AccountId: 011433970860
ContactId: bc1f5f54-bdc5-49ee-887e-7bd4a418b36f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 313510 ms
Total Talk Time (AGENT): 120403 ms
Total Talk Time (CUSTOMER): 144298 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/bc1f5f54-bdc5-49ee-887e-7bd4a418b36f_20250401T18:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Appointment that day for [PII].
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. My name is [PII]. It's spelled [PII]
[AGENT][POSITIVE] Thank you, [PII]. Um, how can I help you today?
[CUSTOMER][NEUTRAL] Yes, so I'm calling this afternoon because I need to get patients benefits and eligibility patients coming in tomorrow and I need to know if they're currently on an active policy.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes ma'am, I can um give you both benefits and eligibility. Can I please get your call back number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Yes, it is Miami Hematology and Oncology Associates. Uh, callback number is [PII]. I have an extension [PII].
[AGENT][NEUTRAL] OK, and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] She's [PII], [PII]. She is policy number is 01634 I'm sorry 8489, then it's M as in Mary, L as in Larry and then 8 the number 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right, let me look up that policy for us real quick.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] OK, I do show that Ms. [PII] does have an active policy with us. Her effective date is [PII].
[AGENT][NEUTRAL] And this is just to verify benefits. It's not a guarantee of payment. This is a supplemental insurance fee. It's a gap insurance that helps with deductible, co-pay, and co-insurance. She has an inpatient calendar year benefit amount of $2000 and.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Patient per calendar day benefit of $500.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, and 2000 is the what per year?
[AGENT][NEUTRAL] Yeah, that's uh
[AGENT][NEUTRAL] Inpatient per calendar year.
[CUSTOMER][NEUTRAL] 2000.
[CUSTOMER][NEUTRAL] Inpatient per calendar here.
[CUSTOMER][NEUTRAL] Now you did say that this is a secondary policy supplemental plan, correct?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] So when you bill, you'll have to send the EOB from the primary insurance with the claim.
[CUSTOMER][NEUTRAL] Second there
[CUSTOMER][NEUTRAL] Supplemental plan.
[CUSTOMER][NEUTRAL] OK, secondary. OK, so, and then for this patient, she's coming in for a follow up tomorrow under her primary she does have a $60 copay. Do you guys pick up that copay?
[AGENT][NEUTRAL] Right, so what the, um, it, it all depends on how the EOB comes in from the primary insurance.
[CUSTOMER][NEUTRAL] OK, let me see if you guys paid it in the past.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Because I believe it's, it's um.
[CUSTOMER][NEUTRAL] I can um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I do show that we've paid you guys in the past um for deductible, co-pay and co-insurance. I see $133.86 that was paid.
[CUSTOMER][NEUTRAL] The 60.
[AGENT][NEUTRAL] On for uh data service [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It all goes by the procedure code that comes in on the EOB.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I'll go ahead and uh collect and then we'll just submit it to you guys.
[AGENT][POSITIVE] OK, sounds perfect, that'll help her.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK, and can I, can I please have a call reference number for this information?
[AGENT][NEUTRAL] Uh, yes, ma'am. You can use my name, [PII], and today's date.
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Oh, so it's [PII]
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] What is the um first initial to your last name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK perfect and then today's date.
[CUSTOMER][POSITIVE] OK great thank you so much for your help to you have a wonderful rest of the day.
[AGENT][POSITIVE] Well, you're very welcome. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, that's it thank you so much bye bye.
[AGENT][POSITIVE] OK, well you have a good day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][NEUTRAL] Bye-bye.