AccountId: 011433970860
ContactId: f78407ae-521a-4e9e-aea8-9f14e25dc924
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 358890 ms
Total Talk Time (AGENT): 242344 ms
Total Talk Time (CUSTOMER): 104291 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
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[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], my name is [PII] and I'm signing up with my company and I'm doing all this uh Medicare stuff Medi whatever I gotta do. What is this APL?
[AGENT][NEUTRAL] Um, APL is
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Go ahead, go ahead.
[AGENT][NEUTRAL] So APL is, um, so we're an insurance company, we offer like supplemental gap insurance, um, if you, all of our policies are through your employer. So like if you have a, let's say Blue Cross Blue Shield, you may have a secondary insurance um with us that helps you like with your co-pay, deductible, co-insurance. If you, if Blue Cross Blue Shield charges you $40 to see the doctor on the back end, you could be reimbursed for that or
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, we offer hospital indemnity policies which are like limited medical benefit policies, uh, critical illness, accident, short-term disability, but it's all through your employer.
[CUSTOMER][NEUTRAL] OK, like for instance, this is APO gap 6 to 7,502,250. What does that mean?
[AGENT][NEUTRAL] Now those particulars, you'll have to ask your benefits department because every, every group has different numbers and, you know, specific to those plans, but Medlink is that supplemental insurance I was speaking of, um, that helps towards your co-pays, your deductibles and your co-insurance. So if you have to pay a co-pay or deductible, you could be reimbursed on the back end or if something is still old after your primary, we could pay to the provider.
[AGENT][NEUTRAL] Um, it's just like a gap in between so that hopefully you don't receive a bill, um, but sometimes there are outstanding balances depending on those benefits, and each group has like that 67 that you're saying that means something particular to your group. So just ask them what the what the, if you can see um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And they don't have a phone number to get a hold of.
[AGENT][NEUTRAL] Who doesn't?
[CUSTOMER][NEUTRAL] There's people here, I'm trying to look at.
[AGENT][NEUTRAL] Your HR department.
[CUSTOMER][NEUTRAL] Uh, I just wanted to call them like, yeah, well, I guess they are, but I don't, I don't know. I just, I just need the providershanet. Are you familiar with [PII]?
[AGENT][NEUTRAL] Yeah, so this would all go through.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I just need to call somebody. I, I need, I don't wanna just click yes on everything or no.
[AGENT][NEUTRAL] The only
[AGENT][NEUTRAL] In terms of APL, the, the only person or people that will have those answers would be your employer, and they'll show you the different plans that you can choose from. You see the benefits and just pick which one, you know, if you go to the doctor more, you might want to look for one that has the office treatment rider or, you know, just, you know how they give you the different plans to choose from. That's what I'm saying it's it's different for each group, so I don't know what your particular employers.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] selection of plans are.
[CUSTOMER][NEUTRAL] Yeah, normally, normally just explain to me, hey, just put this offer, this what this offers, and there's nobody here. I guess I can do it on my own.
[AGENT][NEUTRAL] Yeah, the yeah, for our, on our end, the only person that or people that can answer that is your HR. They have samples of each of the plans that they're offering to you all to choose from and you can read your benefits and see what.
[CUSTOMER][NEUTRAL] Let me ask you something. Is this gap thing APO? Is it worth it?
[CUSTOMER][NEUTRAL] It's costing me $35 a month.
[AGENT][NEUTRAL] I mean,
[AGENT][NEUTRAL] And I'm not saying it's just because I work at APL, but for me it is because if I pay $2 I would want it back.
[AGENT][NEUTRAL] So, yeah.
[CUSTOMER][NEUTRAL] Right. Well, like for, like for instance, I, I recently last this past year where I was at in my other place, I was at the hospital for 20 days and there's a $120,000 bill.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] So what would that case? In that case, the insurance I paid it, what, what would this pay? How would this benefit me?
[AGENT][POSITIVE] Oh, most definitely.
[AGENT][NEUTRAL] So the, it has inpatient benefits like you said if you were in the hospital, so everything goes by like a calendar year, plan year, um, so let's say you have $3000 or $6000 per year to use if you're admitted into the hospital. So like when you went to the hospital if that claim was submitted to us, we could apply all or some of that $6000 to your bill, you know, it, it depends on what we receive from the paper.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the, the most that this, the most that this will pay out is 6000 or 6750?
[AGENT][NEUTRAL] No, that's an example. That's an example. I don't know.
[AGENT][NEUTRAL] You need to talk to your HR department and ask them for your Medlink um options so that you can see and it breaks it down, so that you can see if I'm in the hospital, this is how much I have for a calendar year. If I go to the emergency room or urgent care, this is my outpatient for the calendar year, and you just decide which one, you know, works best for how, what you use the most.
[CUSTOMER][NEUTRAL] I got it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I mean, I guess I gotta talk to them because they're late.
[AGENT][NEUTRAL] Yeah, because
[CUSTOMER][NEUTRAL] But she's new. I don't know what's going on.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, so they, and they, they have each, um, they have each.
[CUSTOMER][NEUTRAL] I don't know what's going on here.
[CUSTOMER][NEUTRAL] I'm gonna go get Obamacare.
[AGENT][NEUTRAL] Well, that's too.
[CUSTOMER][NEUTRAL] Is that the thing?
[CUSTOMER][NEUTRAL] Is that still a thing? I don't know.
[AGENT][NEUTRAL] Yeah, Healthcare Marketplace, yes.
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] But still, if you, if, if you were looking at major and uh like the APL policy, I would definitely encourage.
[CUSTOMER][NEUTRAL] OK, well,
[AGENT][NEUTRAL] I mean, even if you go to the urgent care, there can be reimbursements or um help you pay your claims.
[CUSTOMER][NEUTRAL] So this is more for reimbursement, I guess.
[AGENT][NEUTRAL] Uh, reimbursements and paying for paying the provider if if your primary doesn't pay everything.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] I guess I'll talk to her cause I don't know what's going on here.
[CUSTOMER][POSITIVE] OK. I appreciate your help. Thank you.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] All right. Well, thanks for calling APL. I hope you have a great day and happy New Year.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too.