AccountId: 011433970860
ContactId: e484192c-3742-4f7e-b3d8-3abb73a008ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 383010 ms
Total Talk Time (AGENT): 178749 ms
Total Talk Time (CUSTOMER): 121230 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/e484192c-3742-4f7e-b3d8-3abb73a008ab_20250124T22:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, how you doing, um, I just got my, my card, my benefits packages, packets in the mail. Um, I was, and I made my online account. I was trying to figure out what how to see the coverage for.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Like just physician care check up.
[AGENT][NEUTRAL] Oh, and it's just the physician's office visit?
[CUSTOMER][NEUTRAL] Like my
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, yeah, we can take a look at that on your policy. Uh, what was your name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, and can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] Thank you and then uh do you have your policy number?
[CUSTOMER][NEUTRAL] I got like
[CUSTOMER][NEUTRAL] There's like multiple ones.
[AGENT][NEUTRAL] Are you looking at uh a card?
[CUSTOMER][NEUTRAL] Uh, yeah, but it's just showing sample for illustrated purposes only. It's not showing like I click on like online. I, I click on the download it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] And the packets on here. So since it's not confus got that group hospital indemnity group voluntary dental group vaccine group critical third term life group.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] There should be something on there that says like a certificate number or something like that.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] Yeah you got 0257.
[CUSTOMER][NEUTRAL] 1191
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, [PII], just gonna verify some information really quick. Uh, 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] Thank you. Last thing I need is the email address we've got on file for you. uh, looks like it is an Outlook account.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that information. Alright, give me just a moment, let me get your policy pulled up here and we will take a look.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] I want to definitely this.
[AGENT][NEUTRAL] OK, so physician's office benefit for this policy pays $50 per visit and that is just going to be flat. Uh, this plan does not have, uh, deductible or um co-pays. It just pays a set amount per office visit or procedure.
[CUSTOMER][NEUTRAL] Oh OK, so that is in so the packet I just.
[CUSTOMER][NEUTRAL] The certificate of insurance.
[CUSTOMER][NEUTRAL] And then it says uh.
[CUSTOMER][NEUTRAL] Hospital emergency room. OK, so the physician physician's office initial treatment within 30 days.
[CUSTOMER][NEUTRAL] That's just did work.
[AGENT][POSITIVE] $50 that's correct.
[CUSTOMER][NEUTRAL] And then what would be for my uh prescription coverage?
[AGENT][POSITIVE] For your what? I'm so sorry.
[CUSTOMER][NEUTRAL] For my prescription coverage.
[AGENT][NEUTRAL] Um, give me just a moment. Let me see who that is through. Sometimes that is through us and other times that is gonna be through Farm Avale. Give me just a moment. Let me check that.
[CUSTOMER][POSITIVE] Exactly
[CUSTOMER][NEUTRAL] Yeah, it says how uh [PII].
[AGENT][NEUTRAL] OK, so yes, that all of your prescription benefits would be through Farm Ava, um, do you see the bin number and not the their phone number?
[AGENT][NEUTRAL] I can give that to you if you don't see it.
[CUSTOMER][NEUTRAL] That was the medical benefit for customer service.
[CUSTOMER][NEUTRAL] Oh, it's on here yeah customer service [PII].
[AGENT][NEUTRAL] Yes, do you see your VIN number as well?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK perfect because they will need that.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] I would use that for my prescription for my prescription medication I take monthly.
[AGENT][POSITIVE] Correct, yes sir.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] So just any, so any doctor, any doctor's visit with 50 bucks.
[AGENT][NEUTRAL] That's correct, yes, in a physician's office there are separate benefits for, um, you've got coverage for ER visits, urgent care, uh, physician's office, and then, uh, like physical therapy if that was ever needed, so those are all going to be separate benefits and on inside your policy you'll see there's one specific page that's the schedule of benefits that does break all of that information down just and to the benefit and the dollar amount.
[CUSTOMER][NEUTRAL] OK, is that gonna be on the first.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Not always the first page, sometimes it's buried in there a little bit. Um, I can see which page it's on. Um, most of the rest are going to be uh definitions and things like that. Give me just a moment. I'll try to find it for you and we'll see what page it's on.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh I think I saw it on.
[CUSTOMER][NEUTRAL] Just here.
[AGENT][NEUTRAL] There we are. OK, so looks like that is going to be.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Oh well, it says page one so it's right after.
[AGENT][NEUTRAL] 16
[CUSTOMER][NEUTRAL] Page one, yeah, OK, but it's gonna show page what it's gonna be after all the.
[AGENT][NEUTRAL] Yes, yes, so it'll show um it'll say schedule of benefits, benefit name and then benefit amounts and then it'll show the frequencies as well.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so I'll just give them my policy number for uh whenever I found office.
[AGENT][POSITIVE] Yes, absolutely, yes, sir, and if there's any confusion, if they would sometimes, of course they've maybe not have heard of us or they're unfamiliar with this kind of policy, uh, they are more than welcome to give us a call. You could give them this phone number, um, and we'll be more than happy to speak with them. We do talk to providers all the time.
[CUSTOMER][POSITIVE] OK, alright, thank you.
[AGENT][NEUTRAL] Alright, yeah, did you have any other questions for me, [PII]?
[CUSTOMER][NEUTRAL] Uh, that should be all.
[AGENT][POSITIVE] Alright well thanks for giving us a call. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye.