AccountId: 011433970860
ContactId: b41014a0-b0d0-4933-a333-314e839651ac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 144539 ms
Total Talk Time (AGENT): 44485 ms
Total Talk Time (CUSTOMER): 64920 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/b41014a0-b0d0-4933-a333-314e839651ac_20250127T21:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, good afternoon, [PII]. My first name is [PII]. It's [PII]. First initial to my last name is [PII]. Can I get the first initial of your last name, [PII]?
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] Alright, as I stated, I'm calling from SSM House Saint Joseph Lake Saint Louis Hospital. I just need to run a couple of CPT codes by you for a patient's appointment to see if prior off would be needed or not, if possible.
[AGENT][NEUTRAL] OK, and is this for outpatient facility?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, what's the policy number?
[CUSTOMER][NEUTRAL] Policy number is 778982.
[AGENT][NEUTRAL] And your phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII] direct line no [PII].
[AGENT][POSITIVE] Thank you, [PII]. One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, it's a [PII], date of birth [PII].
[AGENT][POSITIVE] Alright, thanks for that information and you can just give me the description of the codes if you have that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. So it's a um mammogram bilateral and it's an ultrasound.
[AGENT][NEUTRAL] OK. Is it for uh uh medical concern or for wellness?
[CUSTOMER][NEUTRAL] Um, wellness.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] And so wellness services is not covered.
[CUSTOMER][NEUTRAL] You know what, you know what time yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I was just gonna say, I'm sorry, it is for uh abnormal finding on a breast image, so it would be for, it wouldn't be for wellness. I'm sorry because of the di I looked at the diagnosis code. I'm sorry.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] OK, so a prior authorization is not required.
[CUSTOMER][NEUTRAL] OK, and can I just get a reference number from you, [PII]?
[AGENT][NEUTRAL] You'll use my name in today's date is your reference [PII] and first initial of my last name is [PII]. And any other questions you feel I can help out with today?
[CUSTOMER][POSITIVE] No, that's it you've been great thank you so much.
[AGENT][POSITIVE] You're welcome thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Bye bye.