AccountId: 011433970860
ContactId: f9044699-7829-47c1-bed5-b562719ce54d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 540719 ms
Total Talk Time (AGENT): 176978 ms
Total Talk Time (CUSTOMER): 241513 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/f9044699-7829-47c1-bed5-b562719ce54d_20250211T20:52_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling ATL. This is so. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, very good afternoon. I would like to inform you that this call has been recorded for quality and training purpose. My name is [PII]. Last name [PII], calling from Naira facility. Can I have your name and last name initial, please?
[AGENT][NEUTRAL] My name is [PII]. That's [PII]. Last initial [PII], and I need the spelling of your name.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and may I have a callback number just in case we get disconnected and disconnected?
[CUSTOMER][NEUTRAL] Sure. It's [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It's uh 206-238-446.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] Is this a social, Mr. [PII]? Uh, it's too long to be one of our policy numbers.
[CUSTOMER][NEUTRAL] right.
[CUSTOMER][NEUTRAL] Uh sorry, I didn't get that.
[AGENT][NEUTRAL] The number you just provided to me, is that a social or is it a policy number? Because it's a little too long to be a policy number of ours.
[CUSTOMER][NEUTRAL] Uh, this is the policy number which I have, but can you check with the member's first name and last name, date of birth?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. Um, let me have the spelling of the last name.
[CUSTOMER][NEUTRAL] Uh, OK. The last name is [PII], then it's [PII].
[CUSTOMER][POSITIVE] Take care bye bye.
[AGENT][NEUTRAL] OK, the first letter, was it [PII]?
[CUSTOMER][NEUTRAL] Uh, the first name is [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] So the last name, she has two last names?
[CUSTOMER][NEUTRAL] I just, uh, this is the first name, [PII], and the last name is
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So she has two last names. OK, OK, bear with me.
[CUSTOMER][NEUTRAL] Do you want the date of birth as well?
[AGENT][NEUTRAL] Uh, not right now. Give me just a second. Let me do a name search because we cannot search by date of birth, OK? One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I I.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me try one more time and you said [PII] is separate correct?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do have one more number if you want.
[AGENT][NEUTRAL] You have what? I'm sorry?
[CUSTOMER][NEUTRAL] I do have one more member ID if you want if you're not able to pull up that number with the member ID. I have one more.
[AGENT][NEUTRAL] OK, give me the next one then because yeah, I cannot find that one.
[CUSTOMER][NEUTRAL] 02464215.
[AGENT][NEUTRAL] OK, let me try that. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it's [PII]. I'll spell out for you. It's last name, [PII]. And the first name is [PII]. It's [PII], and [PII].
[CUSTOMER][NEUTRAL] And the date of birth is [PII].
[AGENT][NEUTRAL] OK perfect thank you may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII]. However, I'm not calling about the claim. I, I'm calling to check the authorization requirements for genetic testing.
[AGENT][NEUTRAL] Mm, OK, so it's for future service. OK, bear with me. Let me see if I have any policies. This one is terminated.
[AGENT][NEUTRAL] OK, um, I don't have an active policy for this member. This one was effective [PII] and it terminated [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, mhm.
[CUSTOMER][NEUTRAL] OK. So can you provide me a general information regarding authorization?
[AGENT][NEUTRAL] Authorization is not required and you said it's generic testing. What kind of generic testing?
[CUSTOMER][NEUTRAL] Genetic testing.
[AGENT][NEUTRAL] What type of generic testing? Is it like preventative testing?
[CUSTOMER][NEUTRAL] Um, just a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, there are multiple CPT codes in genetic testing. It is to, uh, it is, yeah.
[AGENT][NEUTRAL] Is it
[AGENT][NEUTRAL] Is it preventative? Because there is preventative and there is diagnostic. Is it diagnostic testing or preventative testing? Is it for sickness or yearly?
[CUSTOMER][NEUTRAL] you
[CUSTOMER][POSITIVE] Thank you. Thank you.
[CUSTOMER][NEUTRAL] It is for diagnostic testing.
[AGENT][NEUTRAL] Diagnostic testing. Yeah, um, there is no um.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Pre-cert or pre-requirements for that. Uh, we cannot guarantee the payment over the phone until we receive the paperwork, but there's no, uh, we don't need them.
[AGENT][NEUTRAL] The authorization.
[CUSTOMER][NEUTRAL] OK. And also,
[CUSTOMER][POSITIVE] OK. Thank you for this information. And also, can you please um
[CUSTOMER][NEUTRAL] Uh, tell me that if the, uh, facility Naira where I'm calling from is in network or out of network.
[AGENT][NEGATIVE] There's no network on this one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This is a limited policy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Uh, what do you mean by limited policy? Can you explain, please?
[AGENT][NEUTRAL] It's not a major medical.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Uh, it is not what major medical.
[AGENT][NEUTRAL] It is not a major medical.
[CUSTOMER][NEUTRAL] Major medical. OK.
[CUSTOMER][NEUTRAL] Uh, is this a secondary insurance for this member?
[AGENT][NEUTRAL] No, this is an indemnity plan. This is an indemnity policy, which it just pays flat amount based on the service rendered or the service provided. Um, it is a limited plan.
[CUSTOMER][NEUTRAL] OK. Uh, can you help me with the call reference number for this number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name and today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Uh, can you tell me the current time for my reference?
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] What information I'm sorry, you need?
[CUSTOMER][NEUTRAL] the current time.
[AGENT][NEUTRAL] Of the time. OK, it's [PII]
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Eastern.
[AGENT][NEUTRAL] Centrum.
[CUSTOMER][NEUTRAL] Central, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. Have a very nice day. Take care. Bye-bye.
[AGENT][POSITIVE] You're welcome, Mr. [PII]. Thank you for calling APO. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.