AccountId: 011433970860
ContactId: 0e35f416-8b0b-4fb6-9994-413c2d1f3db5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 167649 ms
Total Talk Time (AGENT): 91650 ms
Total Talk Time (CUSTOMER): 37751 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/28/0e35f416-8b0b-4fb6-9994-413c2d1f3db5_20250228T19:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] with Saint Francis Hospital, and I have a patient that's coming in for a new med, and I'm trying to see if authorization is required.
[AGENT][NEUTRAL] OK, [PII] I'm just needing to see if prior authorization is required for member, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and [PII], what is your call back number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] It is 256-6459.
[AGENT][NEUTRAL] Thank you one moment please while I get the member's information pulled up.
[AGENT][NEUTRAL] And then, any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name please and their date of birth?
[CUSTOMER][NEUTRAL] It's for [PII] [PII].
[AGENT][NEUTRAL] OK, thank you so I do see that he is the subscriber on this supplemental policy.
[AGENT][NEUTRAL] But there is no prior authorization required on this supplemental policy.
[CUSTOMER][POSITIVE] Alright perfect and do you have a call reference?
[AGENT][NEUTRAL] It is active. Oh yeah. Did you need the effective date on it or no? strictly just the prior authorization?
[CUSTOMER][NEUTRAL] Uh, no, I
[CUSTOMER][NEUTRAL] Yeah, as long as they're active.
[AGENT][NEUTRAL] I'm so sorry. I did not understand what you said, [PII], could you repeat that?
[CUSTOMER][NEUTRAL] Uh yeah, I don't need the effective day just as long as they're active.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, they are active now because this is a supplemental policy to the primary insurance. When the claim is submitted to us for review, we will also need a copy of the primary insurance company's explanation of benefits included with the claim.
[AGENT][NEUTRAL] And then once we have processed our claim, you all should be able to check our claim status in our portal by going to [PII].
[CUSTOMER][NEUTRAL] OK, got you.
[AGENT][NEUTRAL] Alright, well, is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Just a call reference.
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] Alright perfect thank you so much.
[AGENT][POSITIVE] You're welcome, [PII], and thank you for calling APL. I hope you have a great weekend.
[CUSTOMER][POSITIVE] Thanks you too bye bye.
[AGENT][NEUTRAL] Um, bye-bye.