AccountId: 011433970860
ContactId: 3128d9df-9975-4e89-b629-9bd7969c3065
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243750 ms
Total Talk Time (AGENT): 111422 ms
Total Talk Time (CUSTOMER): 57832 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/3128d9df-9975-4e89-b629-9bd7969c3065_20250417T17:37_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling on behalf of Lake Mary Surgery Center. I need to verify benefits, please.
[AGENT][NEUTRAL] OK, so this is outpatient facility. And what's the policy number, [PII] [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] 02558033
[AGENT][POSITIVE] And a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] direct.
[AGENT][NEUTRAL] Thank you. What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and date of birth? One moment, please. Um [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you for verifying that information for me, [PII]. I have the information pulled up, um, and I have an effective date of [PII]. Policy is active at this time and this is outpatient facility.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] So the maximum outpatient benefit is up to $5000. Uh, this is a per calendar year benefit.
[AGENT][NEUTRAL] And of course any information provided is verification. It does not guarantee payment of a claim, and I'll check to verify if if any of that has been used. Give me one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm not showing any of the benefit used at this time and did you have any other questions?
[CUSTOMER][NEUTRAL] Um, so this would go to, this is a, this, this policy is considered, um,
[CUSTOMER][NEUTRAL] Like a secondary policy, she has um other insurances primary that would be crossing over to you guys.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, and is it set up to do that, or, um, it would just my billers would have to basically send you a paper claim? How does it work or what's your payer ID?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm. So this is secondary to the major medical policy. Um, I don't believe they cross over, which means that it would have to be manually submitted, uh, a copy of the uh CMS or the UBO4 or the CMS 1500, whichever, and a copy of the major medical ELB would need to be submitted to payer ID number 60801.
[AGENT][NEUTRAL] Well, I don't think you could submit the primary EOB though electronically so I can give you the fax number if you would like.
[CUSTOMER][NEUTRAL] I'll take it.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] [PII] and would you like the claims mailing address?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And um
[CUSTOMER][NEUTRAL] Reference number and initial to your last name, please. Mine's [PII] if you need it.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] You'll use my name in today's date as reference for today's call, uh [PII]. And did you have any other questions I can help out with today?
[CUSTOMER][POSITIVE] I'm good. Thank you so much.
[AGENT][POSITIVE] Oh, you're welcome thanks for calling APL have have a good day.
[CUSTOMER][NEUTRAL] You too. Bye bye.