AccountId: 011433970860
ContactId: 9110e763-03d2-4b0a-86cb-af13015d9051
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286119 ms
Total Talk Time (AGENT): 112882 ms
Total Talk Time (CUSTOMER): 141438 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/9110e763-03d2-4b0a-86cb-af13015d9051_20250522T15:15_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], good morning. Uh, my name is [PII]. I'm calling with the Baptized Surgery Center. Um, I wanted to call and do a verification and eligibility benefits for patients.
[AGENT][POSITIVE] OK, well I can definitely help you with the eligibility and benefits, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, uh [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I have the group number and the outpatient benefits cert number is that the one you're looking for?
[AGENT][NEUTRAL] Yes, the 3rd number is the policy number.
[CUSTOMER][NEUTRAL] OK, um, so 1480502 ML 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Mhm. Call you guys up shortly, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Um last name is [PII]
[CUSTOMER][NEUTRAL] And then the first name is [PII].
[CUSTOMER][NEUTRAL] Yeah, they're, I'm just spelling it for her, yeah, yeah, they're, they're pulling it up after her. Yes, the date of birth is [PII].
[AGENT][NEUTRAL] And the date of birth?
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing the policy is active. It's been effective since [PII]. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] talk to her today please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Um, so she's having a, um, uh, eye surgery in an ambulatory surgical center. Um, so we just wanted to double check cause I know that is, um, we have the information that she has United Healthcare as primary, so we wanted to see what you guys cover as a secondary.
[AGENT][NEUTRAL] OK, um, for secondary, our outpatient, um, benefits is up to $500 per calendar day.
[CUSTOMER][NEUTRAL] Will be up to $500 calendar day?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and OK, so let's go here. OK, and then.
[AGENT][NEUTRAL] Now, it
[CUSTOMER][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] It depends on the um coding because this policy doesn't have any vision coverage. So it depends on how it comes over, um, but for outpatient um surgeries, we do cover up to $500 per calendar day. I just don't know how to be with that vision, um, because we don't cover vision, but depends on the coding when we get it.
[CUSTOMER][NEUTRAL] Do you
[CUSTOMER][NEUTRAL] Um, by any chance if I give you the CPT code now, would you be able to confirm or or no?
[AGENT][NEUTRAL] No, we don't use um the CPT codes for benefits. Once they get the documents, the examiner, um, they'll be able to go over the codes. Now, the primary insurance probably or could possibly have vision insurance, primary has its own benefits and secondary does, so I just want to put that out there just in case. I don't, they do have the outpatient surgery benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, no, yeah, because I'll let her know. No, no, of course I, I just wanted to confirm and let her know, um, alright, and then hold on a second, let me see if there's anything else, um, OK, so on the card I have the PO box as [PII], is that correct? Or is there a different, um, PO box?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, there's a different PO box. Let me know when you're ready.
[CUSTOMER][NEUTRAL] OK, hold on.
[CUSTOMER][NEUTRAL] Yes, go ahead.
[AGENT][NEUTRAL] So it's [PII].
[CUSTOMER][NEUTRAL] Hm?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Maybe [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] [PII] all right perfect now is there a reference number or um is it just documented under the call?
[AGENT][NEUTRAL] Um, there's no call reference number, but you can use my name in today's date, and again that's [PII] The first initial to my last name is [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Perfect. All right, thank you so much have a wonderful day.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can assist you with today?
[CUSTOMER][POSITIVE] No, no, that was it thank you so much.
[AGENT][POSITIVE] Alright, thanks for calling APL. You're welcome. Bye bye.
[CUSTOMER][POSITIVE] Thanks bye bye bye.