AccountId: 011433970860
ContactId: ed3b6b13-9781-464a-ba59-c59475391a4d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 308339 ms
Total Talk Time (AGENT): 156157 ms
Total Talk Time (CUSTOMER): 138247 ms
Interruptions: 4
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/ed3b6b13-9781-464a-ba59-c59475391a4d_20250213T18:02_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. You're speaking with [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Yes, hi, [PII]. My name is [PII] and last name [PII] is the letter [PII] Um, I'm calling to initiate a hospital to hospital inpatient authorization transfer off for one of your members.
[AGENT][NEUTRAL] All right. Can I have your phone number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure. It is [PII], option 2.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And may I have the spelling of your name, please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, got it. I got it right. Thank you. Just checking.
[AGENT][NEUTRAL] All right. All right. May I have your, uh, policy number?
[CUSTOMER][NEUTRAL] Yes, it is 1,124,470.
[AGENT][NEUTRAL] OK, that's give me that number again, that was too many numbers. What is it?
[CUSTOMER][NEUTRAL] 1,124,470.
[AGENT][NEUTRAL] All right. And that patient name?
[CUSTOMER][NEUTRAL] [PII] is the first name and last name is [PII]
[AGENT][NEUTRAL] And what's the date of birth?
[CUSTOMER][NEUTRAL] His date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, that policy number you gave me for him, that policy terminated 121 [PII]. Do you have a more active policy for him?
[CUSTOMER][NEUTRAL] Yes, um, I have 445.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] No, that wouldn't be our number with a 4. It'll start with a 0 and either be a 1 or a 2. So if we start with a 4.
[AGENT][NEUTRAL] So do you, let me see, let me see, can I look and see.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Let me check because that's the number I was provided. Hold on one second.
[AGENT][NEUTRAL] OK, I'm gonna see if he got another policy with us.
[AGENT][NEUTRAL] Mm let me get this social down and bring it up [PII].
[AGENT][NEUTRAL] Yeah um.
[CUSTOMER][NEUTRAL] there is an authorization for the current facility. I don't know if you wanna pull it like that, and then maybe.
[CUSTOMER][NEUTRAL] Get that information from them.
[AGENT][NEUTRAL] On our policy, on our policy, there's no authorization needed. This is the patient's secondary policy that he had with our company and we would need no kind of authorization for any medical treatment. It just all depend on what the primary applied towards the uh.
[AGENT][NEUTRAL] Apply towards the deductible, but let me see, I did find another policy. Let me see if this one active in 903.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, he do have an active policy with us. That's fine. He, he do have an active policy with us. The effective date was [PII] and that policy number is 01979903.
[CUSTOMER][NEUTRAL] They told me to call this number. OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, that makes sense now, because I was giving this number to call and I'm like, how did they get the off? OK. So, um.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, now, what do you, what do you need?
[CUSTOMER][NEUTRAL] So, the member is currently at doctor's hospital and they already got an authorization for that stay, but we need to transfer this member to um another facility um due to needing higher level of care.
[CUSTOMER][NEUTRAL] Uh, and we need to provide a prior authorization for that receiving facility.
[CUSTOMER][NEUTRAL] Um, so we can transfer the patient.
[AGENT][NEUTRAL] OK. As I, OK, as I stated earlier, this is the patient's secondary policy. There's no authorization needed for anything with our company, so you probably need to contact his primary because this is a secondary. It's a gap plan and it's all based on what the primary applied towards the copay, co-insurance, and deductible. So no authorization is needed from American Public Life.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right. And I show um,
[CUSTOMER][NEUTRAL] The primary gravy in.
[CUSTOMER][NEUTRAL] Insurance company, but, um, they told me to call this number, but
[AGENT][NEUTRAL] I would know that because we don't, we don't do anything with the primary. We only deal with when you send in the medical bill. So you have to find out from him who his primary is with, but we're just secondary. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Got it. Yeah, that's what I show here. That's why I was wondering why they asked me to call this number, but um uh thank you very much for your clarification and uh updated.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK. OK.
[AGENT][POSITIVE] You're welcome. Anything else I can help you with today, [PII]?
[CUSTOMER][NEGATIVE] Uh, no, no
[CUSTOMER][POSITIVE] Have a great day.
[AGENT][POSITIVE] All right, thank you for calling American Public Life. You have a wonderful day. Bye-bye.