AccountId: 011433970860
ContactId: ed4ca2d0-e2c8-4076-b783-c192c67f6798
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 334910 ms
Total Talk Time (AGENT): 131180 ms
Total Talk Time (CUSTOMER): 75487 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/ed4ca2d0-e2c8-4076-b783-c192c67f6798_20250402T16:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I needed to see if I need a prior authorization for a home sleep test for a patient.
[AGENT][NEUTRAL] OK, I can help you with prior authorization. Can you please give me your name and your call back number and the name of the facility you're calling from, please?
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] Uh [PII], and it's [PII] and the excuse me, company name is Millennium Physicians Group.
[AGENT][NEUTRAL] OK, and then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, it's, the first name is [PII] The last name is [PII], and it's [PII].
[CUSTOMER][NEUTRAL] And the policy number is 02566221.
[AGENT][NEUTRAL] OK, let me look that up.
[AGENT][NEUTRAL] OK, and I do see that uh Ms. [PII] does have an active policy. The effective date of the policy is [PII].
[AGENT][NEUTRAL] And let me look at her benefits real quick.
[AGENT][NEUTRAL] To see if
[CUSTOMER][NEUTRAL] Uh, the CTP code is 9, yeah, it's 95,800. I don't know if you need to like look something specific for how that works.
[AGENT][POSITIVE] OK, yes, thank you, I appreciate that um.
[AGENT][NEUTRAL] I'm gonna pull up her policy and see if she has sleep or sleep benefits on her policy so it's gonna be just a second while the policy pulls in for us so I can read it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me see what it says real quick.
[AGENT][NEUTRAL] OK. So this is not um a primary major medical insurance. This is a limited hospital indemnity plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I'm looking to see, I do not see anything about sleep study.
[AGENT][NEUTRAL] Um, on her policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But let me check and see what her outpatient benefits are.
[AGENT][NEUTRAL] For you
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She has outpatient benefits for accident or sickness.
[AGENT][NEUTRAL] She gets 22, let's see, and it pays $50.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, for accident or sickness. Um, let me see if there's anything else in here that might help her.
[CUSTOMER][NEUTRAL] Yeah, I'm, I'm questioning why this is listed as like our first insurance I guess.
[CUSTOMER][NEUTRAL] We probably just need to get in touch with her and see if she has a different.
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh, she does have, let's see, physician's office. No, that's not gonna work. We want home.
[AGENT][NEUTRAL] Yeah, the only thing I see that would help her was is her outpatient benefit um for sickness or um accident and sick, oh no, that's surgery.
[AGENT][NEUTRAL] She's not having surgery. Let me keep looking. I'm sorry.
[CUSTOMER][NEUTRAL] That's OK, um.
[AGENT][POSITIVE] I'm trying to find anything I can that can help her out, you know.
[CUSTOMER][NEUTRAL] I'll probably
[CUSTOMER][NEUTRAL] Right, yep.
[CUSTOMER][NEUTRAL] Um, well, from my aspect, all I'm looking for is if there's a prior authorization needed, so I'm gonna say no, but then I'll just let them know that it's not, yeah.
[AGENT][NEUTRAL] No, because it's not the major medical, right.
[CUSTOMER][POSITIVE] Right, yeah, OK, all right, thank you for your help today I appreciate it, yep, thanks.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're so very welcome. Is there anything else, Ms. [PII], I can do for you before we go?
[CUSTOMER][POSITIVE] Nope, all set, thank you.
[AGENT][POSITIVE] OK, you have a wonderful day and thanks for calling APL.
[CUSTOMER][POSITIVE] Thanks.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye.