AccountId: 011433970860
ContactId: f5b2d60f-9f81-44fd-b2c2-9b25f6054bb1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2070820 ms
Total Talk Time (AGENT): 1130760 ms
Total Talk Time (CUSTOMER): 979565 ms
Interruptions: 39
Overall Sentiment: AGENT=1.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/f5b2d60f-9f81-44fd-b2c2-9b25f6054bb1_20250227T19:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Oh, hi [PII], how are you doing?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][NEUTRAL] Good, um, I, I had a whole, you're like the 4th person I've called today.
[AGENT][POSITIVE] Oh goodness.
[CUSTOMER][NEGATIVE] Um, long story, yeah, it's been a, it's been a, a headache and a half. Um.
[CUSTOMER][NEUTRAL] Long story short, I have multiple, multiple, multi-plan on, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, I have my insurance through benefits in a card. I don't know if you're familiar with them.
[AGENT][NEUTRAL] I understand the confusion and the headache.
[AGENT][NEGATIVE] It is very confusing.
[CUSTOMER][NEGATIVE] OK, so it is incredibly confusing and God forbid.
[AGENT][NEUTRAL] The the multi plan, yes.
[CUSTOMER][NEGATIVE] God forbid that we're ever in an emergency situation, I, I think I would just be like take my money because my insurance is just, it, it, it's like I'm doing a magic trick. I'm tumbling through things, I'm having to jump through hoops and I still don't know what's what. So, it's a headache and I've spent a fortune on this insurance and apparently they didn't even want to send me an insurance card, which is half the reason why I'm confused.
[AGENT][NEUTRAL] I understand. Sure.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Um, because I have an APL dental card and I have a card that's, um, I, I guess it's a multi-plan card where it has all of like the pharmacy coverage, division coverage, and the medical coverage, but apparently the medical coverage on there is just preventative and my actual insurance is APL, which I didn't know because they didn't send me my insurance card. Can you imagine this level of confusion? Um, so, uh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I, you know, I can actually, uh, unfortunately I can and I'm so sorry you have to deal with that.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEGATIVE] Seriously though, like I am just like I like I don't have enough problems. I have to like uh decode this mystifying system that they're operating under.
[AGENT][POSITIVE] Yeah, that's the perfect word for it. That is the perfect word for it. OK, so essentially you're, you're needing um your actual medical ID card, right?
[CUSTOMER][NEUTRAL] I'm just like, what?
[CUSTOMER][NEUTRAL] Yes, yes, but I, I'm actually calling for more than just that because like I said, I did opt for the better insurances, right? I'm thinking that I was actually gonna have some level of coverage, right? And um, so recently I used my multiplan card to get my annual checkup and my annual checkup. Um, you know, I told her I was having some issues with my shoulder and I also mentioned the fact that, um, you know, my mom.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Recently passed away and although I really hate therapy, it might be in my best interest for me to go to therapy, right? So, yeah, right, like get my mental health right, but you know, you guys are putting me to torture now I think I need more mental health.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][MIXED] It's not funny, but I get it.
[CUSTOMER][NEUTRAL] I'm like, it is funny, a little bit because it's ridiculous. I've been on the phone for 2 hours, 4.
[AGENT][NEUTRAL] Well, it's one of those things I think if you don't laugh, you'll cry or scream. So, I mean, I get it.
[CUSTOMER][NEGATIVE] Um, it is really like that. It is really like, like I, I'm, I'm looking at this and I'm like, I really spent thousands of dollars on this and they couldn't send me a freaking card, a card, really? Like I feel like I should start a GoFundMe, like help you guys create ID cards.
[AGENT][NEGATIVE] Dying, yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Anyway, the insurance person from, it was, uh, it was a doctor from something called Perlman Clinic which is apparently covered through multi-plan, but then they referred me to a spine and sports doctor for physical therapy, which I'm now trying to figure out what coverage I have through APL, if any at all. And also I'm trying to determine whether or not
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I have any kind of therapy because usually when you have like an employer, they at least cover like 4 sessions, 5 sessions, something. I mean, I'm not like banging my head on the wall super crazy, but you know, I am dealing with life and some challenges, so it may be in my best interest to like get it right.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Absolutely. OK. So we are needing ID cards, uh, and, excuse me, my goodness, to check for physical therapy and um mental health benefits, essentially.
[AGENT][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] OK. Alrighty. Let's get that policy pulled up and I will do what I can to help you out. Um, what was your name?
[CUSTOMER][NEGATIVE] Please, please, anything, anything is helpful because at this point I'm losing my freaking mind. What's left of it.
[AGENT][POSITIVE] I understand. I'll do what I can, I promise, um.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII], and I believe they sent me a virtual version of this card. So if you need any information on there. I just got it, you know, because, oh, I had to call multi plan and then call another number just to figure out that I had to get this insurance card emailed to me before using it. Like, I'm so over this for real. OK, so.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I don't blame you at all.
[CUSTOMER][NEUTRAL] For real, I'm just like, I know I'm a very impatient person in, in general, but this is next level, like, why make my life this difficult?
[AGENT][MIXED] Well, and this stuff is already like on its own, it's already confusing, but just in general like between medical coverage and then insurance on their own it's confusing. So when you take that and then you get all these multi plans, different phone numbers, different coverages through different people and you're left to sort out what's what, what goes where, if anywhere, so it is you're, it is very understandable.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] Seriously, I, I, I'm, I, I'm, I, I've, it's, it's awful the way they have this set up. It should have been, you know, a little bit more streamlined and I mean, even when my mom passed away, I wasn't even sure if I had if I had bereavement leave, like I'm just like, please make my life simpler. I, it's been a headache and a half. I had to use sick time because of my mom's stuff.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Oh my gosh. Yeah.
[AGENT][NEGATIVE] That's awful.
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] Man
[CUSTOMER][NEUTRAL] Sorry, I totally dumped on you, but this is why I need a therapist, um.
[AGENT][NEUTRAL] No, no, that's perfectly fine. I'm not a therapist, but I can listen.
[CUSTOMER][POSITIVE] Thank you, thank you, thank you. So, OK, it looks like.
[AGENT][NEUTRAL] Throwing that out there.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEGATIVE] Yeah, it's, it's so insane. It looks like the policy number is 02497249 and it was effective in uh effective in June, um, that's pretty much all I got on here is I don't know what else.
[AGENT][NEUTRAL] OK, yeah, that's fine.
[AGENT][NEUTRAL] No, that's, that's plenty um really quick also, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] OK thank you and then I'll just gonna verify some information really quick uh what was your last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you and then what was your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, uh, last thing I need is the uh mailing address, uh, we've got for you.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], sorry, [PII].
[AGENT][POSITIVE] Perfect. OK, awesome thank you for verifying that. OK, so first order of business uh let's go ahead and knock out those ID cards. So I was gonna say I can email you a copy, but you already have a virtual one. so do you want me to mail you one?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and, uh, sure.
[CUSTOMER][NEUTRAL] Like a hard copy, not like a paper one, please, like one that I can put in my wallet and actually know that it's an actual card.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Absolutely. I'll go ahead and get that submitted now. Yes.
[CUSTOMER][POSITIVE] Um, thank you.
[CUSTOMER][NEUTRAL] I was gonna start a GoFundMe for you guys.
[AGENT][NEUTRAL] There we are.
[AGENT][NEUTRAL] For us?
[CUSTOMER][NEGATIVE] I don't know why you guys don't send out. Yeah, I don't even know like I
[AGENT][NEUTRAL] Oh, so I'm, I'm, I will stand up for us on this one. We're guilty of a lot of things, but when it comes to ID cards, um, that's the group how they handle, um, how the ID cards and even the policies are sent out, which that's another thing I was going to ask. Um, do you need a copy of the policy, uh, for this policy so you can know what is and isn't covered?
[CUSTOMER][NEUTRAL] Oh, it's environments OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, well, because they sent me over, um, basically, you know, when you get hired and they send you an employee manual and what you can pick and what you can't pick and what what not, that's basically what I have.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] So essentially, uh, brochures, so you have like a brochure, yes.
[CUSTOMER][NEUTRAL] Yes, it's just a, I have like a brochure, so I really don't know like the nuances of the plan. I know very high level what's covered, so something like therapy and phys and physical therapy, both of them. I'm just like, am I covered? Is that something they have?
[AGENT][NEUTRAL] Mhm, right.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Specific things.
[AGENT][POSITIVE] Mhm. OK, so I will go ahead and send this to you. Um, it's very easy to read, not just a bunch of jargon I promise um but there's one single page on there that's going to be your best friend real clear cut and dry, what's covered, uh, the dollar amount frequencies, and the rest of the policy essentially is going to be uh like definitions, um, but of course if you get it, you look through it, you have any questions definitely give us a call back like I said, this is already extremely confusing.
[AGENT][NEUTRAL] Um, now for the policy, do you want me to email that to you or did you want me to mail that as well? or I can do both?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Um, both, it's better. Um, but if you could help me over the phone, that would be great because honestly, I'm, I'm like.
[AGENT][NEUTRAL] Sure, OK.
[AGENT][POSITIVE] Oh yeah, no, no, no, I'll still answer your questions. Oh yeah, I'm not just gonna send your policy and say good luck rooted.
[CUSTOMER][POSITIVE] OK, good, cause I'm literally.
[AGENT][POSITIVE] No, no, I'll help you out.
[CUSTOMER][NEUTRAL] Cause I'm like already lost, it's like I feel like this is like a forensic crime scene, like, OK, now go here. OK, now check that. I'll see how they're related.
[AGENT][POSITIVE] No, I'm not going to, I'm not gonna leave you to decipher it. I'll, I'll definitely help you out. I'm just a very visual person, so I like having something that I can go back and reference. So I always try to offer that, uh, straight away of course obviously you also want to know what it is that.
[AGENT][NEUTRAL] You're paying for and so um and then you know if you have questions or yeah exactly OK so the email I've got is uh [PII] is that where you want me to email this to you?
[CUSTOMER][NEUTRAL] Right, and what I've been paying for.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Cool, OK, I will get that emailed, um, and then I can mail you a paper copy as well if you'd like. So let's take a look, um, I can give you kind of a brief rundown first so and I'm sorry if this is repeated information, but I'm gonna go ahead and just go through my little spiel, um, so this is considered a limited indemnity medical plan.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] So in short, what that means it's different than traditional major medical. It's not going to be like um Blue Cross or Cigna or Aetna. It is limited in what it does and does not cover. Um, it doesn't pay a percentage, it pays a set dollar amount per covered procedure or office visit. Um, with that there are also no co-pays, no deductibles, no authorization required. Um, it's, it's very different, but that's in short how this plan works.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You have hospital confinement benefits. So if you were confined in a hospital, there's a daily benefit amount, uh, intensive care, coronary care. You do have a wellness and a diagnostic test benefit. So for a wellness exam that would pay $75. And then a diagnostic test, which would be like an MRI CT scan that pays $250. And then down here we've got.
[AGENT][NEUTRAL] Outpatient sickness. So, um, if you had to go to the doctor for being sick, that's a separate benefit which would also pay $75 per visit. And then you have a surgical and anesthesia benefit. Um, so, and that varies depending on what kind of surgery that is. In short, that is this policy. So, let me go a little bit more specific.
[AGENT][NEGATIVE] And I don't think this one would have physical therapy benefits.
[AGENT][NEUTRAL] But I will double check.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Or chiropractic care even?
[AGENT][NEUTRAL] Chiropractic, I think is considered more of a specialist, um.
[AGENT][POSITIVE] That is a good question. I can, I can see, um, because I think that's considered more of a specialist.
[AGENT][NEUTRAL] And if that might fall under, obviously, right.
[CUSTOMER][NEUTRAL] Um, just cause I'm trying to hedge, I'm trying to figure out, cause I had gone to, uh, I had gone to an introductory thing for a chiropractor and um he does kind of like the equivalent of physical therapy, but
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's, it's also kind of weird the way he prices things cause he basically, he kind of loops you into a 12, like the 12 like basically you have to come in for 12 sessions at a minimum. So that's why I'm, yeah, it's really strange how he has it set up, but I gave it a shot anyway, like I haven't done it. I've just contemplated it, um, but now that I'm getting a little bit more insight on to what my insurance covers, which is very limited.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, I'm trying to see what is the better option for me cause if you don't cover physical therapy but you cover chiropractic care, then it might be better for me to go with the chiropractic care.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Absolutely. OK, give me just a moment. I'm just gonna briefly skimming over what they specify as exclusions. Um, sometimes mental health is explicitly stated as an exclusion.
[AGENT][NEUTRAL] Um, but it does not. So if it's all right with you, [PII], I'm gonna put you on a brief hold and reach out to our claims specialist just to get some specific, um, you know, but these are kind of left to interpretation, and I don't like that, so I obviously wanna make sure that we know, um.
[CUSTOMER][NEUTRAL] Uh yeah, I mean, the whole system, the my whole experience, not just this is the whole thing has been left to interpretation.
[AGENT][POSITIVE] Yeah, so no, I'm gonna get you something definite.
[CUSTOMER][NEUTRAL] I feel like I need a decoder ring.
[AGENT][POSITIVE] Right, I'm gonna get you something definite and you know even if for better or for worse, at least you will know for sure um yes so I'm gonna put you on that hold I'll get right back with you OK?
[CUSTOMER][NEUTRAL] At least I know, right.
[CUSTOMER][POSITIVE] Sounds good. Thank you.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Currently no agents staffed. Goodbye.
[AGENT][NEUTRAL] Oh man.
[AGENT][POSITIVE] OK, [PII], sorry about that. Wait still with me?
[CUSTOMER][POSITIVE] No worries. Yeah, I'm still here.
[AGENT][NEUTRAL] OK, OK, so to me, um, as I told you the one benefit I was looking at is the outpatient sickness benefit because to me that would I would consider mental health a sickness, um, not so much chiropractic though so that's kind of what I wanted interpretation on um so unfortunately there's.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No physical therapy benefits and no mental health benefits. That also includes no chiropractic either, as this is specific for sickness. So it does cover physician's office, urgent care, emergency room, but it's going to be in regard to a sickness.
[CUSTOMER][NEGATIVE] So I've got no coverage at all for any of this.
[AGENT][NEUTRAL] Not for physical therapy, chiropractic, or um regular therapy or mental health, I guess.
[CUSTOMER][NEUTRAL] Yikes. OK.
[AGENT][POSITIVE] And this is again why I yeah and I'm so sorry to have to tell you that um but that's why I was always encouraged uh trying to send out the policy so you can go through, give it a good read, know exactly what it is that you're paying for because while this plan could be a good fit for some people it's definitely not a good fit for other people. So if it's something you decide isn't right for you and you wanna look at other options, you know, obviously you need to be able to make that educated decision.
[CUSTOMER][NEUTRAL] So, OK, so FYI just totally, totally random, right? The only reason why I started even contemplating this was because one day I called up multi-plan and I asked them for them to give me um a doctor in health like uh in network for, you know, for me to do like my annual checkup, right? And um one of the things I needed to do was to see my OBGYN to get, you know, the, you know, you know, checked out.
[AGENT][NEUTRAL] Mhm. Yeah.
[AGENT][POSITIVE] No worries.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] Which now I'm not even sure if my insurance covers at this point. Um, but anyway, I just went to a regular annual, got my blood work done, and, um, but what happened was multi-plan initially for some reason, they misunderstood my request and they sent me some like
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][MIXED] No doctors that were for like, if you clicked on it, it was like a therapist. It was something called happy something happy life or happy, happier living. And that was on multi-plan. So now I'm so confused because you're telling me that there's no therapy, yet happier living is covered through multi-plan.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, here's the confusion and I'll go ahead and address this as best as I can because as I said this is already extremely confusing we are a small piece of that multi plan so APL this particular policy is that small piece I don't know.
[CUSTOMER][NEUTRAL] Very.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] What other coverages or benefits they might offer so if they offer that it would just be outside of this policy that's not to say you don't have it period um this is just for this policy you have for APL doesn't cover that.
[AGENT][NEUTRAL] But they might and that's I was going to recommend although I know you said you've been on the phone back to back but that I would give them a call um because most of the time with these multi plans they have other things to kind of make up for that might just be something different and sometimes they have those um like the oh my goodness what are they called like a virtual um.
[CUSTOMER][NEUTRAL] Right, and that's what I was looking for was virtual therapy. And that's what it, that's what it sounds like it is. But at the same time, I, here's the thing, is this, the plan, remember when I told you I had the annual checkup at this place, the annual checkup was for this location. It was a clinic called the Per Perelman Clinic, which is in fact covered on the
[AGENT][NEUTRAL] Therapy, but you know what I mean, yeah, right, and as soon as you said that's what I was thinking, yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Multi-plan according to multi-plan, right? So they also offer therapy and physical therapy within their organization, but in their mind they're like, well, if your insurance covers Perelman Clinic, they have to cover all of these other things, but now I'm not sure. I'm so not sure.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] Well, that's again that's possible. I understand and that your confusion is 110% understandable but again multiplan is that bigger umbrella. This particular policy that I was telling you about is just one little piece of that, so they could very well offer other benefits outside of this particular policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[AGENT][POSITIVE] And I'm sorry to add to that confusion and I would love to be able to help you with that if I could but I don't have access to that information um but hopefully.
[CUSTOMER][NEUTRAL] So I would have to call multi-plan and ask them.
[AGENT][NEUTRAL] Yes, I'm sorry. I didn't want to have to say that.
[CUSTOMER][NEUTRAL] But then the thing is, if you call multi-plan, no, no, no, it's fine. But if you call multiplan, right? The thing is, is they don't tell you, they, they're like, we don't know what your insurance is, we just tell you what's in network.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] I don't know what coverage, oh, OK, I know, um, so that would be a question for benefits and a card so let me get.
[AGENT][POSITIVE] That information for you. No, no, stay strong. You got this, you got this.
[CUSTOMER][NEGATIVE] I'm gonna cry.
[CUSTOMER][NEUTRAL] Um, yeah.
[CUSTOMER][NEUTRAL] Yeah, I can't, I can't be, I have, I can't be weak. I don't have mental health coverage. I can't be weak. Get it together.
[AGENT][POSITIVE] We will get there. It's OK.
[AGENT][POSITIVE] No, no, no, you can, you can, you can be weak, you can cry, but we're gonna get this taken care of first. It is OK to cry. All right.
[CUSTOMER][NEGATIVE] No, but no, but honestly, it is terrible that they don't cover mental health because honestly, like I'm, I'm dealing with some of these things like a champ, but what if I wasn't?
[AGENT][POSITIVE] Girl, you're preaching to the choir. Trust me, I get it. I, I've been having to do that. Um, I've been on medication, but I just recently started a therapy myself. Um, I didn't want to, but it was one of those things. I felt like I was kind of pushed up against the wall and I was like, I don't like feeling this way. I got to do something. And it has been beneficial. It was difficult, but it is extremely beneficial and
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] I'm like, yeah, but why is this not more widely covered and available to people? I mean, even a little bit, you know, because on its own, it is so expensive.
[CUSTOMER][NEGATIVE] And the thing is in in the state of [PII], you can't even go to a dental appointment without them saying, are you OK today? Are you doing well? If not, we can get you a mental health professional. It, it's so forced on you almost everywhere you go, but what they're not telling you is, hey, by the way, it's not covered. It's not covered, it's not free.
[AGENT][NEUTRAL] Oh, I didn't even think about that, yeah.
[AGENT][NEUTRAL] Got to pay for it, yeah, exactly. Do you have a $500 per visit or right, OK, so, and again this all that I've been telling you is for this particular policy, [PII], they very well yes for the hospital indemnity plan that's what this is called so you could very well have mental health benefits.
[CUSTOMER][NEGATIVE] So if you were sad before, get sadder.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] For the APL, for APL.
[CUSTOMER][NEUTRAL] OK, but when I
[CUSTOMER][NEGATIVE] But when I call up multi plan, they, they don't, they just, I'm, I don't know and the thing is is they even have a preface, like a disclaimer saying, by the way, if you talk to us, um, it's no guarantee of your actual coverage, so like they didn't know what the insurance was. I'm so I'm so confused.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] That's what I'm thinking.
[AGENT][POSITIVE] I'm not 100% I know and I'm sorry I'm um we have lots of confused people call us regarding this before um but not to this degree and you make a lot of good points frankly I'm not I'm surprised we haven't had more people um call with this kind of like needing this particular information that's what I'm kind of going on a hunch and think.
[AGENT][NEUTRAL] that we should call benefits in a card um not necessarily multi plan but benefits in a card um normally I would say to reach out to your employer um to get that information but yeah that's what I was expecting um or like you know.
[CUSTOMER][NEUTRAL] OK. I'm
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Same employer that didn't give my bereavement lien?
[AGENT][NEUTRAL] Well, yeah, that's what I was thinking. I understand. So this is honestly the only other thing I can recommend um because let's see 90 degrees is gonna be just your preventative, so I don't, I mean, I guess.
[AGENT][NEUTRAL] You could talk to them too, but.
[AGENT][NEUTRAL] I'm just gonna go ahead and give you a couple of these numbers. I don't know if you've, I know you've been on the phone a million times and I'm sorry, um, and it's possible you've talked to them already, um, but just for good measure, uh, let me know when you're ready. I'll give you these phone numbers.
[CUSTOMER][NEUTRAL] No, it's not
[CUSTOMER][POSITIVE] Which, which, OK, I'm ready.
[AGENT][NEUTRAL] OK, so this one is for 90 degrees or um they're also called IMA and that phone number is [PII].
[AGENT][NEUTRAL] 833.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And we're gonna add to the confusion here I'm sorry but so it's you get a number of options uh when you call that number uh to select you know a number for a specific line um and it's not very clear as to what I've I've called it before and I'm like I don't know how people are getting this but to speak with them directly it is option one that you would select um OK and then for benefits in a card.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, let me know when you're ready for that number.
[CUSTOMER][NEUTRAL] I was using the phone with them.
[AGENT][NEUTRAL] Uh, with, uh, benefits in a card or with uh 90 degrees?
[CUSTOMER][NEUTRAL] Yeah, I'm on the
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I think I was on the phone with benefits and a card.
[AGENT][NEUTRAL] OK, that's the.
[CUSTOMER][NEUTRAL] Just now, they would want to transfer me to you.
[AGENT][NEUTRAL] Oh, OK, well, they're the only other ones I could think that it would actually know what kinds of policies you have. There's got to be someone that can tell you what you've got and what it covers.
[CUSTOMER][MIXED] Right, agreed. Cause otherwise I'm just guessing and hoping for the best and then getting stuck with the bill later and I don't love that.
[AGENT][NEUTRAL] Yeah, exactly. Do you know if you've, yeah, do you know if you spoke with 90 Degrees or Ami?
[CUSTOMER][NEUTRAL] I think I definitely spoke with um benefits in the card because that number happened to be an email and they were the ones who transferred me over to you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So the number I just gave you.
[CUSTOMER][NEUTRAL] It was it um
[AGENT][NEUTRAL] Is different. That is uh that's 90 degrees or IMA the number that I just gave you that is different from benefits and the course.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Then the other one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you still want me to give you [PII]'s number? It's all right, sis.
[CUSTOMER][NEUTRAL] Is it [PII] or [PII]? Is that one of those are the ones I just called.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] OK, no, it's not, it's not a, it's neither of those.
[CUSTOMER][NEUTRAL] Wow, OK. Um, OK.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] I'll take the number then.
[AGENT][NEUTRAL] Tell you what, [PII] too just because um I'll I'll go ahead and give you the phone number just so you've got it of course but if you've got time I can put you on a hold and I'll reach out to them and I'll try to talk to them just to get some direction and see if they can give us any kind of direction for you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, yes, I would really, really appreciate it because I feel like no matter what I'm doing, I mean, I'm, it sounds like I'm not having much coverage and the thing is, is I recall paying for two coverages. Um, I think like one was more preventative and one was more like if something
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] Happened and I'm like, well, I mean, my mom fucking died. That was something happened. Like, no offense, and I'm trying to, I'm not gonna yell at you, but I'm like I paid for double insurance because I was like covering my butt and I'm like this is like probably the nastiest thing I'll ever have to live through and my insurance doesn't have any benefit for this, not, not even a little bit.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, no, no, you're, I understand.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, and that's what I wanted, uh, but you need to be able to some place you can go or someone you can call that can say here's what you've got here's who it's through, here's what's covered. I mean there's, there's gotta be something because I, I just see this one little tiny piece that is very limited and it's more of this plan is more evolved around um.
[CUSTOMER][POSITIVE] Agreed.
[AGENT][NEUTRAL] Like hospitals, you know, like if you had a, had a surgery or admitted to the hospital or something like that, that's what this is mainly. So, give me,
[CUSTOMER][NEGATIVE] Yeah, but it sounds like they'll give me $75 for that. Like that's not gonna go far if I ever have surgery.
[AGENT][NEUTRAL] No, and that's what again that no, no, no, not for surgery that's for um those were for like office visits, but um surgical benefits are a bit different, but I'll send this to you. You'll have all of that information. Um, so let me give you this number really quick, [PII], and then I'll put you on a hold. I'll go ahead and call them, um, and then I'll try my best to get some answers for you.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Oh thank you. OK, I'll take the number when you're ready.
[AGENT][NEUTRAL] Sure, OK, it is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. Now, the reason I'm the other thing since you're gonna get some kind of clarification, if you could ask them about the physical therapy aspect of it because I went to, like I said, I went to my annual checkup. That was covered through multi-plan.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And then according to my doctor, they provided me the number and a referral to a physical therapist that they saw was in my insurance. So now I'm very confused because they saw something on my insurance that showed some level of coverage, but it's obviously not through APL, so then where is it through?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure.
[AGENT][NEGATIVE] Right, and I don't understand why they couldn't tell you that, so I don't know.
[CUSTOMER][NEGATIVE] Right. Well, I, I, I, I had to call the doctor's office twice because at one point there was a woman who got annoyed with me and, and hung up on me. So it's been quite a morning.
[AGENT][NEGATIVE] Oh look, it's your fault. This is such a confusing situation, gosh.
[CUSTOMER][NEUTRAL] No, in her case, I, I had asked her if they had left uh a referral for anything on my chart, and then she said no. And then I was like, well, is there a number? Did she leave something on my chart for me to call or something, some something from something? And she was like, oh yeah, by the way, there is something here. And I'm like, OK, so if I hadn't asked those questions, you wouldn't have given me that information.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right. Wow.
[CUSTOMER][NEUTRAL] And then she got pissed off cause I called her out because obviously she wasn't doing her job, but then she hung up. And I, I'm like, OK, great, thank you.
[AGENT][NEUTRAL] Oh, because you called her out, yeah, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Super professional. I'm sure that gives you all kinds of reassurance. Yeah, exactly, jeez. Alrighty, well, give me just a minute, [PII].
[CUSTOMER][POSITIVE] I'm like, yeah, that was super helpful.
[CUSTOMER][POSITIVE] It's been a, it's been a minute. Yes, I will give you as many minutes as you need.
[AGENT][NEUTRAL] I hear you I hear you. I will, I'm just gonna put you on a hold, um, and hopefully it doesn't take too awful long, but if it does just know I'm still here, don't hang up. I haven't, I wouldn't, I'm not forgetting about you, um.
[CUSTOMER][NEUTRAL] No, no, I'm, I'm just gonna be eating my lunch while we talk, or while I wait, it's fine.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] There we go. OK, so I'll sounds good. Alright, I'll get back with you as soon as I can.
[CUSTOMER][POSITIVE] OK, thank you so much. Thank you.
[AGENT][NEUTRAL] Of course, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to Benefits in a card.
[CUSTOMER][NEUTRAL] For English, press one.
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] Your call may be recorded for quality control purposes.
[CUSTOMER][POSITIVE] Thank you for calling Benefits in a car. This is [PII] speaking. How may I help you?
[AGENT][NEUTRAL] Hi, I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] hi this is [PII]. I'm actually with APL um I have a member on the line and she is just uh a bit confused um she said that she's spoken with uh multi plan and she's trying to understand.
[AGENT][NEUTRAL] All of the carriers that she has for coverage and what's explicitly is covered, um, for like uh physical therapy or mental health, um, like actual therapy. So, you know, I told her what benefits she has with us, but she is just having a hard time finding out what other coverages she has. And I don't know if that's, if y'all can help her with that or if that is. I thought it was through multi-plan, but she said that they weren't able to tell her.
[CUSTOMER][NEUTRAL] Because multi plan is for them to find which provider are in our network, um, but I'll be able to tell her what plans she has.
[AGENT][POSITIVE] You will awesome OK um if you would give me just a moment, um, I'm just gonna put you on a brief hold while I let her know I'll get right back with you OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No problem.
[AGENT][POSITIVE] Alright, I appreciate your help. Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hey [PII], are you still there?
[CUSTOMER][NEUTRAL] Mm, yes, I am.
[AGENT][POSITIVE] You're gonna love, you're gonna love those words. I explained the situation and she said, oh yeah, I can help. I can tell her what she's got. So I can get you right over to her. I know. I was like ready for the mm.
[CUSTOMER][POSITIVE] Oh my God, I love people, you know.
[CUSTOMER][POSITIVE] Oh, thank you.
[AGENT][NEUTRAL] So I was like, wait, let me go tell her. OK, so her name is [PII] and this is with benefits and a card. um, if you are ready I can go ahead and hand you over to her.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much. I really, really appreciate you so much right now.
[AGENT][NEUTRAL] You are very welcome. Oh no, I think she disconnected. That's OK. I can call back um I'll just put you on a, no, no, no, it's OK. I promise. So I'm just gonna put you on the back on that hold. I'll get them back on the line and hand you over, OK?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Sounds good. Thank you.
[AGENT][POSITIVE] You are very welcome. I hope you have a great rest of your day, [PII]. Things will look up.
[CUSTOMER][POSITIVE] Uh thank you. I, I really, really appreciate it. You've been so helpful.
[AGENT][POSITIVE] Oh, you're welcome. Happy to help. Alrighty, I hope you have a great rest of your day. Bye bye.
[CUSTOMER][POSITIVE] You, you too. Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Welcome to Benefits in a card.
[CUSTOMER][NEUTRAL] For English, press one.
[CUSTOMER][NEUTRAL] Your call may be recorded for quality control purposes.
[CUSTOMER][POSITIVE] Thank you for calling Benefits and a car. My name is [PII]. How can I assist you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] over at uh APL. How are you?
[CUSTOMER][POSITIVE] Thank you, I'm doing good how about you?
[AGENT][NEUTRAL] Doing well, thank you. I have a member on the line, um, and she's just a bit confused about what all kinds of coverages that she does have, um, and like, particularly looking at, um, physical therapy, mental health, uh, regular therapy. Um, she said she tried calling multiplan and they weren't able to help. So, um, thought I'd get her over with y'all so you can kinda let her know what she's got.
[CUSTOMER][NEUTRAL] OK, yeah, that's fine. You can transfer her over.
[AGENT][NEUTRAL] OK, thank you. Her name is [PII].
[CUSTOMER][POSITIVE] OK thank you have a nice day.
[AGENT][POSITIVE] Alright thank you you too bye bye.