AccountId: 011433970860
ContactId: 5aa18102-13f5-478a-9660-df2d99a07bcf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 203199 ms
Total Talk Time (AGENT): 101223 ms
Total Talk Time (CUSTOMER): 79192 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=2.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/27/5aa18102-13f5-478a-9660-df2d99a07bcf_20250327T17:25_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] Hi, good afternoon. My name is [PII]. I'm calling from McCloud Regional Medical Center. How are you today?
[AGENT][POSITIVE] I'm good. How about you, Mr. [PII]?
[CUSTOMER][NEUTRAL] I'm good, thank you for asking. Um, I am calling just to verify um eligibility and to verify prior authorization for a CPT code.
[AGENT][NEUTRAL] OK, sure, I can assist you with eligibility in PR. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, so my direct line will be [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And you said you're calling from, from an outpatient facility, correct? Or is it an office?
[CUSTOMER][NEUTRAL] Yes, so I'm actually calling from the provider's office, yes ma'am.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] All right. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, so it's going to be 1,554,900.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Mm, perfect. Thank you, Mr. [PII]. All right. And we have an effective date of [PII]. It is active at the moment and this is one of our secondary supplemental plan to the major medical. And what type of service is being rendered?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So, it's gonna be a poly sonogram. I can give you the CPT code whenever you're ready.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Uh, it's OK. I'm not gonna need that. I just need to know what type is it. Um, OK, so, and this test is gonna be taking place in an office setting.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, actually it's gonna be um on campus by outpatient.
[AGENT][NEUTRAL] OK, when you say on campus by outpatient, are you talking about an outpatient facility or is it gonna be on the specialist office?
[CUSTOMER][NEUTRAL] Outpatient facility.
[AGENT][NEUTRAL] OK. All right. Now, let me go ahead and this is not a guarantee of payment, just a verification of coverage. Um, pre-authorization or pre-certification is not gonna be required because we're just a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] And all outpatient testing, go ahead. I'm sorry.
[CUSTOMER][POSITIVE] Perfect. OK. I just want.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, you go ahead. I'm sorry, go ahead.
[AGENT][NEUTRAL] OK. And it looks like all outpatient testing is subject to the outpatient maximum, which is 1000 per occurrence.
[CUSTOMER][POSITIVE] OK, perfect, thank you so much for the information. I figured it was not required, but I just wanted to make sure. um, may I have your name again along with your last name initial, please?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure. My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] Perfect. And do you have a reference number for this call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK. Sounds great. Well, thank you so much for verifying the information for me. I hope you have a great day.
[AGENT][POSITIVE] You're welcome. You as well, and thank you for calling APO. Goodbye Mr.
[CUSTOMER][POSITIVE] Thank you. Bye bye.
[AGENT][NEUTRAL] Yeah