AccountId: 011433970860
ContactId: 77e70fa2-b370-48e1-9a68-4d7562ce435e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 175410 ms
Total Talk Time (AGENT): 78318 ms
Total Talk Time (CUSTOMER): 70364 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/77e70fa2-b370-48e1-9a68-4d7562ce435e_20250416T16:33_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, this is [PII] calling from East Bay Surgery Center. And I was looking to find out, we have a patient coming in next week for a uh procedure at our ambulatory surgical center. And I was looking to see um if um they would have any patient responsibility for that procedure.
[AGENT][NEUTRAL] I'm sure, [PII] I can assist you with benefits. Um, first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII] and my name is [PII]
[AGENT][NEUTRAL] I'm sorry, [PII].
[AGENT][NEUTRAL] Got that corrected.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK. And the policy number, please?
[CUSTOMER][NEUTRAL] 02361658
[CUSTOMER][NEUTRAL] M as in Mary, L as in Lima, 8.
[AGENT][NEUTRAL] Thank you. Now, please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thanks again, [PII] and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII]. The policy is still active and for outpatient benefits, we cover up to $6600 per calendar year, and that's for the co-pay, the co-insurance, and the deductible after the primary insurance processes the claim.
[CUSTOMER][NEUTRAL] Oh, OK, alright, so you pick up the copays, co-insurances and deductible up to 6600.
[AGENT][NEUTRAL] Yes, ma'am, per calendar year.
[CUSTOMER][NEUTRAL] For calendar year, OK, um, and, um.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And you just need the EOB from the the uh Cigna plan.
[AGENT][NEUTRAL] Um, yes, ma'am. Once, um, the primary insurance filed the claim, then you guys will file the claim with us, and along with the claim form, you'll send in the EOB from the primary insurance.
[CUSTOMER][NEUTRAL] OK. Oh, OK. All right. um OK.
[CUSTOMER][NEUTRAL] All right, good to know then. OK. Um, and I'm sorry, what was your first name?
[AGENT][NEUTRAL] Um, it's [PII]. Um, it's spelled [PII] and my last initial is [PII], um, and your reference number will be my name and today's date. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, nope, that was it for now.
[AGENT][POSITIVE] OK well I thank you again, [PII] for calling ATF. Mhm. Have a great day.
[CUSTOMER][NEUTRAL] OK then.
[CUSTOMER][POSITIVE] OK then. Thank you very much then. You too. Bye-bye.
[AGENT][NEUTRAL] Mm bye.