AccountId: 011433970860
ContactId: ca5b8f49-4b5d-43eb-ac91-7e6bbae3240c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 197039 ms
Total Talk Time (AGENT): 92672 ms
Total Talk Time (CUSTOMER): 68302 ms
Interruptions: 0
Overall Sentiment: AGENT=2.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/ca5b8f49-4b5d-43eb-ac91-7e6bbae3240c_20250509T19:01_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, hi [PII], my name is [PII] calling from the business office at [PII]. Um, I wanted to check if authorization is required for, uh, inpatient stay. Um, we did send notification but we haven't heard anything, so could you help me to see if there's any out on file?
[AGENT][NEUTRAL] OK, [PII], so you're wanting to verify prior authorization is required on an inpatient admission. Is that is that correct? Yes, ma'am, I can help you with that. And what is your callback number, please?
[CUSTOMER][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] [PII] and that's a direct number, [PII].
[AGENT][NEUTRAL] OK, thank you. And what is the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] It's 02495893.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is the patient's name, please, and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], and date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so he is a subscriber on this limited benefit plan and [PII] prior authorization is not required.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, it's not required.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Perfect. Um, it looks like there also is a note in the system where.
[CUSTOMER][NEUTRAL] They wanted a fax number. Do we have to fax over clinicals?
[AGENT][NEUTRAL] Uh, no, ma'am, for this coverage with APL again, this is not major medical insurance. This is a limited benefit plan. So there would not be any type of prior authorization for that required with us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claims would be filed and then reviewed and then once they've been reviewed um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There is a portal that you should be able to check our claim status in [PII] and that website's located at [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] But we would not have requested clinicals for prior, you know, like anything related to prior authorization.
[CUSTOMER][NEUTRAL] And public.
[CUSTOMER][POSITIVE] Got it. All right. [PII], I appreciate your time today. Do you have a reference number for today's call?
[AGENT][POSITIVE] Absolutely.
[AGENT][POSITIVE] Sure, you would actually use my name along with today's date.
[CUSTOMER][POSITIVE] I appreciate it, [PII] thank you so much you have a great rest of your day.
[AGENT][POSITIVE] Well, you. Oh, thank you, [PII]. I hope you do too, and I hope you have a wonderful weekend as well and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Mm