AccountId: 011433970860
ContactId: 7ad4732b-fdcc-4115-8d25-515f3346e043
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 205960 ms
Total Talk Time (AGENT): 95631 ms
Total Talk Time (CUSTOMER): 48607 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/7ad4732b-fdcc-4115-8d25-515f3346e043_20250403T14:54_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]. My name is [PII], and I am calling to check if priorop is required any member for outpatient diagnostic testing.
[AGENT][NEUTRAL] OK [PII], you're calling to find out if prior authorization is required for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] That is [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number, please?
[CUSTOMER][NEUTRAL] That is
[CUSTOMER][NEUTRAL] 02432980
[AGENT][NEUTRAL] OK [PII], thank you. Give me one moment to get the information uh pulled up for the member.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And [PII], do you also need eligibility or only just to know the prior author was required?
[CUSTOMER][NEUTRAL] Uh, just checking if prior op is required.
[AGENT][NEUTRAL] OK, so any information that I provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] And that is for [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you. So on this supplemental policy, [PII], he is a subscriber and there is no prior authorization required.
[AGENT][NEUTRAL] Now when the claim is submitted to APL review for review rather we will also have to have a copy of the primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Along with the claim.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal that you should be able to check our claim status in by going to secured.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. And is there anything else I can help you with?
[CUSTOMER][POSITIVE] All right, wonderful.
[CUSTOMER][NEUTRAL] Um, and then the only other thing I need is the first initial to your last name, and is there a call reference number?
[AGENT][NEUTRAL] Yes, and the reference number will be my name along with today's date and the first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK. All right, well thank you so much for your help today. I really do appreciate it.
[AGENT][POSITIVE] Well, well, you're very welcome and thank you again for calling APL. I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you. You as well bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.