AccountId: 011433970860
ContactId: 45ccca3a-4056-4bf2-9893-f201b97f01ff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 379079 ms
Total Talk Time (AGENT): 170240 ms
Total Talk Time (CUSTOMER): 120041 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/45ccca3a-4056-4bf2-9893-f201b97f01ff_20250417T20:05_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] with the University of Kansas Hospital. How are you today?
[AGENT][POSITIVE] I'm good, [PII]. How are you doing today?
[CUSTOMER][POSITIVE] Doing well thank you for asking.
[AGENT][NEUTRAL] Oh, well, how can I help you?
[CUSTOMER][NEUTRAL] I am calling for a couple of things, uh, it's on one patient checking to verify that she has active coverage and then I wanna verify if um she would need a referral to come see a specialist for an outpatient office visit.
[CUSTOMER][NEUTRAL] And then would you be able to verify if we are in or out of network?
[AGENT][NEUTRAL] OK, [PII], so you're needing to take eligibility requirements for an authorization for an office visit and also a question regarding whether your provider is in network or not for her plan. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with those things, um, for sure, two of them, but I will need to pull her policy information up first and verify a couple of things with you for security. So first off, [PII], what's a good callback number for you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then what is the member's policy number, please?
[CUSTOMER][NEUTRAL] That is going to be 02612502.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And she
[AGENT][NEUTRAL] any information that I do provide for you today would be a ver and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Uh let's see. Her name is [PII] and the last name is [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And her date of birth is gonna be [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, thank you, one moment.
[AGENT][NEUTRAL] OK, so [PII], um, again, any information provided would be a verification of benefits and not a guarantee of payment. I do show that she [PII] is the spouse of the subscriber on this limited benefit plan.
[AGENT][NEUTRAL] And it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] And you said it was a limited benefit for them.
[AGENT][NEUTRAL] Yes, this is a limited benefit plan. Yes, ma'am.
[AGENT][NEUTRAL] It is not major medical insurance.
[CUSTOMER][NEUTRAL] And she
[CUSTOMER][NEUTRAL] OK, not major medical.
[AGENT][NEUTRAL] And there, correct, and there is not a prior, there's no prior authorization required or referral.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then you said she is the best so she's not the uh.
[AGENT][NEUTRAL] It's not necessary.
[CUSTOMER][NEUTRAL] Um, um, yeah, referrals not necessary. She is a dependent. She's not the employee, correct?
[AGENT][NEUTRAL] Correct. She's a spouse. Mhm.
[CUSTOMER][NEUTRAL] Is the she's just out, OK.
[CUSTOMER][NEUTRAL] So her husband is the policy holder. OK, I need to switch that in her.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on the network question, this is part of the multi-plan.
[AGENT][NEUTRAL] Network
[CUSTOMER][NEUTRAL] OK, multi plan.
[AGENT][NEUTRAL] Now, to confirm whether your provider is in-network with the phone number for Multiplan, [PII], and then I can also connect you with them. Mhm.
[CUSTOMER][NEUTRAL] Uh let me.
[CUSTOMER][NEUTRAL] So this is a multiple. I'm almost positive we're in network with multi plan but just to be on the safe side, OK, and what's their their phone number?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, sure.
[AGENT][NEUTRAL] OK. The phone number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] and that's the multi-plan network.
[CUSTOMER][NEUTRAL] OK, no referrals, and this is just a limited benefit.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] You, you're able to transfer me correct.
[AGENT][POSITIVE] That is correct, yes ma'am.
[AGENT][NEUTRAL] I can transfer you, yes ma'am, and should you all end up filing a claim with uh on this with the with us for this number once the claim has been processed, [PII], we also have a portal that you should be able to check claim status in and our website for that is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], yes ma'am.
[CUSTOMER][NEUTRAL] OK and then do you have a call reference number for today?
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Yes, ma'am, you would use my name a long wait.
[CUSTOMER][NEUTRAL] OK. And your first name you said was [PII], correct?
[AGENT][NEUTRAL] And is there anything else that I could help you with before I
[AGENT][POSITIVE] That's correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, no, that is all that I need.
[AGENT][NEUTRAL] Is there anything
[AGENT][NEUTRAL] OK, and do you want me to connect you over to multi plan?
[CUSTOMER][POSITIVE] If you can please thank you.
[AGENT][POSITIVE] Certainly, I'd be happy to. So if that's all I can help you with, thank you for calling ATL and I hope you have a very nice rest of your day, [PII].
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][NEUTRAL] Uh, thank you. One moment.