AccountId: 011433970860
ContactId: dafff57f-33fe-43ab-bf80-7bc0657b7614
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 666020 ms
Total Talk Time (AGENT): 339958 ms
Total Talk Time (CUSTOMER): 280705 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/dafff57f-33fe-43ab-bf80-7bc0657b7614_20250228T16:27_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, I'm calling because I would like to know, um,
[CUSTOMER][NEUTRAL] What um lab service my friend can use?
[AGENT][NEUTRAL] What kind of what service? I'm sorry?
[CUSTOMER][NEUTRAL] Lab, la, lab service.
[AGENT][NEUTRAL] Oh, lab services?
[CUSTOMER][NEUTRAL] What laboratory?
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, I'm sorry.
[AGENT][NEUTRAL] No, that's perfectly fine. Um, what was your name? I'm sorry.
[CUSTOMER][NEUTRAL] My name is [PII], and I'm, I'm calling on behalf of [PII], and he's here by my side. I don't know if you would like to like talk to him, but uh he don't speak English, so that's why he asked me to call you guys.
[AGENT][NEUTRAL] I, I understand. OK, um, let's see, [PII] first, if you don't mind, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Of course, [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, and then do you have that policy number?
[CUSTOMER][NEUTRAL] Yes. Uh, the policy number will be 02585017.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] OK, um, does [PII] speak any English at all?
[CUSTOMER][NEUTRAL] Um, just a little bit, I guess he can just like tell you his name.
[AGENT][NEUTRAL] OK, if it's
[AGENT][NEUTRAL] Sure, um, so I would have to verify his information so if it's easier, [PII], um, I can get you with a Spanish speaker, um, that might just be a bit easier for everybody, um, if you don't mind I'll just put you on a brief hold I'll get right back with you, OK?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] So, like you don't like, it wouldn't like be, like, wouldn't be easier if you, if you just get a consent and I can talk to you.
[AGENT][NEUTRAL] Would he be able to uh
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Would he be able to
[CUSTOMER][NEUTRAL] Yeah. Like if you ask him, like I can just tell him.
[AGENT][NEUTRAL] OK, OK. Can you hear me right now?
[CUSTOMER][NEUTRAL] Yeah, he can hear you because you're on speaker.
[AGENT][NEUTRAL] OK. Hi, [PII], how are you?
[CUSTOMER][POSITIVE] Good, thank you.
[AGENT][NEUTRAL] Um, OK, I'm gonna verify some of your information really quick. Um, can I get your date of birth, please?
[CUSTOMER][NEUTRAL] To
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, so, so, uh, email. Oh.
[CUSTOMER][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you and then um can I get your um mailing address like a physical address?
[CUSTOMER][NEUTRAL] We.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Number [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and then we do have your permission to speak with [PII] on your behalf.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK thank you alrighty so we are looking at you said um lab services um can you be more specific? what is it that um he's needing?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Well, he went to, like, he, right now he's going to this um clinic here in [PII], and they do offer lab services, and he needed some lab work done, so he went, um, I think was uh
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Tuesday, and they say that they don't accept this insurance, so they, they recommended him like to call you guys and ask where he could go. So that's why we just um trying to find out where he can go.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Ah
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Got you. OK, so this, it is a bit of a different policy, um, it's considered a limited indemnity medical plan, so it's not a part of a set network it's not like, um, traditional major medical like uh Blue Cross or Aetna. um, there's really no network it just depends on whether or not the provider would, uh, file the claims for him or not. If they don't, he can still file the claims himself so technically he could go anywhere.
[AGENT][NEUTRAL] But for the sake of ease I would try to go somewhere that would be willing to file the claims for him um and now this lab work is this um a part of uh is is it just like a for wellness um or is this regarding um a sickness?
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Uh, let me ask him, era te quelos lossale or era para parameda specifica OK, so it's like a wellness checkup.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] OK, OK, part of a wellness, perfect.
[CUSTOMER][NEUTRAL] Yeah, cause he just like, yeah, cause he just went to a, he just got a new provider and they just wanna have, you know, like all his records and stuff, so I, I'm assuming it's like a wellness checkup.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] OK, that's what I figured, but I just wanted to make sure um OK just a moment I'm gonna take a look at this. I can also send um a copy of this policy, uh, to his email so you'll have it and you can see, you know, exactly what is and is not covered dollar amounts, frequencies, things like that. So in short, the way that this policy works is it pays a specific dollar amount per um covered procedure or office visit.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So he does have benefits for um like treatment in a physician's office that would pay $150 max per calendar day and that's regardless of what kind of treatment he receives there.
[CUSTOMER][NEUTRAL] So the insurance will pay 150?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] This, yes, um per office visit. Now I will say sometimes these are this these kinds of policies are a part of a multi plan.
[AGENT][NEUTRAL] So it's possible that he has additional coverage through um other carriers so if you would like um I I will of course send you this information um but I can also give you a phone number for uh they're called benefits and a card and they would have um all of his other additional uh policies that he might have because I know that there are others that specific for um wellness benefits.
[CUSTOMER][NEUTRAL] OK, but that will be uh on a different card?
[AGENT][NEUTRAL] Um, it's they're called benefits in a card. I, I can give you that phone number.
[CUSTOMER][NEUTRAL] Cart
[AGENT][NEUTRAL] And I can transfer you too if you'd like um first, did you want me to go ahead and email this policy to him?
[CUSTOMER][NEUTRAL] OK, what is the phone number?
[CUSTOMER][NEUTRAL] Yeah, email, email him the, the policy, but um you wouldn't be able to see like which, like uh lab um facilities he can use.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, it's this uh policy doesn't work like that again there's not a specific, there are not specific locations um that.
[CUSTOMER][NEUTRAL] So you just basically, you just basically, just to make sure that I am understanding, um, you just basically go to any, like, for example, like here in [PII], we do have like a quest and um what is the other one? um Lab Lab Corp. So he can go there and, yeah, so he can go and ask if they accept this insurance and like you say, they are willing to email the insurance, not like not himself to meet in the um
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Well of course yeah.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, the, the bill or whatever, you know?
[AGENT][POSITIVE] Definitely ask um and you can even call around um several places and ask if they accept this and if they have any questions or you know if they've not heard of this policy or anything like that they are more than welcome to call us as well um you can just give them the same phone number that you called and we do talk to providers all the time so we might be able to alleviate some confusion if there's any.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah, yeah, like I think for like uh, for the patient it's just more like, yeah, cause we, we don't really understand the whole, you know, the policies like you guys do or the providers.
[AGENT][NEUTRAL] Right, it is very confusing yes and these particular policies are confusing um but then of course it adds to that confusion that they're part of a multi plan so there are other benefits and plans as well that could be through different carriers that's why I'm gonna get you to uh benefits and a card so they can go over all of that information with you just in case he has additional uh wellness benefits.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, sounds.
[CUSTOMER][POSITIVE] OK, yeah, no problem, that, that, that will be good. Like if you can just give me the number.
[AGENT][POSITIVE] OK. All righty.
[AGENT][POSITIVE] Absolutely, um, are you ready for it now?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, that is 1800.
[AGENT][NEUTRAL] 497.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] 4856.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, did you want me to go ahead and benefits in a card?
[CUSTOMER][NEUTRAL] And it's called um
[CUSTOMER][NEUTRAL] Benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you want me to go ahead and transfer for you now?
[CUSTOMER][NEUTRAL] Uh, yeah, so, um, last question, so the $150 per visit is like, uh, if it, if it exceed exceed that $150 he will have to pay like a co-pay?
[AGENT][NEUTRAL] OK, of course.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Unless he has additional coverage that's the maximum amount this policy can pay and again that's for a physician's office uh environment so if and again he could very well have additional benefits through different carriers um but that's the maximum amount this policy could pay per visit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Sounds good.
[AGENT][POSITIVE] All righty.
[CUSTOMER][POSITIVE] No problem. Then we'll just see, it will.
[AGENT][NEUTRAL] Are you ready for me to transfer you?
[CUSTOMER][POSITIVE] Yes, thank you so much for your help. I appreciate it.
[AGENT][POSITIVE] OK, you're very welcome of course I'm gonna put you on a brief hold while I get them on the line for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty and now they do have, I believe they do have a Spanish line. Did you want me to call that line?
[CUSTOMER][NEUTRAL] Get espanol.
[CUSTOMER][POSITIVE] But I still beneficial.
[CUSTOMER][NEGATIVE] They won't and they're also gonna fix you.
[CUSTOMER][NEUTRAL] ban [PII] and to email did you send it already?
[AGENT][NEUTRAL] Yes, I sent a copy of that policy.
[CUSTOMER][NEUTRAL] OK, sounds good. Uh, no, English is fine, like, I guess I will just talk to them.
[AGENT][POSITIVE] OK, OK, just wanted to make sure no worries all right thank you have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to Benefits in a card.
[CUSTOMER][NEUTRAL] For English, press one.