AccountId: 011433970860
ContactId: f67b8a58-40fd-48ae-bd06-a37bd1c53a9c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278579 ms
Total Talk Time (AGENT): 119648 ms
Total Talk Time (CUSTOMER): 117896 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/f67b8a58-40fd-48ae-bd06-a37bd1c53a9c_20250220T16:58_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I was calling to um ask questions about the um my benefit card with you all.
[AGENT][POSITIVE] OK, well I can definitely help you with your questions. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] [PII], my phone number is [PII].
[AGENT][NEUTRAL] Thank you for that, and Ms. [PII], may I have your policy number?
[CUSTOMER][NEUTRAL] Um, uh, is that the group number or or the policy ID?
[AGENT][NEUTRAL] It it should, does it start with a 01 or 02?
[CUSTOMER][NEUTRAL] I see a policy I be oh wait, yeah, it says M.
[CUSTOMER][NEUTRAL] In hospital benefit uh outpatient 0254.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 95
[CUSTOMER][NEUTRAL] 74 M as in Mary, L as in Larry 7.
[AGENT][NEUTRAL] Thank you for that. And I have your policy here. I just need you to verify your date of birth, your mailing and email address.
[CUSTOMER][NEUTRAL] [PII] my um
[CUSTOMER][NEUTRAL] I don't know if you have my work email or my personal, but my work email is [PII]. And if you don't have that, you should have [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My address is [PII].
[AGENT][NEUTRAL] Thank you for that. And the policy actually, um, once I went to it doesn't have an email address on it. Which one would you like to add or did you want one on here?
[CUSTOMER][NEUTRAL] Yeah, you can add my personal [PII].
[AGENT][NEUTRAL] Alrighty, so I've updated the email for you and all the information provided is a verification of benefits, not a guarantee of payment. And how may I help you today?
[CUSTOMER][NEUTRAL] The information
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I was calling, I wanted to ask um a question. Does this cover like uh just copay when I'm in the hospital or like when I go to the doctor and I get a co-pay, does this card cover that as well?
[AGENT][NEUTRAL] Hold on one moment, Ms. [PII].
[AGENT][NEUTRAL] Hold on one moment
[AGENT][NEGATIVE] But it's breaking up. I'm, I'm getting every other word.
[CUSTOMER][NEUTRAL] OK. Can you hear me better now?
[AGENT][NEUTRAL] Yes, can you try that one more time? I heard covered and then it started going out.
[CUSTOMER][NEUTRAL] All right. Can you hear me now?
[CUSTOMER][NEUTRAL] Before out.
[AGENT][NEUTRAL] It's going, this is it's going in and out now.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Hold on one second.
[CUSTOMER][NEUTRAL] Can you hear me now?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so my question was, does this cover just like
[CUSTOMER][NEUTRAL] Outpatient um like when I'm in the hospital, or can I use it like if I go to the doctor and I have a copayment or if I like do lab work and I have a co-payment? Can I use this card or no?
[AGENT][NEUTRAL] So both, you have coverage for in hospitals, like if you're admitted into the hospital and then you have outpatient benefits. Under outpatient, um, you have like the office treatment rider, so any treatment that's done in the office as long as it's not cosmetic, um, should be covered up to your max, which is $3000 per day calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then you also have the
[CUSTOMER][NEUTRAL] So when you say
[CUSTOMER][NEUTRAL] Go ahead. I'm sorry.
[AGENT][NEUTRAL] And then you also have the independent lab facility rider, so like if you go to Quest Diagnostic or what's that like lab core, um those are independent labs, so that rider would go towards those labs.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Up to 3000 a day.
[CUSTOMER][NEUTRAL] OK, so cause they
[CUSTOMER][NEUTRAL] So I would need to call them because they keep sending me a bill as if I need to make sure they have this card on file then.
[AGENT][NEUTRAL] Right, so that they can bill us. Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, I'll give him a call. Thank you. Mhm.
[AGENT][NEUTRAL] And then if you
[AGENT][NEUTRAL] You're welcome and if you need to, you can, um, I would say to give them our phone number so that they can call and verify benefits. A lot of times they'll either see Medlink or APL and they're not familiar with this, they'll say it, they'll say it's not taken or accepted, um, but they just need to call us and verify the benefits.
[CUSTOMER][POSITIVE] OK, alright, I'll give them a call. Thank you.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Was there anything else I can help with?
[CUSTOMER][NEUTRAL] No, that'll be all.
[AGENT][POSITIVE] Alright, have a great day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bye.