AccountId: 011433970860
ContactId: 70750dbc-3e04-4b51-8676-29624e18179b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 252990 ms
Total Talk Time (AGENT): 82976 ms
Total Talk Time (CUSTOMER): 94336 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/70750dbc-3e04-4b51-8676-29624e18179b_20250616T19:19_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm calling from Worcester Urology. I'm calling to check and see if pre-cert is required on a particular procedure. I believe I've already called on it, but I didn't make any notations as to who I talked to or anything, so I'm wondering if maybe if you look at the account you'll see something.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] Sure, no problem. And Ms. [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Certainly it's [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And I am [PII].
[AGENT][NEUTRAL] 26. OK. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] It is 302-766-511.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, is that the, that sounds like a claim number but not like a policy number. Do you have any other numbers on the policy number?
[CUSTOMER][NEUTRAL] 15
[AGENT][NEUTRAL] Or is that a social?
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] I got a copy of his card here. Let me just make sure that I'm reading it correctly off the card here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, his card is APL through multi plan. The policy or certification number is 02586238.
[AGENT][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Oh yep, I was reading you the wrong patient sorry.
[AGENT][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] All right. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you. All right, Ms. [PII], let's see.
[AGENT][NEUTRAL] OK, so what type of procedure is it?
[AGENT][NEUTRAL] For research.
[CUSTOMER][NEUTRAL] OK, I have two I have two CPT codes. The first one is 50,590.
[CUSTOMER][NEUTRAL] The second one is 52353.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Yeah, the recession is not gonna be required on those, um, this particular policy is a limited hospital indemnity plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the procedure is going to be done outpatient at the hospital, so will our provider and the hospital be paid when you say it's a limited?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, we, we only cover the surge, the surgeon charges, but not the facility charges. So this will only cover the surgery. It will cover actual charges um from the surgeon or the anesthesiologist, but it will not cover any um facility charges.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] All right, I will let them know thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] No, that was all.
[AGENT][POSITIVE] OK. Well, thank you for calling APL. Have a good afternoon, Ms. [PII].
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.