AccountId: 011433970860
ContactId: 2f83d110-aa62-488c-8ae7-36143d70d9ad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 157800 ms
Total Talk Time (AGENT): 64079 ms
Total Talk Time (CUSTOMER): 74956 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/2f83d110-aa62-488c-8ae7-36143d70d9ad_20250403T12:17_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning [PII]. My name is [PII] um, and I am calling my system will not verify this plan. It's showing secondary to a Blue Cross South Carolina plan trying to see if the plan is active and try to see about network and uh get the correct benefit and pre certain information.
[AGENT][NEUTRAL] OK, is this for service in an office or outpatient facility?
[CUSTOMER][NEUTRAL] It's facility outpatient, um, diagnostics at place of service is 22.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what's the policy number?
[CUSTOMER][NEUTRAL] It is 02061683.
[AGENT][NEUTRAL] Mhm and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] direct.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you said that you tried to check eligibility and benefits online?
[CUSTOMER][NEUTRAL] No, I didn't. I said my my system in my web is saying contact payer.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Thank you, I have the information for you. I'm showing an effective date of [PII]. This policy is active at this time, and the maximum outpatient benefit is up to $1000 per occurrence, and of course any information provided is verification, not a guarantee of payment and any other questions I can help out with today, [PII]?
[CUSTOMER][NEUTRAL] Do you, uh, the patient is coming in for a CT lung screening. Do you require pre-cert or pre notification when secondary, and do you also show you're the secondary payer?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] We are secondary prior authorization is not required.
[CUSTOMER][NEUTRAL] OK, so anything over the 1000 is the patient's responsibility?
[AGENT][NEUTRAL] We do not determine patients responsibility, but 1000 is the maximum per occurrence.
[CUSTOMER][NEGATIVE] So they're not covered after $1000.
[AGENT][NEUTRAL] The maximum the patient's policy will cover is up to $1000.
[CUSTOMER][NEUTRAL] OK, great. Can I get a reference in the first initial of your last name?
[AGENT][NEUTRAL] You'll use my name in today's state as your reference, [PII] last [PII] [PII], and did you have any other questions?
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] Alrighty well thank you for calling APL have a good day.