AccountId: 011433970860
ContactId: e3357db9-cee9-4d30-8af4-c695db2e667e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 883400 ms
Total Talk Time (AGENT): 446380 ms
Total Talk Time (CUSTOMER): 309221 ms
Interruptions: 8
Overall Sentiment: AGENT=0.9, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/e3357db9-cee9-4d30-8af4-c695db2e667e_20250606T18:32_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, [PII]. My name is [PII]. How are you doing today?
[AGENT][POSITIVE] I'm doing well, [PII] how are you?
[CUSTOMER][NEUTRAL] Uh, OK, I'm trying to sort all this out. So, uh, my company here in [PII], I work for No Staffing Group, they switched our healthcare over to this benefits and a card and American Public Life.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh I've been trying just to find a primary doctor here in [PII] through the multi-plan website. I've called about 2 dozen doctors. No one's heard of APL or benefits in a card.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] And so I'm just looking to get some direct help.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] Um, because I'm getting nowhere.
[AGENT][NEUTRAL] I understand and I do apologize for that um I will start by saying um I'm not familiar with how um multi plan or benefits in a card functions just simply how we are um our plans are not affiliated with any set network they could potentially be used anywhere um that being said, of course what you're doing uh calling around and asking if they have not heard of us or if there's any confusion providers are more than welcome to give us a call as well.
[AGENT][NEUTRAL] We can speak with them and clear up any possible confusion or anything like that um but unfortunately there's not going to be just any like a list or anything like that that I can give you that accepts it it's ultimately going to be up to each provider whether or not they would file the claims for you and that being said, uh.
[AGENT][NEUTRAL] You know, if you had already received treatment or uh you just wanna go somewhere on your own, you can still file those claims so it's just, you know, obviously it'd be a bit easier on you if they would do it, but that's completely up to you.
[CUSTOMER][NEUTRAL] OK. Uh, yes, cause I had gone to see a spine doctor a couple of months ago and uh that I submitted a claim for that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I got the detailed report from the doctor, submitted the claim.
[CUSTOMER][NEUTRAL] So the visit was $500 and I got a check in the mail for $50. So, but I guess that's, that's all I'm gonna get there.
[AGENT][NEUTRAL] Yeah, per
[AGENT][NEUTRAL] That's the limited indemnity.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. So now,
[CUSTOMER][NEUTRAL] When they ask, what is my insurance, do I say American Public Life or benefits in a car?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I would say American Public Life, uh, if it's in a card, it's simply going to be the operators of your policies that you have within the multi-plan. So I know that, um, I don't know all of it, but just from what I do understand, you also have other benefits through, um, other companies, uh, maybe like 90 Degree benefits IMA, um, but this, us, anything to do with, uh, medical, that's going to be APL, that limited indemnity medical plan.
[CUSTOMER][NEUTRAL] OK, yeah, because the claims went to IMA Inc.
[AGENT][NEUTRAL] And it's possible that you might have uh policies with us. I think they offer more along the lines of uh wellness benefits, um, but that would be um uh benefits and a card would be able to direct you more as to what coverages you have and who they're through.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so again, when I call a a doctor's office and they say, what's your insurance? I will say American Public Life, yeah. OK, now.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] American Public Life, yes, yes.
[CUSTOMER][NEUTRAL] Now let me ask you, is there a group number? I don't see a group number on this card. I have a policy slash certification number.
[CUSTOMER][NEUTRAL] And that's it, there's nothing.
[AGENT][NEUTRAL] OK, if that's.
[AGENT][NEUTRAL] Sure, does that begin with a D by chance?
[CUSTOMER][NEUTRAL] I'm, I'm sorry, you're cutting out a bit. Are you on a headphone?
[AGENT][NEUTRAL] Oh, I'm sorry. Um,
[AGENT][NEUTRAL] I'm sorry, uh, so the, um,
[AGENT][NEUTRAL] The ID number that you have on your card, does that begin with the letter D?
[CUSTOMER][NEUTRAL] No, the policy certification number is 02595525.
[CUSTOMER][NEUTRAL] That's all it says.
[AGENT][POSITIVE] Perfect. OK, so that does sound like ours. Give me just a moment.
[CUSTOMER][NEUTRAL] OK, now on my dental card, I do have a group number on the dental card, but not on the medical.
[AGENT][NEUTRAL] OK, and then
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Sure, OK, yeah, give me just a moment, let me get that pulled up, um, before we go any further, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I appreciate that um and I was able to get your policy pulled up I'm just gonna verify some information really quick can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. The last thing I need is the email address we've got on file for you. It looks like it is a Gmail account.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][POSITIVE] Awesome. OK, thank you so much for verifying all of that. OK, so let me see here.
[AGENT][NEUTRAL] OK, I believe the group number would be the same, so the group number for this policy is 70094.
[AGENT][NEUTRAL] Not quite sure why it's not on your card. Yes, so that would be the group number if they need that.
[CUSTOMER][NEUTRAL] OK, that's what it says on my.
[CUSTOMER][NEUTRAL] Right. It's
[CUSTOMER][NEUTRAL] OK, because it says it on this group voluntary dental card but not on the limited.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, I pulled up your card to take a look at that. Yes, that's correct.
[CUSTOMER][NEUTRAL] So the number is the same.
[CUSTOMER][NEUTRAL] Group number 70094 um.
[CUSTOMER][NEUTRAL] OK, now, uh, the other thing was, so you're suggesting to go to the multi plan.
[CUSTOMER][NEUTRAL] Website which I do.
[CUSTOMER][NEUTRAL] OK, provider search now right up top.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It says search by name, specialty, facility type, NPI.
[CUSTOMER][NEUTRAL] Number or license number?
[CUSTOMER][NEUTRAL] So what do I put in there?
[AGENT][NEUTRAL] Sure if you were looking for a specific provider, I would try to keep it vague. I'm going to be completely honest with you, [PII]. I don't know how multi plan operates. I'm not familiar with their website, um, so I would keep it vague though and go to like facility type or practice, um, anything that says says you're just looking for an actual.
[AGENT][NEUTRAL] Just a regular doctor, a primary physician, correct?
[CUSTOMER][NEUTRAL] Yeah. Now, wait a minute. Should I type in primary or general physician? What what's the best thing I can type in here?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I would try primary to be if that was me that I would, I would try that.
[CUSTOMER][NEUTRAL] OK, let's try primary.
[CUSTOMER][NEUTRAL] And my zip code.
[CUSTOMER][NEUTRAL] Search
[CUSTOMER][NEUTRAL] OK, so case in point, top of the list it says CMD.
[CUSTOMER][NEUTRAL] Urgent care, is that something I can walk into with this card?
[AGENT][POSITIVE] An urgent care, yeah, definitely.
[CUSTOMER][NEUTRAL] And they will accept this?
[AGENT][NEUTRAL] Um, uh, if that's what Multilan's website is stating, but again from my experience it's ultimately going to be up to each provider. Um, if you would like, I'm not sure if you have the phone number, but I would call multiplan.
[AGENT][NEUTRAL] Um, so that they can assist you with that.
[CUSTOMER][NEUTRAL] Uh, there is a phone number on the first page there, uh, and so.
[CUSTOMER][NEUTRAL] Where else did I see that ATL was my secondary insurance, not my primary insurance, but you're telling me it's my primary insurance.
[AGENT][NEUTRAL] This is a limited indemnity medical plan, so it could potentially be used as both. It's definitely not your traditional major medical, not like um Blue Cross or Aetna or Cigna. It's a limited indemnity medical plan. So it could absolutely.
[AGENT][NEUTRAL] Be used on its own or it can be used as a supplement or secondary so again if you are not sure who your primary is or if you were under the impression that this was a secondary um I would definitely reach out to benefits and a card regarding that.
[AGENT][NEUTRAL] They're the ones that basically have all the information for all of your coverages and who they're with.
[CUSTOMER][NEUTRAL] OK, um, do you have a phone number for them?
[AGENT][POSITIVE] Yes, give me just a moment, let me get that for you.
[CUSTOMER][POSITIVE] Great.
[AGENT][NEUTRAL] OK, are you ready for it now?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK it is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I'll be able to speak to someone there? I know.
[AGENT][NEUTRAL] Yeah, yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so I will try that first.
[CUSTOMER][NEUTRAL] Right? Can I tell them I'm having trouble finding a primary or?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Should I go through this whole website again?
[AGENT][NEUTRAL] I would, I would also, honestly, I would start um by explaining to them that you need to know all of the policies and coverages you have and who they're with and if you have a different primary or an actual primary medical then to know who that's with as well.
[CUSTOMER][NEUTRAL] And they'll know that.
[AGENT][NEUTRAL] Yes, benefits in the card are the ones that are over all of these.
[CUSTOMER][NEUTRAL] I don't
[CUSTOMER][NEUTRAL] Overall, so that's the umbrella.
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][NEUTRAL] As it were.
[CUSTOMER][NEUTRAL] Um, OK, so.
[AGENT][NEGATIVE] And I apologize. I know these are incredibly confusing.
[CUSTOMER][NEGATIVE] Oh, this is, I really wish they wouldn't have switched, but it was so easy. Now it's not.
[AGENT][POSITIVE] Yeah, all these multi plans and all of that, it's, I understand, um, you are not the only one, trust me, we get calls from so many people that don't even know what they have or what it is, so I do apologize.
[CUSTOMER][NEUTRAL] Oh, that's OK. It's not your fault. But on this, so this limited benefit medical plan, so they'll never cover the whole doctor visit, right? They'll only pay for part of it?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] OK, so as this is a limited indemnity medical plan, it simply means that of course it is limited as to what is and is not covered, and it also just pays a set dollar amount per covered procedure or office visit. So for example, the office visits, it's a maximum of $50 per visit.
[AGENT][NEUTRAL] And now if you would like [PII], I don't know if you have this information or not I can send you a copy of this policy that you have with us, the limited indemnity plan, um, that way you can see, um, you know what is and is not covered dollar amounts, frequencies, things like that.
[CUSTOMER][POSITIVE] Could you please, that would be a big help. You have my email there.
[AGENT][POSITIVE] Absolutely, yes, definitely.
[AGENT][NEUTRAL] Let's see, yes, that is, um, let's see, yeah, that [PII], yes, I can go ahead and send that now.
[CUSTOMER][POSITIVE] Oh great.
[AGENT][POSITIVE] And of course if you have any questions after reviewing that or needing any clarification um definitely give us a call and we'll do what we can to help you out.
[CUSTOMER][POSITIVE] Yeah, just stay with me. I wanna make.
[CUSTOMER][NEUTRAL] OK, great. Can you just stay on with me till I get that email?
[AGENT][NEUTRAL] Oh sure yeah give me just a moment let me go ahead and get that sent.
[CUSTOMER][POSITIVE] Yeah, yeah, take your time.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] And that let's see is funding right now.
[AGENT][NEUTRAL] There we are, just sent.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, alright, and where are you located?
[AGENT][NEUTRAL] I'm in [PII].
[CUSTOMER][NEUTRAL] [PII], right.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] Oh, here we are care team.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] There is a PDF here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, it just says group issues 02955 something up top.
[AGENT][NEGATIVE] There should be several pages um within the policy.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Oh yes, there's 38 pages, yeah.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Download that there.
[AGENT][NEUTRAL] And there will be one page in particular that will be your best friend and let me see if I can't find what page number that is because for the most part the entire policy is going to be made up of um definitions and things like that so it is.
[CUSTOMER][NEUTRAL] Open that up here.
[AGENT][NEUTRAL] Page 22 out of 38 and it's the schedule of benefits and that's just going to simply list the benefit type and then the amount and the frequency and so you can kind of vaguely take a look there and get a general idea uh and then within the rest of the policy you know if you're like well what is considered you know hospital admission you can simply uh find it that way.
[CUSTOMER][NEUTRAL] OK, yep, I got it here on page 22.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, OK, let me continue.
[CUSTOMER][POSITIVE] Try and sort this all out, but thank you for your time and your help. I really appreciate it.
[AGENT][POSITIVE] You are very welcome absolutely I hope you can get it figured out nice and easy and did you have any other questions for me at the moment?
[CUSTOMER][POSITIVE] Uh, no, I'm good. You've been a superstar. Thank you.
[AGENT][POSITIVE] All right, glad to hear it. Thank you. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] You too have a good weekend. Thanks.
[AGENT][POSITIVE] You too. Thanks. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.