AccountId: 011433970860
ContactId: 25e81fb8-e64f-4843-be8f-f5d0dda7e707
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193479 ms
Total Talk Time (AGENT): 100223 ms
Total Talk Time (CUSTOMER): 36520 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/25e81fb8-e64f-4843-be8f-f5d0dda7e707_20250402T18:30_UTC.wav
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[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling to see if authorization is required for outpatient surgery.
[AGENT][NEUTRAL] OK, you're needing to find out a prior authorization is required for a member for outpatient surgery, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and who am I speaking with please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Is it MY?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yes, [PII]
[AGENT][NEUTRAL] OK, thank you, and [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is.
[CUSTOMER][NEUTRAL] 02493350
[AGENT][NEUTRAL] OK, thank you one moment while I get the member's information pulled up please.
[AGENT][NEUTRAL] And I see 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] OK, thank you.
[AGENT][NEUTRAL] OK, so I can see that Ms. [PII] is the subscriber on the supplemental policy and the supplemental policy is active. The effective date on it is [PII].
[AGENT][NEUTRAL] And because it is a supplement to her primary insurance, [PII], there is no prior authorization required with APL. Now, when the claim is submitted to us for review, we will have to have a copy of her primary insurance company's explanation of benefits also.
[AGENT][NEUTRAL] And then once we have processed our claim we do have a portal in which you should be able to check claim status in.
[AGENT][NEUTRAL] By going to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Well thank you so much I do appreciate it um do you have a call reference number?
[AGENT][NEUTRAL] Well, you are certainly
[AGENT][POSITIVE] Oh yes ma'am. You, uh, you're very welcome first off, and you would use my name along with today's date as your call reference.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Number.
[CUSTOMER][NEUTRAL] OK, what's your name again? I'm sorry.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] All right thank you so much and you have a nice day.
[AGENT][POSITIVE] Well, you are very welcome and I hope you have a nice afternoon as well. And thank you again for calling APL.
[CUSTOMER][NEUTRAL] Alright bye bye.
[AGENT][NEUTRAL] Uh-huh, bye-bye.