AccountId: 011433970860
ContactId: 6d410bd3-c66d-41ce-bfd8-7e2c075dd1cb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 137009 ms
Total Talk Time (AGENT): 66315 ms
Total Talk Time (CUSTOMER): 43917 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/6d410bd3-c66d-41ce-bfd8-7e2c075dd1cb_20250114T21:34_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] So I'm calling from a doctor's office. I need to um do a pre-cert on a CT of the neck.
[CUSTOMER][NEUTRAL] Soft tissue in it.
[AGENT][NEUTRAL] OK, yeah, let me, let me do my best to help you out here and may I have your name please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] All right, Ms. [PII] and um do you mind if I get really quick a good callback number?
[CUSTOMER][NEUTRAL] Yeah [PII].
[AGENT][POSITIVE] Wonderful. And the member's policy number?
[CUSTOMER][NEUTRAL] Policy number is 02569587.
[AGENT][POSITIVE] Wonderful and give me a moment to get that all pulled up.
[AGENT][NEUTRAL] All right, and would you be able to please verify for me your patient's first and last name and date of birth?
[CUSTOMER][NEUTRAL] [PII] date of birth [PII].
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] Sorry, one second.
[AGENT][NEUTRAL] Alright, your patient's current and active with us. Um, this is a limited hospital indemnity policy. I can give you a quick benefits, um, update, but I can't, uh, we don't need prior authorization and we can't check codes over the phone for coverage.
[CUSTOMER][NEUTRAL] OK, so she's inactive right now?
[AGENT][POSITIVE] She is active. I'm sorry.
[CUSTOMER][NEUTRAL] You said oh she's OK she is active.
[CUSTOMER][NEUTRAL] So who do I call to do a pre-certs, do you know?
[AGENT][NEGATIVE] Um, we don't do those at our company. I'm so sorry, um, we, we can't really like.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] They call it paying claims over the phone and we can't do that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, I will try to figure this out.
[AGENT][NEUTRAL] Alright, um, if you do need like generic benefit information I can help you out there though.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK, now I'll, I'll just call the hospital. Our hospital should know who she goes through then.
[AGENT][POSITIVE] OK, perfect. Well, if there's anything else I can do for you, Miss [PII], give us a call back and we'll do our best to take care of you.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][POSITIVE] All right thank you.
[AGENT][POSITIVE] My pleasure. Bye bye.
[CUSTOMER][NEUTRAL] Bye.