AccountId: 011433970860
ContactId: d792c533-ed24-4170-9b7e-03a87a01efaf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200330 ms
Total Talk Time (AGENT): 100817 ms
Total Talk Time (CUSTOMER): 86018 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/d792c533-ed24-4170-9b7e-03a87a01efaf_20250313T20:57_UTC.wav
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[AGENT][NEUTRAL] This is [PII].
[CUSTOMER][NEUTRAL] Hey, this is [PII] in customer services. How are you?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][NEUTRAL] I'm good. I have uh [PII] on the phone and she's needing to know what's covered under her policy for um.
[CUSTOMER][NEUTRAL] Pregnancy.
[AGENT][NEUTRAL] OK. And the policy number?
[CUSTOMER][NEUTRAL] 23297002
[CUSTOMER][NEUTRAL] She's fully verified.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. And her callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, you can send her over.
[CUSTOMER][POSITIVE] All right thank you [PII] have a good day.
[AGENT][POSITIVE] You too. Thanks.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I was calling to, um, just inquire information about benefits and coverage to see how the supplemental insurance works since I've never used it.
[AGENT][NEUTRAL] Yes, ma'am. Please verify your name and date of birth one more time.
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK. Just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on your policy was [PII]. I'm showing that your policy is still active. And let's see, for inpatient, if you're ever admitted, we cover up to 7500 per calendar year and that's for the co-pay, the co-insurance, and the deductible after your primary insurance processes a claim.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And for outpatient hospital services, um, we cover up to 3500 per calendar year and that's for the co-pay, the co-insurance, and the deductible after your primary insurance processes a claim. But I'm showing that there is no coverage for independent labs such as Quest or LabCorp, and there's also no coverage for doctor's office visits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm only showing um coverage for inpatient and outpatient hospitals and urgent care facilities.
[CUSTOMER][NEUTRAL] OK. OK, sounds good. So 7500, you said?
[CUSTOMER][NEUTRAL] And 3500 outpatients.
[AGENT][POSITIVE] Yes, ma'am. That's correct.
[CUSTOMER][NEUTRAL] OK, sounds good. Uh, so I guess I would just have to, whenever I, you know, go to the hospital or what not, present both cards, my insurance card and the supplemental card.
[AGENT][NEUTRAL] Um, yes, ma'am, and the provider will give us a call to verify your benefits and we'll give them the same information that I just gave you.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Oh wow, OK, good to know cause like you, like you said, I've had this since [PII] and each time I go to
[CUSTOMER][NEUTRAL] Seek medical care. I just, my insurance I didn't even know about this until someone told me.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Oh wow. Yes, start using it. It's available for inpatient and outpatient hospital services.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, very good to know. OK, thank you so much.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Um, no, that'll be all.
[AGENT][POSITIVE] OK. Well I thank you again, [PII], for calling APL. You have a great rest of your day. Bye.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you.