AccountId: 011433970860
ContactId: 85142ddc-abee-4f45-9aea-6786cebe4ab7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 240729 ms
Total Talk Time (AGENT): 78815 ms
Total Talk Time (CUSTOMER): 100646 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/85142ddc-abee-4f45-9aea-6786cebe4ab7_20250219T14:08_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hello, good morning. This is [PII] last initial [PII].
[AGENT][NEUTRAL] OK, I'm sorry, what was your name again?
[CUSTOMER][NEUTRAL] Um, first name is [PII].
[AGENT][NEUTRAL] OK. How do you spell that?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] And do you have a phone number I can get in case we get disconnected I can call you back.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And you have the policy number?
[CUSTOMER][NEUTRAL] Um, sure.
[CUSTOMER][NEUTRAL] Alright, so policy number it's 016595.
[CUSTOMER][NEUTRAL] 79
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, and the number 8.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] Um, first name is [PII]. Last name is [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. Were you needing claim status or benefits?
[CUSTOMER][NEUTRAL] Um, I already know if the benefits information just for the office visit, will visit, and outpatient benefits.
[AGENT][NEUTRAL] OK, I can give that to you. The effective date is [PII]. Any benefits given over the phone is not a guarantee of payment.
[AGENT][NEUTRAL] This policy coordinates with the primary insurance.
[AGENT][NEUTRAL] Whatever the primary applies to their deductible, co-pay, or co-insurance only.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] For outpatient facilities, we pay up to $7900.
[AGENT][NEUTRAL] Well, visits are not covered.
[AGENT][NEUTRAL] And office visits would fall under that outpatient benefit as well.
[CUSTOMER][NEUTRAL] Alright, so, uh, PCP office visit, office visit will be under the $7900 and the well visit is not covered.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Alright, and you said this, uh, $7900 will cover copays, deductible and co-insurance.
[AGENT][NEUTRAL] Only, yes.
[CUSTOMER][NEUTRAL] OK, thank you and could you provide me now please the claims billing address?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII] thank you. um OK, so I really appreciate your help and lastly, may I have your name and last initial and the call reference number please?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] We do not have call reference numbers. You can use my name and today's date. My name is [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, and what is your last initial sorry.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Alright, so thanks so much for the information [PII] and have a great day.
[AGENT][POSITIVE] Thank you, [PII], for calling FPLU as well.
[CUSTOMER][NEUTRAL] OK, bye.