AccountId: 011433970860
ContactId: e11514ac-7714-47fb-bb9f-444a15201857
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 194940 ms
Total Talk Time (AGENT): 88399 ms
Total Talk Time (CUSTOMER): 72419 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/e11514ac-7714-47fb-bb9f-444a15201857_20250516T15:37_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from South Florida ENT Associates. I'm sorry, I didn't catch your name.
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][NEUTRAL] Thank you very much. I appreciate that. Um, as I was saying, my name is [PII] calling from South Florida ENT Associates. Um, I need to verify benefits for a patient for an upcoming surgery, and you guys are actually secondary to Blue Cross, I believe.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm. OK, sure. Yes, I can assist you with that information, Ms. [PII]. And uh the surgery is gonna take place in an office setting?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Hello, you broke up.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] The phone kind of went off. Um, what did you say?
[CUSTOMER][NEUTRAL] Oh, I'm sorry. Uh, it's, it's going to take place in an ambulatory surgery center.
[AGENT][POSITIVE] Perfect. OK. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, perfect. Thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes, that is 02483265.
[AGENT][NEUTRAL] OK, thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage, and that's just a disclaimer, and this is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we have an outpatient maximum of
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] 1750 per covered person per calendar year.
[CUSTOMER][NEUTRAL] OK, has any of that been utilized?
[AGENT][NEUTRAL] I can check for you. Let's see.
[AGENT][NEUTRAL] OK, so as of today, he has used $150.39.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do you require prior authorization for outpatient procedures?
[AGENT][NEUTRAL] No, we do not. We're just a secondary.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, may I have a reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers, Mr. [PII]. You can use my name in today's date. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, thank you. You've been very helpful. Thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling ATL. Have a good evening and happy weekend.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.