AccountId: 011433970860
ContactId: 6f3340b6-41d1-45a3-b698-4241f6447efd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 246880 ms
Total Talk Time (AGENT): 124907 ms
Total Talk Time (CUSTOMER): 61080 ms
Interruptions: 1
Overall Sentiment: AGENT=1.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/6f3340b6-41d1-45a3-b698-4241f6447efd_20250403T15:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, my name is [PII], and I'm calling from EBA Health. I was calling, um, from an ordering physician's office to see if a prior authorization was needed for a specific CBC code code.
[AGENT][NEGATIVE] OK, so, OK, so first off, I'm having trouble hearing you. There's a terrible echo on the line and it sounds like you're very far away.
[CUSTOMER][NEUTRAL] OK, is that better?
[AGENT][POSITIVE] Could you, that's extremely better. Yes, ma'am. Could, so can you please repeat what you said?
[CUSTOMER][NEUTRAL] Yes, so I'm calling, um, we have a patient this is their secondary insurance and I was just calling to make sure that we were in network because this is an insurance we've never dealt with before and then to verify if a prior authorization is needed for a CPT code.
[AGENT][NEUTRAL] OK, so you're needing to verify network and whether prior authorization is required, is that correct?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that, [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK, thank you and the member's policy number, please?
[CUSTOMER][NEUTRAL] Uh, let me pull it back up here.
[CUSTOMER][NEUTRAL] Uh, member ID is 022879969.
[AGENT][NEUTRAL] Oh, I'm so sorry you're going out again. 02287.
[CUSTOMER][NEUTRAL] 969.
[AGENT][NEUTRAL] 969. OK, thank you, one moment.
[AGENT][NEUTRAL] And [PII], any information that I provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so, uh, I do show that he is the subscriber, Alexis, on the supplemental policy.
[AGENT][NEUTRAL] And this supplemental policy is active with an effective date of [PII], because this is a supplement to his primary insurance, there's not a network with APO it would follow his primary.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] There is no also no prior authorization required. Now when you all file the claim with APL for our review, we will have to have a copy of his primary insurance company's explanation of benefits as well along with the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have reviewed the claim and it's been processed by APL we do have a portal in which you should be able to check claim status.
[AGENT][NEUTRAL] And our portal website is located at secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and what was your first name and first initial to your last?
[AGENT][NEUTRAL] My first name is [PII], initial [PII], and my name along with today's date, [PII] would be your call reference number.
[CUSTOMER][POSITIVE] OK, alrighty well thank you so much I appreciate your help with this.
[AGENT][POSITIVE] All right. Well, yes, ma'am. You're very welcome. And is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, no, ma'am, that's gonna be it.
[AGENT][POSITIVE] OK, well thank you so much then for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.