AccountId: 011433970860
ContactId: cc824a8e-f3ab-41f8-bede-09b13ed76742
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 166440 ms
Total Talk Time (AGENT): 80630 ms
Total Talk Time (CUSTOMER): 61238 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/cc824a8e-f3ab-41f8-bede-09b13ed76742_20250325T17:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I wanted to double check that we're in network with the patient's policy and to obtain benefits.
[AGENT][NEUTRAL] OK, I can help you with network for the patient's policy, Ms. [PII]. Can I please get your callback number and the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] [PII] and I'm calling from Colorado Gastroenterology.
[AGENT][NEUTRAL] OK, thank you. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII], date of birth is [PII] and her policy is gonna be 02563961.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, I do show that Ms. [PII] does have an active policy with us and her effective date is [PII], and there is no um network for this. Uh, this is a supplemental, it's not the major medical insurance.
[CUSTOMER][NEUTRAL] OK. So, um, whatever her primary doesn't cover the, um, her secondary will.
[AGENT][NEUTRAL] No, not with this policy, um, let me, uh, this is just to verify her coverage, it's not a guarantee of payment. She has a gap insurance that helps with deductible, co-pay and co-insurance only. Um, she has an inpatient benefit amount of $2000 per calendar year, and then she also has an outpatient benefit amount of $2000 per calendar year.
[CUSTOMER][NEUTRAL] Most likely, correct?
[AGENT][NEUTRAL] To help with deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK insurance, that's what I was medical insurance.
[CUSTOMER][NEUTRAL] OK. And I'm assuming with this policy, I don't need any prior authorization, correct?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Then I guess that's all that I needed to know. May I have a reference number for this call, please?
[AGENT][NEUTRAL] Yes ma'am, you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] OK, thank you so much, Ms. [PII].
[AGENT][POSITIVE] You're very welcome. I hope you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] Oh thank you. You too. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.