, I'm gonna have to ask ask. Let's see, you can search for me.
[AGENT][NEUTRAL] She's oh.
[AGENT][NEUTRAL] 2344 56.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm sorry, [PII]. I'm trying to see who's not on the phone so they can help me search.
[CUSTOMER][NEUTRAL] No, no, I, I appreciate you looking, yeah, I appreciate you looking into it. We just, they want their child to come here we've never heard of this insurance before we're just not familiar in our area I guess and um so we just need to see if they're gonna have any coverage medically.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] With the pediatrics.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so let's.
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] Yes, that we, we, we handle, we are one of benefits in the cards, um, providers. They have many besides just us, but we are one of them.
[AGENT][NEUTRAL] And that to this, so we're just.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] We just like I said, we've just never had somebody with this insurance to know even you know what type of coverage.
[CUSTOMER][NEUTRAL] Do you cover a well visit? What, what do you cover with vaccines? Um, is there a copay? Like I just need some of those questions answered to know if we can accept this patient or if they would be a private pay or what they're out of network falls with that, you know, we just don't know anything, especially not having a card.
[AGENT][NEUTRAL] OK, all right. Yeah, we, I do see the group has dental with us, group, group term life, hospital indemnity, and disability with us.
[CUSTOMER][NEUTRAL] But.
[AGENT][NEUTRAL] So there's, we're not a major medical. We are a supplemental company.
[CUSTOMER][NEUTRAL] OK, so do you know, is that going to help cover on a well visit for pediatric care?
[AGENT][NEUTRAL] That I don't know. Let me, while we're waiting to see if I can check on this for me. Let me check with somebody in a different department. And so you're saying a wellness.
[CUSTOMER][NEUTRAL] Yes, and I have a code for that if you'd like.
[AGENT][NEUTRAL] A wellness checkup for a child or just wellness checkup period. OK. And the code would be.
[CUSTOMER][NEUTRAL] Right, it would be 999391.
[AGENT][NEUTRAL] 99391. All right.
[CUSTOMER][NEUTRAL] Yeah, and then if we could just check a vaccine or two just to see if it would even be if the vaccines are covered.
[AGENT][NEUTRAL] All right, let's see if we can get somebody on the phone while I can't.
[CUSTOMER][NEUTRAL] Um, it just if we could try like [PII].
[AGENT][NEUTRAL] Alright, hold on one second. Let me see if I can get on the phone with us if there.
[AGENT][NEUTRAL] Um, we're just having a, we're having a very large abundance of calls today.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh goodness, so it's kind of hard to get anybody at the moment because I keep seeing I'm watching the phones everybody's as soon as they hang up they're getting another call. So hold on one second, let's see what I can find.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hello, Ms. [PII]. This is [PII]. How are you, dear?
[CUSTOMER][POSITIVE] I'm great, [PII]. How are you today?
[AGENT][POSITIVE] I'm good, I'm good. [PII], um.
[CUSTOMER][POSITIVE] Good. Well, how can I help you?
[AGENT][NEUTRAL] OK, [PII], I have a a provider on the phone and she's got the person's not showing up in our system yet for benefits on the card, but they are wanting to use them as a uh provider, the insurance is wanting to use this as a provider for their child, OK? And of course providers never heard of APL before and what they will do is just go ahead and say this is a brand new enrollment so we've not gotten it yet. They just want to see if a few things is um.
[AGENT][POSITIVE] gonna be covered like a wellness and a few vaccines. I'm going to stay on the phone with you. If you can, is that something you can check on?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Well, there's not
[CUSTOMER][NEUTRAL] No, listen, until I mean because depending on what they enroll for I can't give them benefits until, I mean I don't know what they're gonna sign up for, um, until we get that enrollment information that they would, yeah, they'll need to, she'll need to the insured and need to speak to benefits and a card.
[AGENT][POSITIVE] Yeah, that is true. That is true.
[AGENT][POSITIVE] You are so correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, on that because I can't.
[AGENT][NEGATIVE] Let me get, let me check with [PII]. I never, I don't go into benefits the card enough to remember how we could go into it and see stuff and I can't remember how to go into it because I don't ever have any reason to be honest with you.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And I, we don't do, yeah, and we don't do that. So I made.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Yeah, because they may not even have a plan that has wellness on it.
[AGENT][NEUTRAL] True, true, that is true. So, OK, yes, let me go back to her and let her know that because I wouldn't think, I was thinking the no, the the, the potential insurer can call and speak with someone in claims and get benefits, but we cannot give provider, I forget.
[CUSTOMER][NEUTRAL] Cause a lot of them don't.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] If they know what
[AGENT][NEUTRAL] Right, if they know which one they're looking at.
[CUSTOMER][NEUTRAL] Yeah, I mean, we don't.
[CUSTOMER][NEUTRAL] Yeah and that's only general benefits questions because we just would have to look at that brochure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, right. Yeah, I remember now I'm getting it backwards over here.
[CUSTOMER][NEUTRAL] You know that was or.
[CUSTOMER][NEUTRAL] Yeah, as far as quoting benefits on something like that, I mean no we can't.
[AGENT][POSITIVE] On just a, yeah, no vague, exactly. All right, dear, thank you.
[CUSTOMER][NEGATIVE] I can't do that.
[AGENT][NEUTRAL] Oops, OK. I'm trying to hang up.
[CUSTOMER][POSITIVE] All right. OK. Can I help you with anything else, please? I'll just hang up and that way you won't lose your call.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK, let me, hold on, let me get, let me find her real quick. I'm jumping around on IMs over here. All right, thank you, [PII]. Have a good day. I'm gonna click off for you. All right, bye dear.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Or you can just
[CUSTOMER][POSITIVE] You're welcome. You too, [PII]. OK, well, call us back if we can help. All right. You're welcome. Bye-bye.
[AGENT][NEUTRAL] OK, thanks. Bye.
[AGENT][NEUTRAL] OK, [PII], are you there?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Until the insurer actually has a policy, they cannot just vaguely give what they think they may have in benefits.
[AGENT][NEUTRAL] So, um, OK, I've had several people check and nobody can get his social pull up, um.
[AGENT][NEUTRAL] So that
[AGENT][NEUTRAL] Hold on, I'm sorry, people are, um.
[AGENT][NEUTRAL] But he is not just yet with us since he is brand new, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, sir, do you have a number I can call you back? I'm gonna try to see if we can find anything on this person. And it's [PII]
[CUSTOMER][NEUTRAL] Well, that's, it's OK. I, that's OK. I appreciate you looking. I will just wait until they're covered because they wanna be new patients anyways, so I'm just gonna tell them we're gonna have to wait until they have a card.
[AGENT][NEUTRAL] OK dear, I do appreciate it and hopefully he'll get enrolled, you know, he'll be showing up with a Wednesday maybe by the end of the week or I'd say Monday possibly. I don't know when they get the file in for benefits on the card for sure. I'm thinking every Friday for some reason they may get the file in, but one day a week we get a file in for benefits in the car for new enrollments and things like that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect well I will let them know.
[AGENT][NEUTRAL] OK. All right, well.
[AGENT][POSITIVE] OK. Well, thank you so much, [PII]. You have a good day.
[CUSTOMER][POSITIVE] Thank you you too bye.
[AGENT][POSITIVE] Thank you, bye bye.