AccountId: 011433970860
ContactId: 0f3d76a3-a814-4b35-bfd6-5988fc9528d5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 437399 ms
Total Talk Time (AGENT): 135815 ms
Total Talk Time (CUSTOMER): 150428 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/0f3d76a3-a814-4b35-bfd6-5988fc9528d5_20250327T15:40_UTC.wav
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[AGENT][NEUTRAL] contacting ATL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, yes, hi, my name is [PII] with uh Baptist Eye Surgery Center, a provider, and I'm trying to verify benefits for a patient.
[AGENT][NEUTRAL] I can help with benefits. I think. What is that policy number, please?
[CUSTOMER][NEUTRAL] Uh yes, it is 02472.
[CUSTOMER][NEUTRAL] 970.
[CUSTOMER][NEUTRAL] M as in Michael, L as in Larry, the number 8.
[AGENT][NEUTRAL] Thank you, and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Uh yes, [PII] and date of birth is uh [PII].
[AGENT][NEUTRAL] OK. Excuse me, just, OK, so you said 02472970.
[CUSTOMER][NEUTRAL] 2970 yes.
[AGENT][NEUTRAL] 297. OK.
[CUSTOMER][NEUTRAL] There
[AGENT][POSITIVE] Thank you very much. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Uh, sure, uh, number here is [PII].
[AGENT][POSITIVE] I appreciate that. Thank you, [PII] that we do have a policy under that number. It doesn't belong to [PII] though.
[AGENT][NEUTRAL] Um, there is a, it's not listed under [PII].
[CUSTOMER][NEUTRAL] OK, it's some a completely different name.
[AGENT][POSITIVE] That is correct, yes.
[CUSTOMER][NEUTRAL] Alright, uh, can I place you on a brief hold so I can just get her on my other line to tell her this? OK, thank you.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Sure, absolutely.
[CUSTOMER][NEUTRAL] And before I give her this information, so you're not showing that she is also like on this policy?
[AGENT][NEUTRAL] That's correct, yes. And what is her date of birth again? I, I just want to be sure if there's not, if it's not listed under something else.
[CUSTOMER][NEUTRAL] OK, uh, yes, [PII].
[AGENT][NEUTRAL] [PII]. OK, let me see if I can't find something else for while while I'm on hold.
[CUSTOMER][NEUTRAL] So I just wanna make sure that this is correct before I call her.
[AGENT][NEUTRAL] Yes, absolutely. So what I did was I put in the number 02472970.
[AGENT][NEUTRAL] And the individual who owns this secondary or gap insurance is not [PII].
[CUSTOMER][NEUTRAL] OK, um, alright, so give me one second, let me call her.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, you know what? I apologize. I was giving you, I was in somebody else's account and didn't realize it, so the name that I have on the policy, um, that I'm giving you is, uh, [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII]. That was my fault.
[AGENT][NEUTRAL] OK, thank you. Uh, thank you. The policy went into effect on [PII]. It is active. Now, um.
[CUSTOMER][NEUTRAL] And I'm sorry, I don't mean to cut you off. I don't mean to cut you off, but um, I, because I got out of this other person's account, um, I didn't save the policy number. Can you give it to me one more time please?
[AGENT][NEUTRAL] Uh, sure.
[AGENT][NEUTRAL] It's 0247.
[AGENT][NEUTRAL] 2970.
[CUSTOMER][NEUTRAL] 2970 and then it was ML8 right? do I have to have that in there?
[AGENT][NEUTRAL] That's correct. Uh, not really, no. Um, that's really just more for us. Um, now, the policy picks up the deductible, co-payment or co-insurance from Lee's Major Medical. So for outpatient services, outpatient hospital services.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We'll pick up the deductible.
[CUSTOMER][NEUTRAL] Well, so this is an ambulatory, this is an ambulatory facility. I don't know if that matters that I tell you that?
[AGENT][POSITIVE] Uh, no, no, that's perfect. That's, that is what we consider outpatient hospital. Um, and we will pick up the deductible, co-payment or co-insurance up to $300 per calendar day. That's just a verification benefits, but, um, that is a per calendar day benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so you cover up to 300.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Alright, so, um, her amount due is 83957, so I would subtract, uh, 300 from that amount, is that correct?
[AGENT][NEUTRAL] That is correct, yes. And that, that is the most that we will pay now. Of course, I, I don't know whether she has any other um any other uh uh insurance, gap insurance, but that's, that is what we will pay.
[CUSTOMER][NEUTRAL] OK, alright, um, and again, uh, so I don't need to give you like a CPT code or anything like that?
[AGENT][NEUTRAL] No, no, as long as it's uh it's uh you're in uh network with their major medical and there's a deductible, co-payment or co-insurance, we should be fine.
[CUSTOMER][NEUTRAL] Alright, OK, um, thank, uh, I'm sorry, just for my verification purposes, can I have your name?
[AGENT][NEUTRAL] Yes, my name is [PII]. The first letter of my last name is [PII]. We're gonna use that today's date as a reference. Is there anything else at all that I can help with?
[CUSTOMER][NEUTRAL] Uh, is there a reference number that you can give me?
[AGENT][NEUTRAL] Uh, no, I'm sorry, we don't have reference numbers. I'm, I'm just gonna have my name and today's date.
[CUSTOMER][POSITIVE] OK, all right, uh thank you very much.
[AGENT][POSITIVE] OK, thanks for contacting API