AccountId: 011433970860
ContactId: d16cc4fe-550f-4210-ab5c-3929e0ef9d03
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183259 ms
Total Talk Time (AGENT): 82912 ms
Total Talk Time (CUSTOMER): 65631 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/d16cc4fe-550f-4210-ab5c-3929e0ef9d03_20250304T20:27_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. This is [PII] in customer service.
[AGENT][NEUTRAL] Hey [PII], how are you doing?
[CUSTOMER][NEUTRAL] Doing good. Hey, I have a nurse from um provider's office calling to um have an authorization for a patient. Um her name is
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Her name is [PII] and the policy number is 259.
[CUSTOMER][NEUTRAL] 8049.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And she will be the spouse.
[AGENT][NEUTRAL] OK, um, you can send it through.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Uh, this is [PII], one of the nurses for [PII].
[AGENT][NEUTRAL] Oh, OK. I'm sorry about that. I didn't, she didn't, she didn't give me your name. You, you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yes [PII].
[AGENT][NEUTRAL] OK, and [PII], I'm [PII]. I'm on the care team. Um, so you were wanting like a prior authorization?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, a prior authorization for a medication.
[AGENT][NEUTRAL] OK, so there's um none of our APL policies require prior authorization because we're not a major medical insurance company.
[CUSTOMER][NEUTRAL] OK, cause she has been taking the Calita, but I guess they switched insurances to you guys, um, but she's having trouble picking that up now. Um, so what should she do?
[AGENT][NEUTRAL] Um, let me
[CUSTOMER][NEUTRAL] Because she said that you guys don't cover that?
[AGENT][NEUTRAL] Let me see what the benefits are. Hold on one second.
[AGENT][NEUTRAL] OK, so she has um a hospital indemnity policy, so it's a limited medical policy with us. Um, it's not like a major insurance company, you know, like Cigna, um, Blue Cross Blue Shield, and on this policy, there is, she has like wellness and diagnostic benefits, but as far as prescriptions, there's no coverage with this policy.
[CUSTOMER][NEUTRAL] So none of her medications would be covered?
[AGENT][NEUTRAL] Not with this policy, no, ma'am. It would be like, um, like if she's confined to a hospital or ever admitted, um, intensive care.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then um she has other additional benefits like wellness and diagnostic surgery.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. OK. All [PII]. I will let the provider know. Thank you for all that information.
[AGENT][POSITIVE] You're very welcome. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Nope, that was it.
[AGENT][POSITIVE] Alright, well thank you for calling [PII]. I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.