AccountId: 011433970860
ContactId: e6e1d429-7af2-4d74-a076-44821376636a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 379260 ms
Total Talk Time (AGENT): 176245 ms
Total Talk Time (CUSTOMER): 177077 ms
Interruptions: 2
Overall Sentiment: AGENT=0, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/e6e1d429-7af2-4d74-a076-44821376636a_20250114T22:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. Um, so before I complete my enrollment, I had some questions about coverage.
[CUSTOMER][NEUTRAL] Um, do you think you could help me out?
[AGENT][NEUTRAL] Uh yes ma'am, I might be able to help you. Um, can you give me your name and your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and what is your callback number, Miss [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and what is the group number you're with?
[CUSTOMER][NEUTRAL] I don't have it yet so.
[AGENT][NEUTRAL] Oh, you, are you?
[AGENT][NEUTRAL] OK, so you don't know your employer's group number?
[CUSTOMER][NEUTRAL] Uh, it's my spouse's employer.
[AGENT][NEUTRAL] OK, um, I won't be able to give you benefit information until the enrollment is complete.
[AGENT][NEUTRAL] And that's because it all depends on how.
[CUSTOMER][NEUTRAL] OK, because I
[AGENT][NEUTRAL] The enrollment is filled out what plan, um, who's gonna be on the plan and what group number it's under because each group has its own plan.
[CUSTOMER][NEUTRAL] Um, your phone is breaking up a little bit.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, I see.
[AGENT][NEUTRAL] Yes ma'am, in order, in order for, in order for me to be able to give benefits uh you'd have to have a policy.
[AGENT][NEUTRAL] Because it all depends on what kind of plan the group has.
[CUSTOMER][NEUTRAL] If I know the name of the employer, could you pull that up?
[AGENT][NEUTRAL] I still would not be able to do that because it would depend on the enrollment and how it's done.
[AGENT][NEUTRAL] Now, if you go to, if he goes to a human resources department, they should be able to give him the breakdown of his benefits and what is included on each plan.
[CUSTOMER][NEUTRAL] OK. Um,
[CUSTOMER][NEUTRAL] So I did click that. I, so I did click that, and I saw the whole thing and there was no mention in the entire twenty-page document about OBG, prenatal care or like pregnancy at all. And while I am not currently pregnant, we were aiming to start a family this year and I would be under the benefits with the card coverage.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, if it's not on the document that the employer provided then it's not a covered service.
[CUSTOMER][NEUTRAL] Um, so like, prenatal care and like
[CUSTOMER][NEUTRAL] Delivery and everything would not be covered?
[AGENT][NEUTRAL] If it's not written in the document that you got from the employer, then it's a non-covered service.
[CUSTOMER][NEUTRAL] OK, um, and to inquire more about what is and isn't covered, I need the group number.
[AGENT][NEUTRAL] No, you would just, it would be that document that they gave you gave him for you guys to look at to decide if you wanted to enroll in the benefits, everything that is covered is under that document.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so it's basically not covered. So if we did start a family, it would all be out of pocket.
[AGENT][NEGATIVE] If it's, if it's not on the, the paperwork that you received, then it's non-covered.
[CUSTOMER][NEUTRAL] All right, um, I was told that the number I called to reach you would connect me with a person who could give me more detailed answers.
[CUSTOMER][NEGATIVE] About what is and isn't covered.
[AGENT][NEUTRAL] Right. Without having a policy, we can't do that.
[CUSTOMER][NEUTRAL] OK, that's complicated, um, and then how do I get the policy number pre-enrollment, you know what I mean? because like right now, so like my state offers insurance, um, and their deadline is tomorrow, so if I wanna sign up through my state.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I have to do that tomorrow and I'm trying to decide if I should go through with enrolling with the benefits on a card or if I should enroll through my state and to make that decision I need more detailed answers.
[CUSTOMER][NEUTRAL] Um, do you have like anyone you can refer me to or transfer me to?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] About that?
[AGENT][NEUTRAL] I really don't because unless you have a policy with us all the information is given to the group for what is covered and what is not covered, uh, what plans they choose there's several different plans that they choose depending on what group it is so unless it and then they give you the paperwork to be able to decide if you want the policy or not.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And so the paperwork is, is what you need to go by as far as making your decision because that's what the benefits would be.
[CUSTOMER][NEUTRAL] Yeah. It's weird though because it's like there's a lot of things listed on there that say no coverage afterwards, but to not have any mention at all of OBG prenatal or pregnancy or childbirth in the entire document, kind of threw me, you know, that's why I was like, oh I got a call about this.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes ma'am, I understand.
[AGENT][NEUTRAL] Right, right. Yes, ma'am, I understand.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] In your opinion, because it's not mentioned at all, it's pretty much a guarantee that they're not gonna cover any of that.
[AGENT][NEUTRAL] That's correct. If it's not mentioned in the pamphlet or the paperwork that they gave you, and it's a non-covered service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] All right. That's unfortunate. All right.
[AGENT][NEUTRAL] OK. Yes, ma'am.
[AGENT][POSITIVE] OK, Ms. [PII]. You have a blessed day and thank you for calling APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You do the same, bye.
[AGENT][NEUTRAL] Alright, bye bye.