AccountId: 011433970860
ContactId: 278ab3aa-37d7-485f-b06f-1647a0324a03
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 346440 ms
Total Talk Time (AGENT): 116544 ms
Total Talk Time (CUSTOMER): 106142 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/278ab3aa-37d7-485f-b06f-1647a0324a03_20250609T20:35_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good afternoon. My name is [PII], last initial [PII]. I am calling from uh Mercy pre-certification department, and I'm needing to see if prior authorization is required for a CPC code.
[AGENT][POSITIVE] OK, sure. I can assist you with the otherization, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh yes, my direct dial is [PII].
[AGENT][NEUTRAL] Mhm. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Um, yes, that is going to be.
[CUSTOMER][NEUTRAL] Where did I put that?
[CUSTOMER][NEUTRAL] D as in David 432.
[CUSTOMER][NEUTRAL] 237-71.
[AGENT][NEUTRAL] Do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEGATIVE] No, um, I had just been speaking with, uh, [PII] at 90 Degree Benefits, and she gave me your number for prior authorization purposes. She didn't.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Tell me about a policy number for APL.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, OK, um, let me have the spelling of the last name. Let me do a quick search.
[CUSTOMER][NEUTRAL] OK, um, [PII].
[AGENT][NEUTRAL] And the spelling of the first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Do you have an address for Miss [PII]?
[CUSTOMER][NEUTRAL] Uh, let's see what we have on file for her.
[CUSTOMER][NEUTRAL] Uh, we have [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] I'm here.
[AGENT][NEUTRAL] Yes, may I have her date of birth?
[CUSTOMER][NEUTRAL] Oh, I'm sorry, I didn't hear you say that, um, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you. All right. OK, so I did find her policy. She has a limited hospital indemnity plan. What type of service is being rendered?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, it is an outpatient, um, it's a facet injection.
[AGENT][NEUTRAL] Injection. For, for what type of injection? I'm sorry.
[CUSTOMER][NEUTRAL] Um, it's pain management.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK. And you said this is an outpatient facility or is it an office?
[CUSTOMER][NEUTRAL] Um, it'll be outpatient facility.
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Alright, let me look into her benefits really quick.
[AGENT][NEUTRAL] OK, authorization is not gonna be required. Now this particular policy, the only thing that it covers under outpatient will be surgery. We do not cover any other procedures done in an outpatient facility.
[CUSTOMER][NEUTRAL] OK, um, this particular, um, injection is considered a surgical procedure.
[AGENT][NEUTRAL] OK. So let me go ahead and give you this benefit and this is not a guarantee of payment, just a verification of coverage. And it looks like the benefit for the outpatient facility surgery benefit is $500.01 time per year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] An authorization is not gonna be required.
[CUSTOMER][NEUTRAL] All right, um.
[CUSTOMER][NEUTRAL] Can you, can you spell your first name for me please?
[AGENT][NEUTRAL] Sure. My name is [PII] [PII] [PII].
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Alright, and will there be a reference number for our call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Is there anything else I may help you with today? OK.
[CUSTOMER][POSITIVE] Uh, no, ma'am, that was it. Thank you very much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good afternoon.
[CUSTOMER][POSITIVE] Thank you you as well.
[AGENT][POSITIVE] You're welcome. Thank you. Bye-bye.
[AGENT][NEGATIVE] No, sorry.
[AGENT][NEUTRAL] Excuse me.