AccountId: 011433970860
ContactId: 36313a3c-d690-4514-8b62-2524d2f7eeec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 351970 ms
Total Talk Time (AGENT): 92336 ms
Total Talk Time (CUSTOMER): 133202 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/36313a3c-d690-4514-8b62-2524d2f7eeec_20250103T16:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Palm Beach Orthopedic Institute regarding a patient of ours that um says that she has a secondary insurance with you guys, and I was just trying to confirm this because she's having surgery, um, on Monday, so I just wanted to make sure what she's saying. I don't wanna.
[CUSTOMER][NEUTRAL] You know, charge or something and not supposed to be, but she says that she has this as a secondary and that you guys cover her deductible from her first United Healthcare Insurance.
[AGENT][NEUTRAL] OK, and what's your name again?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And my last initials are.
[AGENT][NEUTRAL] OK. And you're calling for eligibility and benefits, right?
[CUSTOMER][NEUTRAL] Yeah, cause she says that her, yeah, her primary is United Healthcare, but when I sent her a chart, she was like, well, I have also, and I was like, well, I don't see that here, so.
[AGENT][NEUTRAL] And did you
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Now are you calling for an office visit, benefit or?
[CUSTOMER][NEUTRAL] Let's see what's
[CUSTOMER][NEUTRAL] No, she's she's actually having surgery on Monday. It's pain management in yeah, she's having pain management injection.
[AGENT][NEUTRAL] So outpatient surgery, OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh, where is it being performed in an outpatient setting or in office?
[CUSTOMER][NEUTRAL] Uh, outpatient setting ambulatory.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] 02451787 M as in Mary, L as in love, 8.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, and your name is [PII], correct?
[CUSTOMER][NEUTRAL] Well not mhm.
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] And her name is [PII].
[AGENT][NEUTRAL] Thanks for that information, [PII]. The policy effective date is [PII] currently active at this time.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And I show that the maximum outpatient benefit is up to $1000. Um, this is per calendar day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] So it's a daily benefit.
[AGENT][NEUTRAL] And this information is verification, not a guarantee of payment. One moment.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Because the, the girl at your doctor's office.
[CUSTOMER][NEUTRAL] That's fine
[CUSTOMER][NEUTRAL] Send an email to your daughter so she'd be able to get it.
[CUSTOMER][NEUTRAL] For you
[CUSTOMER][NEUTRAL] It has to be printed out
[CUSTOMER][NEUTRAL] And you're also gonna bring.
[CUSTOMER][NEUTRAL] OK, alright, so I'll email that later.
[CUSTOMER][NEUTRAL] You have to ask your primary doctor. She's the one that she's.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Cholesterol
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, they're the ones like weather.
[CUSTOMER][NEUTRAL] Take
[CUSTOMER][NEUTRAL] Yeah, that's
[CUSTOMER][NEUTRAL] Any vitamin
[CUSTOMER][NEUTRAL] The primary doctor
[AGENT][POSITIVE] [PII], thank you so much for holding.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, so you have the $1000 per calendar day.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And of course the information is verification, not a guarantee of payment.
[AGENT][NEUTRAL] And did you have any other questions?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So that um 343 98 you guys will pick that up um due to her having the secondary.
[AGENT][NEUTRAL] So we can't verify it until we get a copy of the primary EOB. So, um, any cover charge applied towards the major medical deductible, co-insurance or co-pay is what this policy assists with, but we can't guarantee until we get the EOB.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, OK, OK, great, right, OK, no problem. Well thank you so much and what is your name?
[AGENT][NEUTRAL] It's [PII] A. First initial of my last name is [PII]. And did you have any other questions?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, that's it thank you so much have a great day.
[AGENT][POSITIVE] All right, thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye bye.