AccountId: 011433970860
ContactId: ed7006f7-d112-4baa-b504-065b389abb0f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 672020 ms
Total Talk Time (AGENT): 272533 ms
Total Talk Time (CUSTOMER): 209903 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/ed7006f7-d112-4baa-b504-065b389abb0f_20250224T14:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um one second, one moment, um.
[CUSTOMER][NEUTRAL] Yes, sir, hello. Uh, good morning. Um, I am with, uh, your plan for multi-plan, a limited benefit med plan VIP BIC, uh, and I understand that, um, both the insurance website and the, the facility that I'm at, the, the website says that they accept the insurance, but they're having difficulty entering my information, talking about a contract popping up and that's not how they do things.
[AGENT][NEUTRAL] All right. And I guess you are insured with APL?
[CUSTOMER][NEUTRAL] Yes, uh, APL, a multi-plan, a limited benefit med plan, VIP BIC. I have the card with me that, you know, I have to cut out and whatnot, um, and it says on the back medical benefits vacations, the customer service to call this number, so that's, that's what I'm here for today.
[AGENT][NEUTRAL] Mhm. All right. Um, do you happen to have your policy number on hand?
[CUSTOMER][NEUTRAL] Yes, uh 025.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 972.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 23
[AGENT][NEUTRAL] Alright, and what is a good call back number in case our call gets disconnected?
[CUSTOMER][NEUTRAL] Uh, sure. Uh [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right, perfect, and I will go ahead and search, see what.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] For your policy number?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] All right, and is this for Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right. For verification steps, can you verify your date of birth and address for me, please? Excuse me.
[CUSTOMER][NEUTRAL] Yeah, yeah, sure, um, yeah, sure, uh, [PII] and uh address [PII].
[AGENT][NEUTRAL] Excuse me. All right. I do see here your policy and is for a hospital indemnity, um.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] Let's see, and it's starting to be active [PII].
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I do see that your policy is active. What is the the office the provider saying about it or mentioning about it?
[CUSTOMER][NEUTRAL] So, uh, they try and enter the information on the card into the system, but there's something about a contract pops up and uh that's not how they handle things apparently.
[AGENT][NEUTRAL] Um, well.
[AGENT][NEUTRAL] Contract that is, that is weird.
[AGENT][NEUTRAL] Mm, so they are checking your eligibility, I guess, for them to um file a claim on your behalf. Um, that would
[AGENT][NEUTRAL] I would guess that they will have to reach out to APL and whenever they give us a call, they provide your policy information and that's when we confirm that you are indeed covered. Because I do see from our end that everything is fine here.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So I, I get sometimes it happens that um the provider's office is not linked with APL um so you would have to find another provider that does work with um this um policy with APL.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I, what
[CUSTOMER][NEUTRAL] So, um, I'm not.
[CUSTOMER][NEUTRAL] I'm not quite understanding what the problem is. I'm sorry.
[AGENT][NEUTRAL] Well, the policy is active, um, so I'm sorry, I'm actually not understanding why the um provider's office is having an issue with accessing the information. Um, I'm not sure where, where are they trying to access it. Is it through the website?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Or are they or are they calling APL?
[CUSTOMER][NEUTRAL] Um, I think they were trying to call, um, maybe if I could like put the you on speaker and maybe, uh, see if I can, uh, uh, if we can talk with the person at the desk and see if that might help.
[AGENT][POSITIVE] Yes, that, that could help.
[CUSTOMER][NEUTRAL] OK, so I'll try that one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I have someone on call on speaker. Would you like to speak with them?
[CUSTOMER][NEUTRAL] It's on speaker. You want me to change it?
[CUSTOMER][NEUTRAL] Alright, OK, it's on speaker right now.
[CUSTOMER][NEUTRAL] Good morning. This is City in the Westchester Square.
[AGENT][NEUTRAL] Hello, good morning. This is [PII] from APL. Um, I was just advised that you are not able to uh verify the coverage for the patient. Is that correct?
[CUSTOMER][NEUTRAL] That is correct. We made a few attempts this morning to the department that is listed on the card for the status of the insurance, and we weren't able to receive any confirmation.
[AGENT][NEUTRAL] OK. Um, I'm not sure um if you are trying to access information within the
[AGENT][NEUTRAL] Um, website, um, I'm not sure also, are you all familiar with APL's website?
[AGENT][NEUTRAL] How it works.
[CUSTOMER][POSITIVE] We didn't first moment, we have been calling the direct number that is listed on the back of this card, which I'm happy to confirm with you.
[CUSTOMER][NEUTRAL] Um, at this time, one second.
[CUSTOMER][NEUTRAL] The the phone number we were using was [PII].
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Yes, and each attempt we were disconnected via the operator while waiting for an agent to be available online.
[AGENT][NEUTRAL] OK, I see. Um, so to verify his information, usually the providers just called us and give us the, give us the information of um the patient, and we can just verify through the phone. Um, what I can do right now is transfer you to someone to the benefits department or claims department and they can go ahead and um provide that information and confirmation for you. Would that work?
[CUSTOMER][NEUTRAL] Yes, so we would need that on a recorded line if possible.
[AGENT][NEUTRAL] No, sorry, can you repeat that, please?
[CUSTOMER][NEUTRAL] Yes, we would like, we would like this information available on our recorded line if possible. I'll be to move forward.
[AGENT][NEUTRAL] Mhm. Yes, it will be in the same call.
[CUSTOMER][NEUTRAL] It wouldn't be available on our phone line or?
[CUSTOMER][NEUTRAL] Can you give us a direct phone number?
[AGENT][NEUTRAL] Yes, um, let me see.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Um, you can always reach out to this phone number that the patient is using, and that will direct that will give you a directory where it will be, it'll be sending you to the claims department or the benefits.
[AGENT][NEUTRAL] And that information can be verified there.
[CUSTOMER][NEUTRAL] So we have selected the provider option on the line and there is no option for urgent care or private medical institution. It only provides for accidents, gap, um, hospital, and dental.
[AGENT][NEUTRAL] OK, then this well, it will be the hospital um option since this policy is hospital indemnity uh policy.
[CUSTOMER][NEUTRAL] Right, would you know if the patient has benefits with the urgent care?
[AGENT][NEUTRAL] Um, I cannot verify that for you unless I um transfer you to someone with the benefits department. Unfortunately, I do not have that piece of information, yes. Would you like me to transfer you to the benefits department?
[CUSTOMER][NEUTRAL] I understand.
[CUSTOMER][NEUTRAL] Yes I understand.
[CUSTOMER][NEUTRAL] Yes, but we would need to make this call on our landline. I'll take a transfer now.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] I will go ahead and provide the um insured's information as well.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Good morning, [PII]. This is [PII] in customer service. I have uh an insured in office of providers on the line, um, who were having trouble um verifying the information for the patient. Um, the policy, the policy number is 259.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 7223.
[CUSTOMER][POSITIVE] All right, [PII], I'm happy to help him. Do we have a first name?
[AGENT][NEUTRAL] Uh yes, [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Alright awesome.
[CUSTOMER][POSITIVE] Thank you so much. If you wanna send him through I'm happy to take the call, [PII].
[AGENT][POSITIVE] All right, thank you very much you have a nice day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You are on.
[CUSTOMER][NEUTRAL] Hi, this is [PII] over in customer care at APL. How can I help today?
[CUSTOMER][NEUTRAL] OK.