AccountId: 011433970860
ContactId: f0e216b6-316d-4125-97ba-30ae8ff14c14
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273059 ms
Total Talk Time (AGENT): 123282 ms
Total Talk Time (CUSTOMER): 101654 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/f0e216b6-316d-4125-97ba-30ae8ff14c14_20250519T18:39_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII], how are you doing?
[AGENT][POSITIVE] I'm good and you?
[CUSTOMER][NEUTRAL] Hi, thank you. My name is [PII]. First, my last name is [PII], I am calling from the facility, um, calling because we had a patient to come into the emergency room. Patient got admitted. The patient is still in-house. The patient gave the card indicating that this is the secondary. Now, I did verify with the young lady, um, [PII], and she gave me all that information about the patient's um insurance.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] But I forgot to ask her um was authorization going to be required for this?
[AGENT][NEUTRAL] OK [PII], so you're needing to verify authorizations required for an admission based on the coverage the member has with us. Yes, ma'am, I'll be happy to check that and I can help you with that. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] My direct line is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you and the policy number for the member?
[CUSTOMER][NEUTRAL] 02409018
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments to get that member's information all pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information provided would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] This is for [PII]'s date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and so on this supplemental policy, no, ma'am. There is no prior authorization required, [PII], with APL, and I don't know if [PII] mentioned this to you, but because it is a supplement to his primary insurance, when the claim is submitted to APL for review, we must also receive a copy of his primary insurance company's explanation of benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] As well
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed our claim here at APL we do have a portal that you all should be able to check claim status in and the website for that portal is located at secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] So that's [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, ma'am, that's it.
[CUSTOMER][NEUTRAL] OK, and you said that um.
[CUSTOMER][NEUTRAL] For these claims to be processed that you that you need a copy of the primary um COB.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] The primary, no, EOB.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Explanation I've been, mhm.
[CUSTOMER][NEUTRAL] EOB hold on I wrote it wrong.
[AGENT][NEUTRAL] The primary insurance companies.
[CUSTOMER][NEUTRAL] Yeah, for coordination of benefit.
[AGENT][NEUTRAL] Explanation of benefits showing the amounts supplied to the deductible co-pay or co-insurance.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, copay uh coinsurance.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Those are the only two that'll cover the copay and the coinsurance.
[AGENT][NEUTRAL] Deductibles, it's deductibles, co-pays, and co-insurances of covered services.
[CUSTOMER][MIXED] Deductible but not out of pocket.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, alright, [PII], what is the first initial of your last name, please?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And do I use today's date as a reference to our account number as well?
[AGENT][NEUTRAL] My name and correct. my name along with today's date.
[CUSTOMER][NEUTRAL] Alright then, [PII], that's all I needed.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, well, if that is all I can help you with, [PII]. It was my pleasure in speaking to you today and thank you again for calling APL. I hope you have a wonderful afternoon.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.