AccountId: 011433970860
ContactId: eddb3631-2222-4d66-ad27-c70e56904167
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278500 ms
Total Talk Time (AGENT): 125633 ms
Total Talk Time (CUSTOMER): 88956 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/eddb3631-2222-4d66-ad27-c70e56904167_20250113T17:30_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling because I'm trying to verify um my insurance benefits because there seems to be a discrepancy at my doctor's office.
[AGENT][POSITIVE] OK, Ms. [PII], I'd love to help you with some benefits today. And do you mind if I go ahead and get a good policy number for you?
[CUSTOMER][NEUTRAL] Yes, one second.
[CUSTOMER][NEUTRAL] Policy number 17816.
[AGENT][NEUTRAL] 17816
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] All right. Unfortunately,
[AGENT][NEUTRAL] I'm not seeing a I mean that policy number is pulling up, but it's not pulling up with anybody with the name [PII] on it. 17816. Is there any more to it than that?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, it's 17, yes, it's you're welcome. 17816. This is the policy I have through my job, and I logged in and this is what I'm seeing.
[AGENT][NEUTRAL] OK, let me see if maybe that is the group number.
[CUSTOMER][NEUTRAL] Next to it it says policy number, but I'm not sure.
[AGENT][NEUTRAL] And what is the name of your employer?
[CUSTOMER][POSITIVE] Total orthopedic care.
[AGENT][NEUTRAL] OK, yeah, that's gonna be that group number. And Miss [PII] your last name, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, perfect. And would you be able to verify for me, please, Ms. [PII], your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, thank you and.
[AGENT][NEUTRAL] I'm just gonna verify some additional information with you. Uh, your mailing address, please?
[CUSTOMER][NEUTRAL] [PII] I'm [PII].
[AGENT][POSITIVE] Thank you so much. I really appreciate it. I just have two more things, Miss [PII], the email and the phone number.
[CUSTOMER][NEUTRAL] Email is [PII] and the phone number is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is that a good number to call you if we got disconnected?
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, and let me take.
[AGENT][NEUTRAL] Look here real fast.
[AGENT][NEUTRAL] All right. And what benefit information can I help you out with, Ms. [PII]?
[CUSTOMER][NEGATIVE] I'm just I'm trying to understand what is it that you guys cover because I'm supposed to go do a procedure in an outpatient facility and um the doctor's office just called me to tell me that um that I don't know if you guys are not covering it or they're not accepting the insurance. I'm not sure. Does all doctors take APL?
[AGENT][NEUTRAL] Yeah, so, um, any, we don't have a network, we follow your major medical, so any doctor can, um, file with us. Um, some doctors choose not to, and it's just a choice they make. It has nothing to do with, um.
[AGENT][NEUTRAL] With our network and our side of things, but they just, some doctors don't want to file a secondary insurance and they won't, um.
[AGENT][NEUTRAL] But it does look like you have outpatient coverage with us. We are your secondary insurance, so we try to work to pick up and pay on things that are applied to your co-pay or co-insurance or your deductible left behind from your major medical.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] I'm so sorry.
[CUSTOMER][NEUTRAL] Do you guys have a list of doctors that you guys work with or no?
[AGENT][NEUTRAL] No, because we follow your major medical, so if your major medical works with them, we work with them.
[CUSTOMER][POSITIVE] OK. All [PII], thank you very much.
[AGENT][POSITIVE] Yeah, it's my pleasure. If there's anything else you need as far as help if you have to file the claim or anything like that, just let us know and we'll do our best to help you out OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Hey, it's my pleasure. Thank you.