AccountId: 011433970860
ContactId: dc019530-65bc-4645-bed5-24bc8649b0fb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 476970 ms
Total Talk Time (AGENT): 266113 ms
Total Talk Time (CUSTOMER): 200849 ms
Interruptions: 2
Overall Sentiment: AGENT=2.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/dc019530-65bc-4645-bed5-24bc8649b0fb_20250114T17:17_UTC.wav
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[AGENT][POSITIVE] Hi, thank you for calling APL. This is. How can I help you today?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh, yes, I'm trying to sign on.
[CUSTOMER][NEGATIVE] Um, to your site, sign up, um, with my card that I got, it doesn't have a member ID number, but I use my social and saying to give you guys a call because it's not fine with me, I guess.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] OK, yeah, I'd love to take a look in that for you. Um, do you, do you have that policy number handy, ma'am?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Peer ID
[AGENT][POSITIVE] No, it might say certificate number or inpatient outpatient number, um, but it'd be like oh OK perfect.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, 0.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 2563978 M like in Mary L like in Lamp 7.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Perfect. And would you mind verifying for me, pretty please, your first name, your last name and your date of birth?
[CUSTOMER][NEGATIVE] That's [PII] [PII] and I'm his mom. He's right here lying down next to me. He's not doing too well.
[AGENT][NEUTRAL] OK perfect um would you mind, so I actually, um, as far as the online stuff I have to get like some authorization from [PII] to talk to you. Is that something that would I could do real quick?
[CUSTOMER][NEUTRAL] Oh yeah, yeah, yeah, he's right there, he can hear you. Alright.
[AGENT][POSITIVE] OK beautiful thank you.
[AGENT][NEUTRAL] Hi [PII], this is [PII] with APL. I was hoping you could verify some information and then give me authorization to speak to your mom.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, would you be able to verify for me pretty please your um mailing address?
[CUSTOMER][NEUTRAL] Yeah, it's uh [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you so much and then would you also be able to verify for me your email address?
[CUSTOMER][NEUTRAL] Yeah, it's my full name [PII], so [PII].
[AGENT][NEUTRAL] It looks like I have uh maybe a professional one on hand.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] [PII] Re Theater?
[AGENT][NEUTRAL] It looked
[AGENT][POSITIVE] Yes, perfect, that's it thank you and then.
[CUSTOMER][NEUTRAL] Oh, that's right. I have [PII].
[AGENT][NEUTRAL] That might be what was holding you back on the online service center is that email address and then do I have permission to speak to your mom if she needs anything further?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Of course.
[AGENT][POSITIVE] OK perfect um and I can I can talk and what was her name again? I can talk to her.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. I really appreciate that.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][POSITIVE] Hi, [PII], thank you so much for your patience while I went through that verification.
[CUSTOMER][NEUTRAL] I think it
[CUSTOMER][NEUTRAL] Yeah, I think, I think it's the email that is different. Do you, could you change it on your end or could we go in and then afterwards change it?
[AGENT][NEUTRAL] The email, yeah.
[AGENT][NEUTRAL] I can
[AGENT][POSITIVE] I can update it on my side, yes, so we want it to be [PII].
[AGENT][NEUTRAL] And then [PII].
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, cause that's what I have here.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] I know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect.
[AGENT][POSITIVE] Perfect. And I've got that updated on my side for you. So it might take a second or two for it to update with our system, but let me go in.
[AGENT][NEUTRAL] And check.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Last 4?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][NEUTRAL] 2
[CUSTOMER][NEUTRAL] Yeah, after she update it then I will try on this end.
[AGENT][NEUTRAL] Alright it just updated on my side for that email so um give that a try and see if it lets you in now.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hold on, it's searching, yep.
[AGENT][POSITIVE] Perfect awesome I am so glad I was able to help you out and then is there anything else we're needing today while we're on the phone?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I think, how does, how does this work? This was only if he has to go to the hospital.
[AGENT][NEUTRAL] OK, yeah, so, um, the policy, let me pull up just like some information on it for you real quick. Uh, what we are is we're the secondary insurance, so we try to pick up and pay on things that are applied to the co-pay, co-insurance and deductible for, um, sickness or injury. Um we don't cover things that are routine, so like a well check. Um, it doesn't sound like that's what's going on though here, um, and then.
[CUSTOMER][POSITIVE] Yes thanks.
[CUSTOMER][NEUTRAL] No, we went, we went to urgent care yesterday, so I should have showed this as well.
[AGENT][NEUTRAL] Yeah, so let me double check that you have um benefits in an urgent care facility, but most of them do, you know, since urgent care has become so popular, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So let me pull up these outpatient benefits for you and you'll actually there should be some documents you're able to see on the website as well that go into benefits, but it looks like you're covered outpatient in a hospital ER urgent care, surgical um surgery in a hospital outpatient facility, diagnostic testing in a hospital, um, outpatient treatment for mental or emotional disorders in a hospital, a physical therapy facility, or in the ambulance.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Um, and if you're in a doctor's office, it looks like you have maybe benefits for treatment, so that wouldn't cover like consultation fees, but it would cover like if you had to receive treatment in the doctor's office as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it's best, so it's best when we, if he has to go to the doctor to uh to give them both.
[AGENT][POSITIVE] I would give them both, yeah, absolutely. There's some things that might not be covered at the doctor's office because it's just for treatment, but I would say it's better to have a claim get denied than to miss benefits because we didn't submit one.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, because I think, yeah, we didn't submit, we didn't give this to them yesterday, cause I didn't know, so.
[AGENT][NEUTRAL] That's OK we don't have a time limit, so you're more than welcome if you wanna call them back or um reach out to them and let them know that you have this um they have to wait for major medical to send them their paperwork anyway so it's not like they could have filed with us right away um but you're more than welcome to give them that information and we don't have a time limit on our side we accept claims as long as um the date of service was during their active period of coverage.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Oh OK alright so I could call them back and just have them also um submit them right, OK.
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][POSITIVE] Alright, OK, thank you so much and with this I see.
[AGENT][POSITIVE] Hey, it's my pleasure.
[CUSTOMER][POSITIVE] And with this, uh, you should be able to see everything and whatever, whatever, so that's good. You can read up on it some more.
[AGENT][NEUTRAL] Yes, absolutely, there should be a policy document in there like a policy certificate um that will give all of that information.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] All right, thank you so much for your time and your patience with us.
[AGENT][POSITIVE] Oh, it's my pleasure. Thank you so much and you all have a wonderful day. Tell [PII] I wish him the best and good luck.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Yes, thank you. OK, bye bye.
[AGENT][POSITIVE] My pleasure thank you bye bye.