AccountId: 011433970860
ContactId: b98c6362-4f6e-419a-a62c-09494f19e329
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286339 ms
Total Talk Time (AGENT): 104355 ms
Total Talk Time (CUSTOMER): 58070 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/b98c6362-4f6e-419a-a62c-09494f19e329_20250116T20:06_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, I'm trying to submit prior authorization for a patient.
[AGENT][NEUTRAL] OK. Um, sure, I can assist you. And may I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and may I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] D404-089-29
[AGENT][NEUTRAL] Excuse me. Do you see a policy certificate number? It's gonna start with a 0 followed by 7 digits. That's gonna be a number.
[CUSTOMER][NEUTRAL] Let me look.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 02559567
[AGENT][NEUTRAL] All right. And what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, I didn't pull that name, um.
[CUSTOMER][NEUTRAL] The insurance card I have is scanned in so it's kind of blurry. Can you pull up my name and date of birth by chance? just in case I had a number wrong.
[AGENT][NEUTRAL] OK, sure. Um, let me have the spelling of the last name.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the spelling of the first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] I'm waiting on the system.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I give this one let me try.
[AGENT][NEUTRAL] OK. Let me have that date of birth one more time.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, I found it. And what type of service is being rendered for the pre-op authorization?
[CUSTOMER][NEUTRAL] We are looking for a CT scan.
[AGENT][NEUTRAL] OK, right, for this particular policy, um, pre-authorization is not gonna be required because this is one of our limited hospital indemnity plan.
[AGENT][NEUTRAL] So it is a limited policy. It's not a major medical.
[CUSTOMER][NEUTRAL] It's a
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you explain to me what that means in just a few short words just so I know.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. Uh, it means that, um, we don't pay like, um, a percentages, there's no deductibles, co-payment or co-insurance. Uh, we pay a flat amount and anything remaining is up to the provider's discretion. We don't have any contractual involvement on the remaining. So we're just gonna pay that flat amount and that's all. So um since we're not a major medical, we do not require a pre-authorization or authorization.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK sounds good thank you very much.
[AGENT][NEUTRAL] We pay a small amount.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Nope, that should be it.
[AGENT][POSITIVE] OK, thank you for calling APO. Have a good day, Miss [PII].
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.