AccountId: 011433970860
ContactId: a738b4db-9281-4ae8-b7f6-ab78032aaffa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 387320 ms
Total Talk Time (AGENT): 106752 ms
Total Talk Time (CUSTOMER): 112050 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/17/a738b4db-9281-4ae8-b7f6-ab78032aaffa_20250617T14:23_UTC.wav
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[AGENT][NEUTRAL] APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi sir, my name is [PII]. I'm calling from a mutual patients home delivery pharmacy with CVS Caremark Mailwater Pharmacy from our Fast Start department. I have the doctor's office on my back line calling in to get to the prior authorization department.
[AGENT][NEUTRAL] OK, uh, we generally don't do prior authorization. It's not required for most of our plans. Do you have any sort of member ID? I can double check for you?
[CUSTOMER][NEUTRAL] It's 251-415-43501.
[CUSTOMER][NEUTRAL] It should be for [PII].
[AGENT][NEUTRAL] That's actually too long to be one of our policy numbers. Um, I can look it up by their name if you can spell that for me or their social.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And then [PII]
[CUSTOMER][NEUTRAL] And then the date of birth should be [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I'm just gonna check on him real quick. I'll be right back.
[AGENT][POSITIVE] No problem, go ahead.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you so much for holding.
[AGENT][NEUTRAL] Yeah, not a problem. So I was able to locate a member plan. Would you like their policy number?
[CUSTOMER][NEUTRAL] Uh, sure.
[AGENT][NEUTRAL] It's 022.
[AGENT][NEUTRAL] 834-85.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][NEUTRAL] You're welcome. So no pre-op is required on the member's plan. It's a limited benefit plan, so it pays a set amount depending upon what they're being seen for. Um, if you're needing to check for in network provider or anything like that, that actually goes through multi-plan.
[CUSTOMER][NEUTRAL] What about the prior uh uh the pharmacy benefits?
[AGENT][NEUTRAL] Oh, pharmacy benefits.
[AGENT][NEUTRAL] Prescription and pharmacy benefits um look like they go through uh.
[AGENT][NEUTRAL] Yeah, through you guys you're calling from CVS Caremark, right?
[CUSTOMER][NEGATIVE] Yes, apparently the commercial doesn't take care of their, uh, prior authorization department for for pharmacy benefits.
[CUSTOMER][NEUTRAL] And so we've been trying to, we've been trying to get me and the doctor's office been trying to get you.
[CUSTOMER][NEGATIVE] The pharmacy benefits, uh, prior authorization department but we haven't been having that much luck.
[AGENT][NEUTRAL] OK. Uh let's.
[CUSTOMER][NEUTRAL] And I think the number that is so we called [PII] because it's saying that it's handled by.
[CUSTOMER][NEUTRAL] This, uh, this number.
[CUSTOMER][NEUTRAL] For prior authorizations, but every time we call it it's taken us to like.
[CUSTOMER][NEUTRAL] The member benefits that the members.
[CUSTOMER][NEUTRAL] Uh, medical benefits instead of the pharmacy benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, cause I show.
[AGENT][NEUTRAL] And you were, you said 4750056?
[CUSTOMER][NEUTRAL] Um, so which one is that?
[AGENT][NEUTRAL] So, for, it says I show on their card, for questions regarding prescription drug in a pharmacy network, it gives [PII].
[CUSTOMER][NEGATIVE] Yeah, I called that number. I called, I called as a member and I called as the doctor's office and they still couldn't get me to the place.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, that's
[CUSTOMER][NEUTRAL] Yeah, I think maybe
[AGENT][NEGATIVE] Cause yeah, I mean, we don't do.
[CUSTOMER][NEUTRAL] Maybe they just don't do the prior authorizations for it.
[AGENT][NEUTRAL] Yeah, we just don't do any prior off on our side usually. um.
[AGENT][NEUTRAL] And the only other number I have is.
[CUSTOMER][NEUTRAL] I just think she can do 7 my meds.
[CUSTOMER][NEUTRAL] Because they have another place where it's like an automated system thing so she could probably do that.
[AGENT][NEUTRAL] OK. All right. Yeah, I'm sorry, I don't have any other information on that.
[CUSTOMER][POSITIVE] Are you OK, thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] Thank you you too.