AccountId: 011433970860
ContactId: 3bd82e18-0cf5-44fd-8a24-94c92a1c1a85
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 225179 ms
Total Talk Time (AGENT): 94673 ms
Total Talk Time (CUSTOMER): 75567 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/05/3bd82e18-0cf5-44fd-8a24-94c92a1c1a85_20250605T17:49_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi there. Uh, my name is [PII]. I'm calling from um the ordering doctor's office. I need to, they, I've never seen this insurance, so this is new to me, but, um, I need to get an authorization for a CT scan and as well as um a colonoscopy and EGD.
[AGENT][NEUTRAL] OK, I can take a look at it for you. Could I, uh, [PII], could I get a callback number for you?
[CUSTOMER][POSITIVE] OK, thanks.
[CUSTOMER][NEUTRAL] Yes ma'am, um, direct line is [PII].
[AGENT][NEUTRAL] Thank you and what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] 02623153
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, it is.
[CUSTOMER][NEUTRAL] It's [PII] I don't know how to say that [PII], uh [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying the policy. And you are calling for a uh pre-authorization.
[CUSTOMER][NEUTRAL] Yes, the first kind is for a CT scan.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] OK, this policy does not require pre-authorization.
[CUSTOMER][NEUTRAL] For anything, surgeries or anything?
[AGENT][NEUTRAL] For anything, no, ma'am.
[CUSTOMER][NEUTRAL] OK. Not required. Is it like a, but it's covered though, right? Is it a limited benefit plan where they don't, do they have surgery benefits or?
[AGENT][NEUTRAL] It is a limited benefit plan. Uh, let me check the benefits for you. Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, please be advised verifying benefits does not guarantee payment.
[AGENT][NEUTRAL] See, so a CT scan and surgery. Is this in a physician office surgery or in an outpatient facility?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] It'll be an ambulatory surgical center outpatient for the surgery and for the um CT it'll be done here in the office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for the CT scan, uh, it looks like, uh, it pays, uh, the maximum payment would be $100.
[AGENT][NEUTRAL] And then for uh any follow up testing, it is uh it will pay up to $25.
[AGENT][NEUTRAL] And let's see, surgery center.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like for um.
[AGENT][NEUTRAL] The surgery, outpatient surgery.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, the policy pays $250.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] That's it, yes, ma'am.
[CUSTOMER][NEUTRAL] 250, OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Is there anything else I can help you?
[CUSTOMER][NEUTRAL] Alright and then uh do you have a call reference number?
[AGENT][NEUTRAL] To reference our call, you'll use my name, [PII] and today's date.
[CUSTOMER][NEUTRAL] OK, and your last initial, just put it on there.
[AGENT][NEUTRAL] [PII] Charlie.
[CUSTOMER][POSITIVE] Great. Thank you so much. Have a great day. Bye bye.
[AGENT][POSITIVE] You're welcome, [PII]. You have a wonderful day.