AccountId: 011433970860
ContactId: dff0bb13-a4b5-43da-90d1-a733ac78038c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 132139 ms
Total Talk Time (AGENT): 79135 ms
Total Talk Time (CUSTOMER): 45880 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/dff0bb13-a4b5-43da-90d1-a733ac78038c_20250314T14:03_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], and I'm calling from AMed Orthopedics and Sports Medicine.
[CUSTOMER][NEUTRAL] I was calling to see if a patient requires authorization or prior notification for an outpatient procedure please.
[AGENT][NEUTRAL] OK, [PII], I can certainly look that up. What is that policy number, please?
[CUSTOMER][NEUTRAL] It is 02587142.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][POSITIVE] OK, I appreciate that. Is there a callback number I can have in the event that we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, the direct number is [PII].
[AGENT][NEUTRAL] OK, I do appreciate that. So this is a secondary or gap insurance, um, and, uh, so it is uh it doesn't really have to have a pre-authorization for anything as long as you're in network with the um major medical. Now this went into effect on [PII], but what will happen is you'll, you'll go through the major medical first and as long as there's a deductible, co-payment or co-insurance, uh, we will pick that up.
[AGENT][NEUTRAL] Now, the benefit for that is up to $500 per calendar day. That's just a verification, not a guarantee payment, but we're fine wherever it is that you get, you know, whatever procedure you're doing, as long as it's for sickness or accident and there is a deductible, co-payment or co-insurance. So really the pre-op is going to come from the major medical but not from us. We, we don't need it.
[CUSTOMER][NEUTRAL] OK, um, usually most secondaries don't, but some of them have been, so we have to like we're required to call all secondaries now, um, do you?
[AGENT][NEUTRAL] Of course, yeah, absolutely, yeah, no, I just wanted to reassure you, you don't need it with us.
[CUSTOMER][NEUTRAL] Oh no, yes, perfect, and do you provide call reference numbers just stating we've spoken?
[AGENT][NEUTRAL] Uh, yes, my name is [PII]. The first letter of my last name is [PII], and we're gonna use that today's date as a reference. Now is there anything else at all that I can help with? Any other questions that you might have about raising the claim, or?
[CUSTOMER][POSITIVE] No, that was everything thank you so much for your help today [PII].
[AGENT][POSITIVE] OK, well thank you for contacting APO have a good day. Have a good week.