AccountId: 011433970860
ContactId: 84b50961-c2ca-4d58-8e9c-edae04aa2889
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 253639 ms
Total Talk Time (AGENT): 100222 ms
Total Talk Time (CUSTOMER): 53963 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/84b50961-c2ca-4d58-8e9c-edae04aa2889_20250130T20:30_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII]. I'm calling from Nichola's Children's Hospital.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And how may I assist you?
[CUSTOMER][NEUTRAL] Um I just need to check uh if a CPT code is covered with the American public life.
[AGENT][NEUTRAL] OK, Ms. [PII], and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] How do I know what the policy number is?
[AGENT][NEUTRAL] It's gonna start with a 0 followed by 7 digits. If it's a secondary policy, it's gonna say outpatient cert.
[CUSTOMER][NEUTRAL] I have outpatient benefit cert number.
[AGENT][NEUTRAL] Mhm, yes, that's it.
[CUSTOMER][NEUTRAL] It's 01611.
[CUSTOMER][NEUTRAL] 790.
[CUSTOMER][NEUTRAL] M as in Mary, L as in Larry, 8.
[AGENT][NEUTRAL] All right. And what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so dependent for. OK. And what is that code?
[CUSTOMER][NEUTRAL] 30,560.
[AGENT][NEUTRAL] 30,560. And this is gonna take place outpatient facility or office?
[CUSTOMER][NEUTRAL] Um, it's gonna be outpatient on campus.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] One moment, let me put that code really quick.
[AGENT][NEUTRAL] And this is not a guarantee of payment, just a verification of coverage?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. Um.
[AGENT][NEUTRAL] So this is a secondary supplemental plan to the major medical. It has to be approved and the amount needs to be applied towards the deductible co-payment and co-insurance in order for us to um approve as well, OK? Um, so it looks like it is a, a cover procedure, um, as long as it's approved and paid by the major medical.
[CUSTOMER][NEUTRAL] Give me one
[CUSTOMER][NEUTRAL] You said as long as it it's approved in what I'm sorry.
[AGENT][NEUTRAL] Pay by the major medical because we're just a secondary.
[CUSTOMER][NEUTRAL] So it has to be paid by the primary, right?
[AGENT][POSITIVE] Correct, yes. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. Do you have any other questions for me or any other concerns?
[CUSTOMER][NEUTRAL] Um, can I just have a reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK. My name is [PII]. That's [PII], last initial is [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good afternoon, Ms. [PII].
[CUSTOMER][NEUTRAL] You too. Bye.
[AGENT][POSITIVE] Thank you. Bye-bye.