AccountId: 011433970860
ContactId: e94915c4-b7d9-457f-b7d4-81f74818ae5b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 418160 ms
Total Talk Time (AGENT): 195411 ms
Total Talk Time (CUSTOMER): 94001 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/e94915c4-b7d9-457f-b7d4-81f74818ae5b_20250410T16:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling because I'd like to request my um an ID card.
[AGENT][NEUTRAL] OK, I can help you with your ID card. Can I get your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], do you have your policy number handy?
[CUSTOMER][NEUTRAL] Uh, give me one moment.
[CUSTOMER][NEUTRAL] And that'd be my insurance policy, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, give me one moment.
[AGENT][NEUTRAL] I can look it up by your name too. How do you spell your last name?
[CUSTOMER][POSITIVE] [PII]
[AGENT][NEUTRAL] And [PII]
[CUSTOMER][NEUTRAL] All right, yes.
[AGENT][NEUTRAL] OK, pulling it up. Give me one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this for your meddling gap policy, is that right?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me get that pulled up.
[AGENT][NEUTRAL] OK, [PII], I just need to verify a few pieces of information. Do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And your birth date?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] And your address?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then lastly just your email address.
[CUSTOMER][NEUTRAL] Uh, personal or?
[AGENT][NEUTRAL] Looks like a personal on Gmail.
[CUSTOMER][NEUTRAL] Work
[CUSTOMER][NEUTRAL] Uh [PII] Well, I think it was, yeah, [PII].
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, let me, uh.
[AGENT][NEUTRAL] OK, um, do you want me to email that to you?
[CUSTOMER][NEUTRAL] Uh, the card, I mean like.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, can I get the physical card?
[AGENT][NEUTRAL] Yeah, we can mail you out one.
[CUSTOMER][NEUTRAL] Or both if possible.
[AGENT][NEUTRAL] Yeah, I'll do both.
[AGENT][NEUTRAL] OK, I'll, I'll get the physical card in the mail and then I'll email it to you right now just so you have it on on handy if you need it, OK?
[CUSTOMER][POSITIVE] Yeah, thank you.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And is there anything else I can help with today?
[CUSTOMER][NEUTRAL] Uh, yes, how does that card, uh, work?
[AGENT][NEUTRAL] Um, so, let me see, let me pull up your policy. Give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you, you have major medical insurance like through United or Florida Blue or?
[CUSTOMER][NEUTRAL] Yes, United.
[AGENT][NEUTRAL] OK. So how this plan works, and this is not a guarantee of payment, it's a basic outline of your policy. So the way it works is that after UnitedHealthcare processes a claim, this plan will come in and potentially pick up any co-pay, deductibles or co-insurance that UnitedHealthcare didn't pay.
[AGENT][NEUTRAL] Um, so it, you know, it depends on the type of service that you get. Um, for example, if you were inpatient in the hospital, you have a $2500 calendar year benefit. So whatever UnitedHealthcare didn't pay, it would pay up to $2500.
[AGENT][NEUTRAL] Of what was left over and then, does that make sense?
[CUSTOMER][POSITIVE] Yes it does.
[AGENT][NEUTRAL] OK, and then for your outpatient benefit, you have 1500 per calendar year.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, and let me ask you, uh.
[CUSTOMER][NEUTRAL] Can I do like a, can I backtrack like a claim?
[AGENT][NEUTRAL] Yeah, so your effective date, yeah, there's no timely filing, so anything that you have claims that you want to submit for from your effective date, which was [PII].
[AGENT][NEUTRAL] You could submit those for processing and potential consideration, yeah.
[AGENT][NEUTRAL] We just need
[CUSTOMER][NEUTRAL] OK, and you, uh-huh.
[AGENT][NEUTRAL] Let me tell you what we need. So if you did file a claim, you'll want to be sure and include the primary explanation of benefits from UnitedHealthcare, showing how they process the claim.
[AGENT][NEUTRAL] And then you'd want to get the claim, um, because we need to know like the, the codes that you were seeing for, what diagnosis it was.
[AGENT][NEUTRAL] Um, so, but yes, you can file anytime.
[CUSTOMER][NEUTRAL] OK, and if I, if I already made up, uh, a payment on, um, does would it be covered still like the whole claim?
[AGENT][NEUTRAL] So it, it, so if you made a payment to the hospital or?
[CUSTOMER][NEUTRAL] So that
[CUSTOMER][NEUTRAL] Or like uh let's say uh credit card that I use to, to, to pay for a procedure.
[AGENT][NEUTRAL] So we would just process the claim according to, so, for example, if you had a procedure, UnitedHealthcare paid and you had $1000 left over.
[AGENT][NEUTRAL] And you submitted it to us, we would potentially pay you $1000.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it just depends on, yeah, does that make sense?
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][POSITIVE] Yes, it does, yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Um, all right, thank you very much.
[AGENT][NEUTRAL] OK, um, also, do you have access to our online portal?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] OK, you want me to send you instructions on how to access that because from there you can see like your policy, how it processes, um, there's claim forms.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes, please, that'd be helpful.
[AGENT][POSITIVE] OK, all right. I'll, I'll attach that um instruction guide. So, um, if you have any issues just give us a call back and we'll be glad to help, OK?
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] OK, thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Alright.