AccountId: 011433970860
ContactId: f22f57df-dce9-4d5e-8305-9ef30e2e193b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 204240 ms
Total Talk Time (AGENT): 84891 ms
Total Talk Time (CUSTOMER): 91212 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/f22f57df-dce9-4d5e-8305-9ef30e2e193b_20250516T13:53_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, good morning, [PII]. So, I'm, I'm calling from a provider's office. I need to verify the patient was active during the data service.
[AGENT][POSITIVE] OK, sure. I can assist you with the eligibility. And may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Uh, [PII], it's [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it shall B for [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, number would be [PII]. My extension is [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the name of the facility you're calling from for my notations?
[CUSTOMER][NEUTRAL] We're, I'm calling from South Florida ENT Associates Inc.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK. He just provided this number. So he provided 02491470 M like Mary, L like Larry, and the number 8.
[AGENT][NEUTRAL] OK, thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes. His name is [PII].
[CUSTOMER][NEUTRAL] Uh, initial S. [PII].
[CUSTOMER][NEUTRAL] Date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. Thank you, Ms. [PII]. All right, and you said you need eligibility. We have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plans to the major medical.
[CUSTOMER][NEUTRAL] Because it's [PII] and still active. Question, does the cover visits or no visits, other visits?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me check on that benefit. And this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. OK, for this one, I see that it covers office procedures like any treatment or procedures done in the office, it will be uh considered under the outpatient maximum, which is 250 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 250 per
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Yeah, he had an office visit and a procedure done.
[CUSTOMER][NEUTRAL] So, OK.
[AGENT][NEUTRAL] OK. Mhm.
[CUSTOMER][NEUTRAL] And the group number, can you look at the group number? because he provided 25921. I just wanna make sure it's correct.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] 25921. Yes, that is correct.
[CUSTOMER][NEUTRAL] Thank you, [PII]. So, that will be all. Uh, do you have a reference number for me?
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you would like. Is there anything else I may help you with today, [PII]?
[CUSTOMER][POSITIVE] That will be all. Thank you so much. OK. Have a great day.
[AGENT][POSITIVE] You as well, and thank you for calling. Have a good weekend. Bye bye, Ms. [PII].
[CUSTOMER][NEUTRAL] You too. Bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.