AccountId: 011433970860
ContactId: f9d73496-1db4-4aa7-abd6-c169964a2d6a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 173419 ms
Total Talk Time (AGENT): 74128 ms
Total Talk Time (CUSTOMER): 82600 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/f9d73496-1db4-4aa7-abd6-c169964a2d6a_20250609T17:19_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hi, I'm sorry, what was your name?
[AGENT][NEUTRAL] It's [PII] Mhm.
[CUSTOMER][NEUTRAL] Hi
[CUSTOMER][NEUTRAL] Hi, this is [PII] and I'm calling from Worcester Urology. I'm calling because we have a patient that we want to do a procedure on, um, on Friday, and I'm just calling to see if it requires pre-cert prior off.
[AGENT][NEUTRAL] OK, I can verify that for you, Ms. [PII]. And what is the policy number, please?
[CUSTOMER][NEUTRAL] Um, it is 02586238.
[AGENT][NEUTRAL] OK, thank you and give me a moment and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Certainly it's [PII]. I am [PII].
[AGENT][NEUTRAL] OK, and the patient's name, date of birth?
[CUSTOMER][NEUTRAL] The patient is [PII]. His birthday is [PII].
[AGENT][NEUTRAL] OK, uh, so his effective date is [PII], and under this type policy, um, prior authorization is not required.
[CUSTOMER][NEUTRAL] OK, so any outpatient procedure would not require, you don't need a CPT code or anything?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, alright, and can you tell me where he's at on his deductible?
[AGENT][NEUTRAL] Uh, there's no deductible on this policy.
[CUSTOMER][NEUTRAL] OK, do you have a plan limitation or anything that I need to worry about?
[AGENT][NEUTRAL] Well, let's see this type of policy is a limited medical indemnity plan, uh, like what outpatient benefits would you need?
[CUSTOMER][NEUTRAL] And like he's going to have surgery at a surgical care center, an outsources ambulatory care center.
[AGENT][NEUTRAL] OK. Well, under his policy, there's no benefits as far as the facility, but he does have a benefit that covers surgery performed in a facility.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So they'll cover surgery but not the facility itself.
[AGENT][NEUTRAL] Correct. He doesn't have any separate benefit for outpatient facility like a surgery center.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, so if he were to go to the local hospital, would that make any difference or would that be the same?
[AGENT][NEUTRAL] It would be the same. If it was hospital, you have to be confined in order for benefits for the facility.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, that tells me what I need to know then thank you.
[AGENT][POSITIVE] Alright, you're welcome. Thank you for calling APL. Have a great day. Oh, go ahead.
[CUSTOMER][NEUTRAL] Uh, can I, uh, Kiki, [PII], I'm sorry, I need a call reference.
[AGENT][NEUTRAL] Uh, you can use my name in today's date if you like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you very much.
[AGENT][POSITIVE] Alright, you're welcome, Ms. [PII]. Thank you for calling APL bye.
[CUSTOMER][NEUTRAL] Hm mhm.
[CUSTOMER][NEUTRAL] Mm bye bye.