AccountId: 011433970860
ContactId: 79669445-29cf-43e7-885d-03083eda7f13
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 417750 ms
Total Talk Time (AGENT): 181593 ms
Total Talk Time (CUSTOMER): 204764 ms
Interruptions: 2
Overall Sentiment: AGENT=1.6, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/06/79669445-29cf-43e7-885d-03083eda7f13_20250506T17:44_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] Yeah, hi, good afternoon. I'm calling. I never received uh my card in the mail, probably because I moved. Uh, I did have a forwarding address, but the post office kind of, uh, made some errors with that. So I wanted to, uh, get the card, uh, sent out to me and probably update my address with you.
[AGENT][POSITIVE] OK. Uh well, I can definitely help you with both the address and the ID card. May I have your name and a good contact number just in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Absolutely my name is [PII], and your contact number is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And then, um, I can search your policy with your full social if you'd like, or if I don't know if you do have the policy number.
[CUSTOMER][POSITIVE] Uh-huh, I could, I, I could, I could give you, I could give you, uh, that, or I could also give you the payer ID or the group ID that helps you out as well. I have those, that information. You tell me which one would be easier for you.
[AGENT][NEUTRAL] Um, I can use the group ID.
[CUSTOMER][NEUTRAL] OK, the group ID would be 16577.
[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] OK, uh, [PII]. The email will be my last [PII]. You probably have the old address which is [PII], uh, either [PII] or [PII] with a zip of [PII].
[AGENT][NEUTRAL] Yes, and thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So what is the new address that you'd like me to um change it to?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] The new address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And that's in [PII].
[CUSTOMER][NEUTRAL] With the zip of [PII].
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Alright, hold on one moment, let me see that.
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEUTRAL] All right, so I've updated the mailing address for you and then I'm gonna go ahead and put the request for your ID cards to be mailed to the new address here. Um, did you, do you have the digital copy or would you like a digital copy?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 06.
[CUSTOMER][NEUTRAL] If you could give me that, yeah, you can send that to me via email if you want.
[AGENT][NEUTRAL] OK. Um, so I'll go ahead and email you.
[CUSTOMER][NEUTRAL] And some quick questions.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And and just some quick questions for you with uh when you're ready to send the uh plan itself.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] I'm ready.
[CUSTOMER][NEUTRAL] All right, uh, refresh my memory, what exactly, what am I covered with? Is it me and my son? How does, uh, what is this, uh, exactly over here?
[AGENT][NEUTRAL] So this is your secondary insurance, we pay towards your co-pays, deductible, co-insurance after um primary, which is Florida Blue. Um, so if you have to pay a co-pay or something, um, to be seen when we receive the claim on the back end, you can be reimbursed or something is still owed to the provider, we can pay them um to try to get that balance down or eliminated.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Correct, OK.
[CUSTOMER][NEUTRAL] Um, oh, OK.
[AGENT][NEUTRAL] Um, let me see what your ma.
[CUSTOMER][NEUTRAL] So if I have I, cause I just went to my primary care about a couple of months ago, I paid a copay. It was a small one, but I could get that reimbursed.
[AGENT][NEUTRAL] Um, yes, you do have, you could, you have the office treatment rider, so basically your policy is broken down. So if you're admitted into the hospital, you have coverage for inpatient, $1000 a year, and then for outpatient, you have $250 per day. So you don't have any coverage for like the office setting if they
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But you do have coverage for the treatment that you get in the office. So if they charge you for like a facility charge, that will most likely be denied, but whatever treatment you receive could be covered as long as it's not cosmetic.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I was, uh, I think it was just the actual visit itself, the co-pay that the insurance didn't cover, uh, for the visit. So I'm guessing from what you're telling me that's, uh, the rest of it wouldn't be covered because I didn't do any other than the annual physical, you know what I mean? She didn't charge me anything extra. It was just that, uh, co-pay for the visit.
[AGENT][POSITIVE] Yeah, well, I would definitely go ahead and file it.
[CUSTOMER][NEUTRAL] So I'm guessing so I understand correctly that what.
[CUSTOMER][NEUTRAL] OK, so then I'll get the information and uh from I just basically just need um the paper showing that I was there on the uh on whatever day it was.
[AGENT][NEUTRAL] Well, you have two options. You can either call the doctors or or wherever you go, um, you know, you went and let them know that you have a secondary policy and give them the policy number and our phone number for them to file, or yes, you can file on your own as well. You'll just need the explanation of benefits from Florida Blue, the itemized bill from the doctor, and then your claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, so this is actually good to know, yeah, because I, uh, alright, cool, cool, cool, cool, OK, uh, and answers all my questions, of course I'll give you guys a call back if anything, when should I, uh, be expecting, uh, the cards in the mail?
[AGENT][NEUTRAL] Well, we usually say right, we usually say about a week, um, because it's coming from [PII], but again, you know, it's the mail, so we're not sure for sure.
[CUSTOMER][NEUTRAL] Give or take, of course.
[CUSTOMER][POSITIVE] Fair enough.
[CUSTOMER][POSITIVE] Fair enough.
[CUSTOMER][NEGATIVE] I, I mean, I only put in a forwarding address when I moved in August, and I never got it. I didn't get you guys. I didn't get my, uh, Florida Blue. I had to call and give address updates to get all this stuff. So, cause I've been, what, since I believe, um, September.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] over with you guys, give or take, when they did the enrollment. So there you go. We're in [PII]. I still haven't received it. It's not your fault. I'm sure, I'm sure you mailed it, but, you know, I just, again, with uh, the post office shop and the bar, my forwarding, a lot of things didn't get over, so we'll figure.
[AGENT][POSITIVE] Oh my goodness.
[AGENT][NEUTRAL] Well, hopefully, you, well, I hope that you go ahead and get this one and I'm emailing it to you as well. So I hope you don't have this problem again, but yeah, that, that mail could be unpredictable.
[CUSTOMER][POSITIVE] Cool. No, no, no, no, no, no, definitely.
[CUSTOMER][POSITIVE] Yeah, I know it is what it is. What can you do? But I thank you very much for your time and your information. Very much appreciated. You enjoy the rest of your day, OK?
[AGENT][POSITIVE] You're very welcome.
[AGENT][POSITIVE] You also, [PII], and thanks for calling APL.
[CUSTOMER][POSITIVE] My pleasure. Take care now. Bye-bye.
[AGENT][NEUTRAL] Bye bye.