AccountId: 011433970860
ContactId: 114f1231-66fa-4716-a961-36c737cc1f83
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 168550 ms
Total Talk Time (AGENT): 95325 ms
Total Talk Time (CUSTOMER): 33736 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/114f1231-66fa-4716-a961-36c737cc1f83_20250219T19:43_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I need to see if pre-ser is required for inpatient stay.
[AGENT][NEUTRAL] OK, you're needing to verify if pre-certification is required for an in-hospital admission, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and who am I speaking with?
[CUSTOMER][NEUTRAL] This is [PII].
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] It is 024222.
[CUSTOMER][NEUTRAL] 97
[CUSTOMER][NEUTRAL] ML 8.
[AGENT][NEUTRAL] OK thank you one moment please.
[AGENT][NEUTRAL] And [PII], 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 and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so this, he is the spouse of the subscriber on the supplemental policy. This is a supplement cola to the primary insurance.
[AGENT][NEUTRAL] And this policy is active with an effective date of [PII].
[AGENT][NEUTRAL] But there is no prior authorization required with APL.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] When the claim is submitted to us though for review, we must also receive a copy of the primary insurance company's explanation of benefits along with the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we've processed our claim, you should be able to go to our portal to check claim status and have access to our explanation of benefits and the website for our portal cola is secured. [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes ma'am, uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That's correct, yes ma'am.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Do you have a call reference number for me?
[AGENT][NEUTRAL] Yes sir, you would use my name along with today's date.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] Well, you are certainly very welcome so if that's all I can help you with, thank you again for calling APL and I hope you have a great afternoon.
[CUSTOMER][NEUTRAL] You as well.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye.