AccountId: 011433970860
ContactId: dde921a6-661c-446d-a7f9-f5ffb0797c2d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 352160 ms
Total Talk Time (AGENT): 163749 ms
Total Talk Time (CUSTOMER): 99858 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/dde921a6-661c-446d-a7f9-f5ffb0797c2d_20250505T16:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, sir. My name is [PII]. Um, I just recently got this insurance and
[CUSTOMER][NEUTRAL] I don't know if my doctor is just not in network, but when they run my insurance, they're saying it's coming up as a life insurance.
[AGENT][NEUTRAL] It's coming up as life insurance? Hmm.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEGATIVE] Life insurance, yes, so they won't accept my insurance.
[AGENT][NEUTRAL] What's the uh
[CUSTOMER][NEUTRAL] And I'm
[AGENT][NEUTRAL] OK, what's the policy number that you have?
[CUSTOMER][NEUTRAL] Um, grab my card out one more second. Let's see here. So my policy number is 025.
[CUSTOMER][NEUTRAL] 84462, I mean 52, excuse me.
[AGENT][POSITIVE] OK, not a problem.
[AGENT][NEUTRAL] Alright, let me pull this up here.
[AGENT][NEUTRAL] OK. And then if I could just verify your first, last name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII], and then could I also verify, please, your physical address and email address for security reasons.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] All right, thank you so much. And you have a card also that you gave them?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Hm.
[AGENT][NEGATIVE] Why they would be saying this is life insurance. It's not that.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] They're talking about I gotta have $80 to come in and see my doctor tomorrow. And I'm sick, so I, I'm trying to scrape up the $80 cause I, I, I can't shake whatever I got going on with me. I can't shake it off, so I gotta go see a doctor.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I need to, that who's in my network. I need to have a surgery and I, I can't find a doc. I don't know I'm gonna be able to find a doctor.
[AGENT][NEUTRAL] So, the plan itself doesn't require any sort of network for usage. The type of plan that it is, is called a limited benefit hospital indemnity plan. So, you should be able to go to any doctor that will take it and basically see them for whatever you need to be seen for.
[AGENT][NEUTRAL] Um, if a physician needs to verify the coverage and benefits, they can call this number that you just called, and an agent will verify the coverage is active, and then what your benefits would be, um, if you're needing to go to like a physician for a doctor's office visit, your plan covers that. So, you know, um,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] They act like they never have heard of this insurance. They've been giving me trouble ever since I've been going, ever since I had it. They didn't, they have seen me a few times with it, but then this last time they gave me a call and told me that they wouldn't be able to see me no more unless I pay $80 because this is a life insurance policy. It's not an insurance policy.
[AGENT][NEUTRAL] Let me see
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So if they're not willing to contact us directly on your behalf to verify coverage, the other resource that I can provide to you is there is a list of providers that you can do a search for at [PII].
[AGENT][NEUTRAL] And uh that would give you a list of providers if you want to try and find a different provider to accept this plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But you're pretty much saying that any doctor's office can, will accept this or they're supposed to.
[AGENT][NEUTRAL] Well, that there's no network required. I mean, we can't make a physician accept the insurance, you know, um, but yeah, there's no in or out of network because the plan itself pays just a set amount depending upon what you're being seen for since it's a limited benefit plan. Um, maybe just reiterate to them it's not an insurance, you know, and they can call us to verify that and we can give them the plan type.
[CUSTOMER][NEUTRAL] So if I get on the [PII], they should be able to contact somebody.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, yes, absolutely. And all they need to ask for is verification of benefits at that number and then give them your policy certificate number that you gave me and then we can do that for them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'll try to, try that again.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Mhm. Bye-bye.
[CUSTOMER][NEUTRAL] Mm