AccountId: 011433970860
ContactId: 6838d337-3530-411c-9b44-d314120a80a7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247800 ms
Total Talk Time (AGENT): 101819 ms
Total Talk Time (CUSTOMER): 111285 ms
Interruptions: 2
Overall Sentiment: AGENT=1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/6838d337-3530-411c-9b44-d314120a80a7_20250129T17:33_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII], and I am calling from a provider's office. I never, um, actually dealt with this in this insurance. I was hoping you might be able to help me.
[AGENT][POSITIVE] OK, um, I can assist you, um, Ms. [PII], and may I have a callback number just in case we get disconnected? You're welcome.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Absolutely area code [PII]. That's my direct no extension.
[CUSTOMER][NEUTRAL] Sorry, excuse me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] It's OK. You said [PII]?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK and um where am I calling to if I call back?
[CUSTOMER][NEUTRAL] Oh, that's my um direct line sorry, and I have a um confidential voicemail.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and you're calling from which uh facility provider?
[CUSTOMER][NEUTRAL] So I'm calling from the office of Doctor [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have a policy number for me, Ms. [PII]?
[CUSTOMER][NEUTRAL] Uh yes, it's 01852008.
[AGENT][POSITIVE] OK. Thank you.
[AGENT][NEUTRAL] And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yes, uh, name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you, Ms. [PII]. How may I assist you with this number?
[CUSTOMER][NEUTRAL] I just wanted to know if an authorization is required for a CT scan of his sinuses.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] No, um, this is a secondary supplemental plan to the major medical and authorization is not gonna be required. Um, let me go ahead and check. We follow primary. Um, let me go ahead and check and if we cover, and this is gonna be an outpatient facility or is it gonna take place in the office?
[CUSTOMER][NEUTRAL] In the office
[AGENT][NEUTRAL] It's gonna be in the office, OK, um, let's see.
[AGENT][NEUTRAL] And this is not a guarantee of payment, just a verification of coverage. It looks like um we do cover office procedures or office treatment, and this is subject to the outpatient maximum which is $6800 per covered person per calendar year after a $100 deductible per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and the authorization isn't required because you're secondary.
[AGENT][NEUTRAL] And I'm sorry, did I say 100? Did I say 1000? I do apologize.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, you said 100. It's OK, it's, it's 1000.
[AGENT][NEUTRAL] It's 1000. I'm so sorry. Yes, it's 1000.
[CUSTOMER][NEUTRAL] OK, no, that's OK, that's fine. Hey, listen, there's a lot of, there's a lot of zeros sometimes I get confused too. It's fine.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] And it is Wednesday, so it's it's, it's the middle of the week thank [PII], um.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so it's 1000, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the prior, the prior authorization is not required because it's um this is a secondary insurance.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, I have 2 more quick questions. I promise I won't bother you again for the rest of the day. One, what is the um first initial to your last name?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And do you have a call reference number for me?
[AGENT][NEUTRAL] We don't. You can use my name in today's name, [PII].
[CUSTOMER][NEUTRAL] OK, what time is it where you are?
[AGENT][NEUTRAL] It is [PII]
[CUSTOMER][POSITIVE] [PII] perfect thank you so very much for all your help. You have a great day and enjoy the rest of your week.
[AGENT][POSITIVE] You're welcome. You as well, Ms. [PII], and thank you for calling APR. Have a good week. You're welcome. Bye bye.
[CUSTOMER][POSITIVE] Thank you you too.
[CUSTOMER][NEUTRAL] Bye.