AccountId: 011433970860
ContactId: a64ea3de-7d3d-465d-bc1c-74ff7efdb591
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 196979 ms
Total Talk Time (AGENT): 69389 ms
Total Talk Time (CUSTOMER): 53870 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/a64ea3de-7d3d-465d-bc1c-74ff7efdb591_20250619T16:28_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] with Doctor [PII]'s office, and I'm trying to find out if pre-certification is required for sleep studies for a patient.
[AGENT][NEUTRAL] Um, we don't require prior author or pre-cert for any services because we're secondary or supplemental.
[CUSTOMER][NEUTRAL] OK, that's interesting because this patient said this is the only insurance that she has.
[AGENT][NEUTRAL] OK. Do you wanna check benefits or eligibility?
[CUSTOMER][NEUTRAL] Um, we might check benefits just to be on the safe safe side.
[AGENT][NEUTRAL] OK, [PII], could I get a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And what's that policy number? Do you have that?
[CUSTOMER][NEUTRAL] It is 02559742.
[AGENT][NEUTRAL] And what was the patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I show the policies effective [PII].
[AGENT][NEUTRAL] Let me pull up her benefits. Give me just a moment.
[AGENT][NEUTRAL] Anything I quote on a guarantee of payment, it's a basic outline of the policy.
[AGENT][NEUTRAL] Um, so is this study gonna be done in an outpatient hospital facility or?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, uh huh.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Well, it looks like for this policy, so this is like a limited hospital indemnity policy.
[AGENT][NEUTRAL] Um, I'm not showing they have services, um, payable for surgery in an outpatient hospital facility, um, but I know sleep study is not surgery. Um,
[AGENT][NEUTRAL] Uh
[AGENT][NEGATIVE] It doesn't look like she has coverage for that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you mind if I could get a call reference number?
[AGENT][NEUTRAL] Sure, it's uh my name is [PII], first initial to last name, [PII], and today's date.
[AGENT][POSITIVE] And anything else I can help with today?
[CUSTOMER][POSITIVE] Nope, that should be everything thank you so much.
[AGENT][POSITIVE] OK, thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] You too, thanks.
[AGENT][POSITIVE] Thanks bye bye.
[CUSTOMER][NEUTRAL] Mhm bye.