AccountId: 011433970860
ContactId: f55a8194-8a8c-408c-9c53-5eda6f58cc45
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 499260 ms
Total Talk Time (AGENT): 171630 ms
Total Talk Time (CUSTOMER): 131075 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/f55a8194-8a8c-408c-9c53-5eda6f58cc45_20250619T14:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], this is [PII]. How are you doing?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][NEUTRAL] Uh, I have an insurance with you guys, I guess, uh.
[CUSTOMER][NEUTRAL] Let me pull up that policy number.
[CUSTOMER][NEUTRAL] I believe it's uh medical ID [PII].
[CUSTOMER][NEUTRAL] For policy 02622449.
[AGENT][NEUTRAL] Is it
[AGENT][NEUTRAL] OK. And are you a uh broker or a provider?
[CUSTOMER][NEUTRAL] Huh? I'm, I'm the, I'm the owner of the, I'm the owner of the account.
[AGENT][NEUTRAL] Are you
[AGENT][POSITIVE] Oh OK, I'm sorry.
[AGENT][NEUTRAL] You said 262-2?
[AGENT][NEUTRAL] Or for
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 5 or 449?
[CUSTOMER][NEUTRAL] Give me 1 2nd real quick.
[CUSTOMER][POSITIVE] I got it on my pictures so I literally pulled it up all the time.
[CUSTOMER][NEUTRAL] 02622449.
[CUSTOMER][NEUTRAL] That's my policy number. I'm just calling to see if I if my policy covers labs.
[CUSTOMER][NEUTRAL] Or is there any particular place that I have to do labs so you guys can cover it?
[AGENT][NEUTRAL] OK, I can help you with that. Um, can I get you to verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] In the address that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you're wanting to see if it covers labs?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I'm here, my provider, they asked me to do labs and uh I just wanna see if you guys cover it or they outside network or what's going on.
[AGENT][NEUTRAL] Let me look.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right. It looks like, and this is just a verification of benefits, not a guarantee of coverage. Um, if it's blood work, I'm not seeing that covered. It looks like the diagnostic testing benefit is due, it will be like medical imaging.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] So I can do medical imaging, but I can't do blood work?
[AGENT][NEUTRAL] Uh, for this one, yeah, it looks like.
[AGENT][NEUTRAL] Your diagnostic testing is limited to MRIs, CAT scans, um, if you're doing a thyroid test, the radioactive iodine test, a CT or PET scan, those are the diagnostic testing benefits under this policy.
[CUSTOMER][NEUTRAL] So what policy do I need to have to be able to qualify for lab?
[CUSTOMER][NEUTRAL] Or do you just you guys just don't cover it?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Um, with the hospital indemnity policy, it doesn't typically cover labs like that. Let me see.
[AGENT][NEUTRAL] If you have
[CUSTOMER][NEUTRAL] But I'm not at the hospital. I'm at my doctor's, I'm my doctor's office.
[AGENT][NEUTRAL] Oh, OK, give me one second.
[AGENT][NEUTRAL] OK, I'm not showing it on that policy either. I'm checking your other policies just to see.
[CUSTOMER][NEUTRAL] It's.
[CUSTOMER][NEUTRAL] I know I have the VIP classic which that one covers on medical, doesn't it?
[AGENT][NEUTRAL] Well, that was your hospital indemnity policy, the number that you gave me. So I'm checking with your other policies that you have because you also have a critical illness and an accident policy.
[AGENT][NEUTRAL] As well, so I am checking for those as well.
[CUSTOMER][NEUTRAL] So I don't have like just a regular doctor visit policy.
[AGENT][NEGATIVE] Uh, not with us, you don't, cause I, I, I was checking for through all of your policies, um, and through us, you do not.
[AGENT][NEUTRAL] It looks like if you
[CUSTOMER][NEUTRAL] Um, which policy would I have to choose?
[CUSTOMER][NEUTRAL] To actually get a just a doctor's visit policy.
[AGENT][NEUTRAL] Yeah, the
[AGENT][POSITIVE] Yeah it looks like with us.
[CUSTOMER][NEGATIVE] Cause I had called in and they didn't explained that to me.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] I had called in a while back and they, they said me I had the VIP VIP classic.
[CUSTOMER][POSITIVE] I was able to go visit a doctor anytime my doctor anytime I was in network using that APL policy number I gave you.
[AGENT][NEUTRAL] Um, with us, you just have hospital and
[CUSTOMER][NEUTRAL] So was I giving the wrong information?
[AGENT][NEUTRAL] Yeah, with us, all you have is the hospital indemnity and accident and critical illness. I mean, you also have term life insurance and dental. As far as wellness visits, I would check with your employer to see if you have major medical through
[AGENT][NEUTRAL] A different company, um, because we're not major medical, we're only supplemental.
[AGENT][NEUTRAL] So if you're wanting wellness visits that you'll wanna contact, yeah, you'll wanna contact your employer or uh benefits in a card.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Can I have the number for benefits in the car?
[AGENT][NEUTRAL] Yes, sir, give me just one second.
[AGENT][NEUTRAL] Alright, the number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then this way you'll be able to contact them and see if you wanted to make any changes to your plans that you currently have any upgrades or downgrades, um, or see if there's any benefits for wellness exams and just basic routine medical exams.
[CUSTOMER][NEUTRAL] So this is how.
[CUSTOMER][NEUTRAL] OK, uh, all right, let me call them right now and see what's going on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then if not I mean I have to buy something and thank you.
[AGENT][NEUTRAL] OK, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, that's it now.
[AGENT][POSITIVE] Right, thank you for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] Bye bye.