AccountId: 011433970860
ContactId: 6a39354a-9690-40cd-ac43-39af752f563b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285700 ms
Total Talk Time (AGENT): 129817 ms
Total Talk Time (CUSTOMER): 74826 ms
Interruptions: 1
Overall Sentiment: AGENT=2.2, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/6a39354a-9690-40cd-ac43-39af752f563b_20250424T14:23_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. That's spelled as [PII] [PII]. I'm calling from facility to check authorization required or not and also for the network status.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that you're needing to verify if prior authorization.
[CUSTOMER][NEGATIVE] Sorry, I'm unable to hear you clearly.
[AGENT][NEUTRAL] What was your, what are you needing assistance with today?
[CUSTOMER][NEUTRAL] I'm looking for network status and also for authorization required or not for a member.
[AGENT][NEUTRAL] OK, so you're wanting to find you have a network question and you also want to find out if prior authorization is required, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And what is your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII] with the extension [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] Yep, the member ID is 021.
[CUSTOMER][NEUTRAL] 562
[CUSTOMER][NEUTRAL] 23
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] And send me the 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 date of birth?
[CUSTOMER][NEUTRAL] Name of the patient is [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] OK, thank you. So I do show she is the subscriber on the supplemental policy, and because it is a supplement to her primary insurance, there is no network with APL. This would follow her primary insurance and also there would be no prior authorization required with APL.
[CUSTOMER][NEUTRAL] OK, since, uh,
[CUSTOMER][NEUTRAL] Medicare is primary. No authorization will be required and there will be in network, right?
[AGENT][NEUTRAL] We do not show that Medicare is primary for her.
[CUSTOMER][NEUTRAL] OK. Could you please spell your name for me?
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] First initial to last name [PII], we showed a major medical insurance company as Blue Cross and Blue Shield of North Carolina.
[AGENT][NEUTRAL] Now, if a claim is going to be filed with APL for this member, we will also have to have a copy of her primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And lastly, um.
[AGENT][NEUTRAL] Well if we receive a claim once it has been processed, we do have a portal that you should be able to check claim status in by going to secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Your name is spelled as [PII], right?
[AGENT][NEUTRAL] No, sir. [PII].
[CUSTOMER][NEUTRAL] May I know the call reference number for this one?
[AGENT][NEUTRAL] My name and today's date.
[CUSTOMER][POSITIVE] OK, thank you [PII]. Thanks for your assistance.
[AGENT][NEUTRAL] All right. And is there anything else?
[AGENT][POSITIVE] Well, you're welcome, [PII]. Can I help you with anything else?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] All right. Well, thank you again then for.
[CUSTOMER][NEGATIVE] No thank you that's it.
[AGENT][POSITIVE] Thank you for calling APO and I hope you have a great day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Bye bye. Thank you.
[CUSTOMER][NEUTRAL] Yeah