AccountId: 011433970860
ContactId: ecd16673-e409-433d-9903-acd70a555321
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 361970 ms
Total Talk Time (AGENT): 147099 ms
Total Talk Time (CUSTOMER): 166058 ms
Interruptions: 4
Overall Sentiment: AGENT=1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/ecd16673-e409-433d-9903-acd70a555321_20250605T14:17_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, um, I'd like to know first of all, I'm having trouble logging in and I don't know what to do about that, um.
[CUSTOMER][NEUTRAL] And then I want to know whether or not something is gonna be um covered with this insurance, the supplemental.
[AGENT][NEUTRAL] So are you the provider or the insured?
[CUSTOMER][NEUTRAL] Insured
[AGENT][NEUTRAL] Can I have a policy number?
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] 02544955
[AGENT][NEUTRAL] And what is your name, mailing address, and your date of birth?
[CUSTOMER][NEUTRAL] My name is [PII]. My mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And my date of birth is [PII].
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] Oh [PII], could you verify?
[AGENT][NEUTRAL] The email address that you would like for us to have on file for you?
[CUSTOMER][NEUTRAL] I'm not sure. Do you have one on file already?
[AGENT][NEUTRAL] We don't
[CUSTOMER][NEUTRAL] OK, um, I believe it would.
[CUSTOMER][NEUTRAL] Be best to use my work [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So I have [PII].
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that's what I said [PII].
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] And what's your callback number, [PII]?
[CUSTOMER][NEUTRAL] The card number?
[AGENT][NEUTRAL] Callback number just in case your call is disconnected.
[CUSTOMER][NEUTRAL] I'll call back. It's [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] So are you online?
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] [PII]. I'll walk you through logging in.
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] Hold on just a moment.
[CUSTOMER][NEUTRAL] I had it up, but
[CUSTOMER][NEGATIVE] I was actually on hold with your company for 57 minutes and finally hung up and called back. So I'm sure it has closed out at this point. Pardon me?
[AGENT][NEUTRAL] Oh, must be busy.
[AGENT][NEUTRAL] It must be busy. There must be a high volume of phone calls here.
[CUSTOMER][NEUTRAL] Yeah, I guess so. Um.
[CUSTOMER][NEUTRAL] OK, let me hit now that you have an email address for me.
[CUSTOMER][NEUTRAL] OK, now you put in an email address it's allowing me to go forward, um.
[CUSTOMER][NEUTRAL] Is there a way to see what are, what things are covered with this with APL?
[AGENT][NEUTRAL] I can tell you, um, so I'm not familiar with the online account because they just recreated it and reproduced it so I'm not sure what's available online.
[AGENT][NEUTRAL] Other than to submit a claim, but.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] What are the services that you're planning on going in for?
[CUSTOMER][NEUTRAL] OK, I
[CUSTOMER][NEUTRAL] I am going in for an appointment tomorrow because I believe I have a detached, not a detached, hopefully not detached, a torn retina. I'm having the same symptoms as I had once before and I want to know whether or not the surgery for that is covered.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Would it be considered as outpatient surgery at an outpatient surgery center or would it take place in the office?
[CUSTOMER][NEUTRAL] It's going to take place in the retina clinic, I believe.
[AGENT][NEUTRAL] OK, so treatment received in the office?
[CUSTOMER][NEUTRAL] Is there a difference if it's in their office?
[AGENT][NEUTRAL] Treatment received in the office, it looked like you have um outpatient benefits of.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Of $3750 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so if the, if it's done in their office.
[CUSTOMER][NEUTRAL] It's $3750 per calendar year.
[AGENT][NEUTRAL] Well, no, that's actually for everybody combined. So individually that outpatient benefit per person amount.
[CUSTOMER][NEUTRAL] What was the
[AGENT][NEUTRAL] It's $1250 per calendar year. I apologize. The 37,550 is for the entire policy itself for each member that's listed on the policy, but it's only you, but it's $1250 per per individual.
[AGENT][NEUTRAL] Per calendar year and this is not a guarantee of benefits just a disclaimer of the policy's coverage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that helps me understand whether or not, you know, a lot of times when you hand them this card, they look at you like you're nuts and they don't even bother trying to process it, but I wanna make sure that they process it.
[AGENT][NEUTRAL] Well, that's the secondary insurance. They should process it cause it's your secondary insurance.
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEGATIVE] I don't know why they'd be so difficult. They just don't wanna do their job, just being lazy.
[CUSTOMER][POSITIVE] I know, so I will make sure that they do that.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] I agree, I agree. Thank you so much for your help today. I appreciate it.
[AGENT][POSITIVE] You're welcome, [PII]. Is there anything else that I can assist you with today?
[CUSTOMER][POSITIVE] Nope, I think we're good you have a good day.
[AGENT][POSITIVE] Thanks for calling APL and you have a great day as well and I hope everything goes well.
[CUSTOMER][POSITIVE] Thank you very much. Bye-bye.
[AGENT][POSITIVE] You're welcome goodbye.