AccountId: 011433970860
ContactId: 777070c9-339f-4a3e-832f-a90d72285b30
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 535979 ms
Total Talk Time (AGENT): 217940 ms
Total Talk Time (CUSTOMER): 225037 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/20/777070c9-339f-4a3e-832f-a90d72285b30_20250520T17:43_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. Um, I just received my cards in the mail. And I'm going to my medical doctor this afternoon. I have, have an appointment and I haven't, uh, have a, I haven't had a card to give them the APL. How does this work? Can you kinda tell me, I pay a copay.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] You know, I pay a copay every time I go to the doctor. Does that take care of that?
[AGENT][NEUTRAL] Um, let me take a look and see what type of policy you have, but I can definitely help you with the coverage. Um, may I have your name and a good
[CUSTOMER][NEUTRAL] OK. I
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] is my name.
[CUSTOMER][POSITIVE] And I have the policy number if you would like. I didn't mean to interrupt you. Sorry about that.
[AGENT][NEUTRAL] Oh, no, you're fine. It's OK. Um, I will need the policy number, but may I have a good contact number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII] is my cell phone number.
[AGENT][NEUTRAL] OK, and then the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] 01986736
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] All right, and I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] All right. My birth date is [PII]. My mailing address is [PII]. They got [PII] on here, [PII], but it's [PII] Um, and what else did you want? My mailing, uh, my email is [PII]. [PII].
[AGENT][NEUTRAL] Let me repeat that.
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. Let me update the um city. It's [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII]. Everything else is correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] They just got [PII].
[CUSTOMER][NEUTRAL] And it's [PII].
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Oh, you know what?
[CUSTOMER][NEUTRAL] Oh what?
[AGENT][NEUTRAL] For some reason, it's not letting us save it with a C. Hold on one second. I don't, and it's [PII] is the um zip code, right?
[CUSTOMER][NEUTRAL] The zip code, yes, ma'am. Yeah. You know what it might come up as? [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What?
[CUSTOMER][NEUTRAL] Because that's where our post office is, is [PII].
[CUSTOMER][NEUTRAL] So usually it comes up [PII].
[AGENT][NEUTRAL] OK, like if you
[CUSTOMER][NEUTRAL] Instead of [PII]. We were.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. Same zip code?
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII]. Did that help?
[AGENT][NEUTRAL] That's true
[AGENT][NEUTRAL] Let me see, I'm getting ready to try to save it. Hold on one second.
[AGENT][NEUTRAL] So let's see if it's saved.
[AGENT][NEUTRAL] Nope. Hold on one moment, let's try it this way.
[AGENT][NEGATIVE] For some reason, it won't let us. I'll send that over to customer service so they can um fix it because they enter everything in. So hopefully they can see why it's not working, but
[CUSTOMER][POSITIVE] No problem. If you, if you wanna leave it like it is, you can. It's, I was just letting you know it's [PII], not [PII].
[AGENT][NEUTRAL] As long if you're OK with it, it's fine. Whatever you want me to do, that's what I'm gonna do.
[CUSTOMER][NEUTRAL] All right. Yes, ma'am. I mean, if they, if you, if they can fix it, you know, uh but if not, it's not a big deal.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Well, I'm gonna try and get them to fix it and then um we'll let you, we'll let you know what happens.
[AGENT][NEUTRAL] And so, um, for this policy, so this is your secondary policy, so we don't apply your co-pay, we help pay your co-pay, um, deductible and co-insurance after primary. Um, now your doctor's offices or your doctor visits would be under outpatient in which you have $500 a day to use for outpatient expenses. Um, so the in-office, depending on how they bill, if they charge you.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you know how some places charge for the facility and then for the visit?
[AGENT][NEUTRAL] If they separate it out.
[CUSTOMER][NEUTRAL] No, ma'am. This is just a, this is just a $40 copay today.
[CUSTOMER][NEUTRAL] They charged me $40 co-pay.
[AGENT][NEUTRAL] OK, that's, that's fine.
[AGENT][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm just, well,
[AGENT][NEUTRAL] OK, so what I was gonna, what I was explaining is with the
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So when they give us, when we get the bill, there's no coverage for the office setting itself if they charge us for a facility, but if they charge us for all the treatment, then you have the office treatment rider which uses that $500 a day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Got you, got you. So, do I present this to the doctor's appointment or no?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I don't kind of get, I really don't, I don't get it. Uh, so, how, how do you pay, how do you pay half of the, the treatment or the co-pay or whatever?
[AGENT][NEUTRAL] So anytime
[AGENT][NEUTRAL] When they file the claim. So anytime you give your Florida Blue card, give this card because [PII]. So they're gonna bill Florida Blue and then get the explanation of benefits and then bill us right after.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Gotcha. So how do I get my money? You just send a check in the mail?
[AGENT][NEUTRAL] Right, um, check or direct deposit?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] All right. All right.
[AGENT][NEUTRAL] So if you pay a co-pay, um, on the back end, you can be reimbursed once we receive the claim. We can see you pay the copay, so out of that $500 the co-pay could be reimbursed or something still owed to the doctor after primary pays, you know, whatever they pay, we could pay up to that $500 or both. You can get your refund or reimbursement and pay to the provider. It just won't go over that 500.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you wanna go to Jordan's Olympics with me or no? Yeah, all good.
[CUSTOMER][NEUTRAL] All right. Well, thank you, and I'll give it to him. I have a doctor's appointment at [PII] today. I forgot. Um.
[CUSTOMER][NEUTRAL] Yes ma'am, I'll give it to them and do I need to go online and and and fill out for this it said I just received it in the mail. Do I need to do anything on my end?
[AGENT][NEUTRAL] No, it's
[AGENT][NEUTRAL] There's an online portal, but you won't need that. I mean, that's just so you can like file claims and get your cards and stuff, but for the visit today, no, you just need to present the card to them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you. Thank you so much. I appreciate it.
[AGENT][NEUTRAL] You're welcome, Ms. [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, ma'am, that's everything. Uh, and, and like if I went, like if I went to the emergency room, the dentist, any of that, I would show that card, right?
[AGENT][POSITIVE] Alright, well thank you so much for calling.
[AGENT][NEUTRAL] Not dentists, this is medical only.
[CUSTOMER][NEUTRAL] OK, all right, got you.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome. Well, thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye