AccountId: 011433970860
ContactId: b67eb9a2-c5d6-4f08-bae1-3964c6ff16c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 377799 ms
Total Talk Time (AGENT): 148030 ms
Total Talk Time (CUSTOMER): 212512 ms
Interruptions: 10
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/b67eb9a2-c5d6-4f08-bae1-3964c6ff16c4_20250609T17:41_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APO. This is [PII].
[CUSTOMER][NEUTRAL] No, I, I read [PII].
[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL.
[CUSTOMER][POSITIVE] Hey, good morning.
[AGENT][POSITIVE] Let's try this again. Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Why?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hi, good afternoon. I'm calling because I wanted to check on a pre-authorization for a patient.
[AGENT][NEUTRAL] OK, you're wanting to verify prior authorization would be required for a member, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you. And last, what is your callback number?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] Um, you said policy ID?
[AGENT][NEUTRAL] I did, yes ma'am.
[CUSTOMER][NEUTRAL] I have it as 547-823-968.
[AGENT][NEUTRAL] OK. Is that the social?
[CUSTOMER][NEUTRAL] the front door
[AGENT][NEUTRAL] Cause that would not be a policy number for us.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I'm guessing, let me see, hold on, let me check that real quick.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Find you.
[CUSTOMER][NEUTRAL] OK, so the policy certificate number?
[AGENT][NEUTRAL] Uh, you do have that?
[CUSTOMER][NEUTRAL] Is that an
[CUSTOMER][NEUTRAL] Yes, it's gonna be 02622715.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] that
[AGENT][NEUTRAL] OK. And so what type of policy are you calling about, [PII]? The medical, dental, what type? OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, dental.
[CUSTOMER][NEUTRAL] Here we're looking to break into a maximum security prison. We were wondering if you have any gear that can help us.
[AGENT][NEUTRAL] OK, [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's gonna be [PII], and his date of birthday is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] I'm over there.
[AGENT][NEUTRAL] Well, I do show that he is a subscriber on this dental policy and it is active with an effective date of [PII]. There is no prior authorization required.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That one.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does he, um, well, it looks like they submitted it back on [PII] for the amount of 710 for scaling and route planning.
[CUSTOMER][NEUTRAL] Do you guys have like a mailing address or a fax number that we can fax it to?
[AGENT][NEUTRAL] OK, so you're, are you wanting to check claim status? Has the claim already been submitted?
[CUSTOMER][NEUTRAL] This
[CUSTOMER][NEUTRAL] No, it's a pre-authorization or predetermination request.
[AGENT][NEUTRAL] OK, and we do have something in line for review for him. When was it submitted?
[CUSTOMER][NEUTRAL] 52725.
[CUSTOMER][NEGATIVE] No, no.
[AGENT][NEUTRAL] Uh, give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, I'm gonna take 15 uh there we go.
[CUSTOMER][POSITIVE] We're actually loaded. Let's go I think they should be right.
[CUSTOMER][NEUTRAL] You, yeah, yeah, we got on that we don't know how to apply it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] And how did you all submit that to us, [PII]?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] It's um, they submitted it electronically.
[AGENT][NEUTRAL] And you said that was on [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the charge and you said the charge is 1710. Is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm gonna see if that's what's in line for reviews.
[AGENT][NEUTRAL] Bear with me just a moment.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] wait hold on you sell these things and wait.
[CUSTOMER][NEUTRAL] is
[CUSTOMER][NEUTRAL] This actually crazy.
[CUSTOMER][NEUTRAL] Or what, uh, hey, hold on, hold on guys, we're literally dragging on a plane this is uh.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah pay for all this stuff you know.
[AGENT][NEUTRAL] OK, so I can see that that has been, that has been received. That is what is in line for review, but it has not yet been reviewed.
[CUSTOMER][NEUTRAL] OK, sounds good so I'll just put it as pending. Do you know how long it takes for them to review something like this?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] Typically, uh, approximately 7 to 10 days, and we received this on the [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] According to the record, yes ma'am, so just give it a little, a little more time, [PII]. So is there anything, and I know that I had spoken with you before and also giving you our portal website so that if you all file a claim.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][POSITIVE] Sounds good.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] In the future that you all could.
[AGENT][NEUTRAL] Check claim status at [PII]. Yes, OK, alright, so is there anything else that I could help you with today, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, OK.
[CUSTOMER][POSITIVE] I know that's gonna be all. Thank you so much.
[AGENT][POSITIVE] OK, well, you're very welcome and thank you for calling APL. I hope you have a nice afternoon.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Uh-huh. You're welcome. Bye-bye.