AccountId: 011433970860
ContactId: f341e9d1-18f5-40bb-a91a-91822ad9ed8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277779 ms
Total Talk Time (AGENT): 119800 ms
Total Talk Time (CUSTOMER): 140869 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/f341e9d1-18f5-40bb-a91a-91822ad9ed8e_20250307T14:14_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] Yes, my name is [PII]. I'm calling from AdventHealth Palm Coast, and I'm trying to verify some benefits for a member. Unfortunately she said she doesn't have an ID number, so I don't know if you can help me with her name, date of birth, and um I do have her social security number.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you. We, we can, we'll be able to, should be able to look her up with that information. What's a good callback number, please?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Wonderful, um, it's a direct line [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And let's try the social. What is that social, please, ma'am?
[CUSTOMER][NEUTRAL] OK, I have [PII].
[AGENT][NEUTRAL] And what is the patient's name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right. And [PII]'s date of birth, please, ma'am.
[CUSTOMER][NEUTRAL] I have [PII].
[AGENT][POSITIVE] All right. Well, that was easy. We got her.
[CUSTOMER][POSITIVE] OK, great. That's wonderful cause I know some insurances we call, they're like, sorry, we can't help you. You have to have the patient call and get an ID number and all this stuff. Even though I have everything, some of them just won't, so I'm, I'm glad you were able to help me.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I am, and I can provide that policy number for you.
[CUSTOMER][POSITIVE] Perfect, that's what I was gonna ask for next, yes, go ahead.
[AGENT][NEUTRAL] [PII], that active policy number is 230.
[AGENT][NEUTRAL] 4274.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the policy is active as of [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, 1123. OK. So what type of plan is this? She's saying it's a secondary to her um commercial medical?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So she is scheduled for an outpatient surgery to be done outpatient hospital and we're looking for a facility benefits.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Well, she does, now, first of all, all benefits given over the phone is a verification of coverage, not a guarantee of payment. She does have outpatient coverage up to $1500. That is a per calendar year benefit.
[AGENT][NEUTRAL] And that is, of course, the verification of coverage and I guarantee of payment. And as of right now, [PII], she has that full benefit remaining for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK wonderful so I guess my last question is since I don't have a card copy is um where are we billing this to? Is it under APL?
[AGENT][NEUTRAL] Mhm. It would be APL and I can provide mailing address, fax number and payer ID. We will need the primary EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yes, I just need the address, that's all.
[AGENT][NEUTRAL] So.
[AGENT][NEUTRAL] Sure. Uh, APL claims address is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] City, [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][POSITIVE] OK wonderful thank you my last thing is, may I just get a reference number for the call?
[AGENT][NEUTRAL] The reference number would be my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] OK, actually I did think of another question. So with this plan I guess because you said you need the primary EOB we can bill you, um, this isn't something the patient has to submit to you, right? We can go ahead and bill you, OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's correct. As long as you have the assignment of benefits on file.
[CUSTOMER][POSITIVE] OK, OK, perfect. Well thank you so much for all your help. I hope you have a good day.
[AGENT][POSITIVE] I hope you have a great day as well. [PII], it was a pleasure to assist you with that benefit, and I hope you have a great weekend.
[CUSTOMER][POSITIVE] Thank you, you too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.