AccountId: 011433970860
ContactId: ab9fdc7d-e4ee-47a2-bc8f-bb11528790a2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219210 ms
Total Talk Time (AGENT): 101086 ms
Total Talk Time (CUSTOMER): 57066 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/ab9fdc7d-e4ee-47a2-bc8f-bb11528790a2_20250210T14:13_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] Good morning. This is [PII] speaking, and I'm calling on behalf of Doctor [PII] from Texas Digestive Disease Consultants, and I'm calling regarding uh authorizations.
[AGENT][NEUTRAL] I'm sorry, are you needing claim status?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] No authorizations. I need to determine if I need the authorization for colonoscopy and EGD.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh, you're, I'm sorry, you're needing to find out if prior authorization is required, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes ma'am, I can help you with that and who am I speaking with again? I'm sorry I didn't understand your name.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Can you spell your name for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, that's good. Thank you. And your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] 02503207.
[AGENT][POSITIVE] OK, thank you one moment.
[AGENT][NEUTRAL] And any information [PII] that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and date of birth?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] This is the patient [PII], uh, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, so I do show that she is the spouse of the subscriber on the supplemental policy, and the supplemental policy is active. Effective date is [PII] because this is a supplemental policy to the primary insurance for us, there is no prior authorization required.
[CUSTOMER][POSITIVE] Thank you so much. Uh, any call reference number?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, she would actually use my name along with today's date, and when you all file the claim with APL for our review, we must also have a copy of her primary insurance company's explanation of benefits as well.
[AGENT][NEUTRAL] And then once we have processed our claim Vaska, we do have a portal that you should be able to check claim status and have access to our EOB.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And our portal website for that is secured. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You are very welcome. Is there anything else that I can help you with?
[CUSTOMER][POSITIVE] No thank you have a wonderful day.
[AGENT][POSITIVE] I hope you have a wonderful day too, and thank you again for calling APL.