AccountId: 011433970860
ContactId: 40835e58-a631-46d7-993e-5ce8465a6f86
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 191210 ms
Total Talk Time (AGENT): 93313 ms
Total Talk Time (CUSTOMER): 60279 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/40835e58-a631-46d7-993e-5ce8465a6f86_20250502T18:24_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, I was calling because one of the patients, our patients gave us this as her insurance, and we wanted to know if a patient required authorization for a surgery.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so you're just needing to verify whether a prior authorization is required or not, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, you like to thank you and then what is the callback number for you please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and the policy number for the member please.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Policy number.
[CUSTOMER][NEUTRAL] Um, where would I see that? I'm looking at her card. It says, it says insured, it says coverage group effective day plan in hospital benefits outpatient benefits.
[AGENT][NEUTRAL] OK, it'll be the either, either number, the in hospitals or the outpatient.
[CUSTOMER][NEUTRAL] OK, outpatient 02353184.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] OK, thank you. It's just one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And 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 their date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so she is the spouse of the subscriber on the supplemental policy, and because it is a supplement you looked to their primary insurance, there is no prior authorization required.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now because it is a supplement, yes ma'am, just a couple more things though for you, you let's say because it is a supplemental policy when the claim is filed with APL for review, we will have to have a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][POSITIVE] OK perfect thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we've processed our claim here we do have a portal that you should be able to check our claim status in.
[AGENT][NEUTRAL] And the website for that is secured. [PII].
[CUSTOMER][POSITIVE] Uh, OK, alrighty perfect.
[AGENT][NEUTRAL] All right, well, is there anything else I could help you with today?
[CUSTOMER][POSITIVE] No, that would be it thank you so much.
[AGENT][POSITIVE] Well, you're certainly welcome and thank you for calling APL. I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Yes ma'am. Thank you.