AccountId: 011433970860
ContactId: b934fe8e-9392-415c-973a-7e841e9ec3eb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 144539 ms
Total Talk Time (AGENT): 63320 ms
Total Talk Time (CUSTOMER): 65257 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/b934fe8e-9392-415c-973a-7e841e9ec3eb_20250318T18:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. I'm calling from Adina Regional Medical Center in [PII]. Um, we have a patient.
[CUSTOMER][NEUTRAL] That has Aetna insurance and then they also have your insurance and they're listing the generic as the primary insurance so I just need to verify what sort of insurance she has on file and verify if something requires prior authorization.
[AGENT][POSITIVE] I'll be happy to help you with that all. May I have a policy number?
[CUSTOMER][NEUTRAL] Policy number is 255025532777.
[AGENT][POSITIVE] Thank you. May I have a good callback number for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. May I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] Thank you for verifying that information. Please be advised that verification of coverage does not guarantee the payment of a claim. This policy is effective [PII] and it is active. This plan will always be secondary to their primary and prior authors not required.
[CUSTOMER][NEUTRAL] OK, and then, um, I guess, so that's all I need to know and what's the reference number for the call?
[AGENT][NEUTRAL] It will be my name, which is [PII] Last initial is [PII] along with today's date.
[CUSTOMER][NEUTRAL] OK, um, do you happen to know, um, I, I think what she's getting done on this instance is a sleep study. Do you know if that's a covered benefit for her?
[AGENT][NEUTRAL] Would it, where would the place of service be?
[CUSTOMER][NEUTRAL] Outpatient at the hospital?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, actually, actually, I'm sorry, home sleep study, it's, it's gonna be at home.
[AGENT][NEUTRAL] OK, so if it's home sleep study, she does not have the benefit for that. So no, it will not be covered if it's at home.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It has to be in a doctor's office.
[CUSTOMER][NEUTRAL] OK, but then.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] OK or facility and and and if it, if she does get one in a facility uh that wouldn't require prior authorization though.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] OK, great. OK, thanks [PII], I appreciate it.
[AGENT][POSITIVE] Oh, you're so welcome and thank you for calling American Public Life. Have a great day. Bye-bye.
[CUSTOMER][NEUTRAL] You too bye bye.