AccountId: 011433970860
ContactId: e78c4c4e-9f46-4b68-9135-0e0571476fa0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 192960 ms
Total Talk Time (AGENT): 85122 ms
Total Talk Time (CUSTOMER): 52838 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/e78c4c4e-9f46-4b68-9135-0e0571476fa0_20250530T15:52_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII], last initial [PII] I am a utilization review nurse at Progress West Healthcare.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I have a patient, uh, [PII].
[CUSTOMER][NEUTRAL] It's in our hospital right now and his insurance is listed as you guys, so I wanted to call and um get the authorization started if you do cover medical.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK [PII], so you're wanting to verify eligibility and see if prior authorization is required?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am, I can help you with those things. And what is your callback number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] Uh, looks like it's 02221072.
[AGENT][NEUTRAL] OK, thank you. Give me a moment while I say to get that information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And my seeing 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 and their date of birth?
[CUSTOMER][NEUTRAL] [PII], which is [PII] Date of birth, uh [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so [PII], I do show that he is a subscriber on this hospital indemnity limited benefit plan. This is not a major medical policy, um, and this policy is active, effective [PII].
[AGENT][NEUTRAL] And there would not be any prior authorization required on this policy.
[CUSTOMER][POSITIVE] OK, that's what I was calling to find out. Thank you so much I appreciate it.
[AGENT][NEUTRAL] Well, you're very welcome and then lastly, [PII], if you will end up filing a claim with this with us for this member once the claim has been processed, we do have a portal that you all should be able to check claim status in and our website for the portal is located at [PII].
[CUSTOMER][POSITIVE] OK, thank you so much appreciate that.
[AGENT][POSITIVE] Well, you, you are certainly very welcome and again if that's all I can help you with, thank you for calling APL and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye bye.