AccountId: 011433970860
ContactId: 0afb3aae-e480-4274-bb9a-688d6ff73229
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 218419 ms
Total Talk Time (AGENT): 110741 ms
Total Talk Time (CUSTOMER): 74112 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/0afb3aae-e480-4274-bb9a-688d6ff73229_20250417T19:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII], and I'm calling to find out if one of your members requires a prior authorization for a certain CPT code.
[AGENT][NEUTRAL] Sure, I can see if authorization is required. Uh, [PII], can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Um, yeah, [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Yeah, 001715332.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And what was the name and date of birth for the member, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that. Uh, so of course this policy is active. Effective date was [PII], and this is a limited indemnity medical plan, so just pays a set dollar amount per covered procedure and our office visit and so no copays, no deductibles, and no pre-authorization is required.
[CUSTOMER][NEUTRAL] OK, do you know if they have um coverage for an echocardiogram for outpatient?
[AGENT][NEUTRAL] So for this kind of policy I'm unable to view uh benefit information unfortunately that is handled through uh they're called web TPA. I can give you their phone number and then I can transfer you to them if you'd like.
[CUSTOMER][NEUTRAL] Or they do they have any?
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK, so basically you are.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] They handle the um.
[CUSTOMER][NEUTRAL] You're you're APL, right?
[AGENT][NEUTRAL] Yes, this is American Public Life um and they essentially handle all of the claims and things like that just for this policy.
[CUSTOMER][MIXED] OK, but basically for APL bill preser is required.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, could I get um just a call reference at uh.
[CUSTOMER][NEUTRAL] The first initial to your last name?
[AGENT][NEUTRAL] Sure, uh, did you need web TPA's information?
[CUSTOMER][NEUTRAL] I don't think so. It looks like um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Someone else, you know, I, I may go ahead and do it when you're, when you're done, um, cause I don't see any benefits listed at all.
[AGENT][NEUTRAL] Sure, OK. So,
[AGENT][NEUTRAL] No worries, yeah, I definitely would these policies can be, no, no, that's OK. They can be very specific as to what is and is not covered, um, so reference number would just be my first name, last initial, and today's date, uh so my name is spelled [PII]
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] And then I can give you that phone number whenever you're ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect, I'm ready.
[AGENT][NEUTRAL] OK, that is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And if you call that number, you would select option 3 to speak with them.
[CUSTOMER][POSITIVE] All right. Thank you so much, [PII]. I really appreciate your time.
[AGENT][NEUTRAL] All right, yeah, was there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's perfect. Thank you.
[AGENT][POSITIVE] All right, well, thanks for giving us a call. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] See you. Bye-bye.