AccountId: 011433970860
ContactId: 010843b0-ea32-4c89-8e84-7a6ae47dea59
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 202199 ms
Total Talk Time (AGENT): 84755 ms
Total Talk Time (CUSTOMER): 91337 ms
Interruptions: 4
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/19/010843b0-ea32-4c89-8e84-7a6ae47dea59_20250319T15:22_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ACL. My name is [PII]. How can I assist you today?
[CUSTOMER][POSITIVE] Thank you for calling ACL. My name is [PII]. How can I assist you?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm calling from State of MRI, and I'm calling to verify um if we participate with this insurance.
[AGENT][POSITIVE] OK, I'd be happy to assist with network providers today, [PII], if I can get a good callback number for you.
[CUSTOMER][POSITIVE] OK, I'd be happy to assist with that provider.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Um, her, I have ID number and a certification number, which one?
[AGENT][NEUTRAL] The cert number.
[CUSTOMER][NEUTRAL] So it's 02592661.
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] Patient
[CUSTOMER][NEUTRAL] Um [PII] [PII].
[AGENT][NEUTRAL] Thank you for that information. Please be advised the verification of coverage is not a guarantee of payment. I do show the policy is currently active. Effective date is [PII], and I do show with this particular policy patient can see any provider that they choose.
[CUSTOMER][NEUTRAL] That information please be advised of verification.
[CUSTOMER][NEGATIVE] Not a guarantee
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What would be her benefits for an MRI?
[AGENT][NEUTRAL] Um, is it for wellness?
[CUSTOMER][NEUTRAL] Is it
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm. Let me see if she has, she has a diagnostic benefit, so that would fall under her diagnostic benefit, um, and that is 250 per calendar year.
[CUSTOMER][NEUTRAL] I'm sorry, wellness.
[CUSTOMER][NEUTRAL] Um-hum.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Deductible?
[AGENT][NEUTRAL] No, that's her benefit amount. This is a, um, this is a limited benefit hospital indemnity plan, so that would be her benefit amount. Anything over that 250 would be her responsibility.
[CUSTOMER][NEUTRAL] Or copay.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Plan so that would be.
[CUSTOMER][NEUTRAL] OK, so they only pay 250 and then anything over that would be OK.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] So she has no deductible or copay?
[AGENT][NEUTRAL] No, just that benefit amount.
[CUSTOMER][NEUTRAL] OK, 250, and what's the plan type?
[AGENT][NEUTRAL] The plan type it's just a limited benefit hospital indemnity plan.
[CUSTOMER][NEUTRAL] Plan it's just a little bit.
[CUSTOMER][NEUTRAL] 100.
[CUSTOMER][NEUTRAL] And do you have the billing address for claims?
[AGENT][NEUTRAL] Billing address one moment.
[CUSTOMER][NEUTRAL] Billing address
[AGENT][NEUTRAL] The claim should go to IMA.
[CUSTOMER][NEUTRAL] The claim should go to IMA.
[AGENT][NEUTRAL] And that PO box is 21704.
[CUSTOMER][NEUTRAL] And that PO box
[CUSTOMER][NEUTRAL] 7
[AGENT][NEUTRAL] In [PII].
[AGENT][NEUTRAL] 551-21.
[CUSTOMER][NEUTRAL] 55
[CUSTOMER][NEUTRAL] You said that was IMA?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and what does that stand for?
[AGENT][NEUTRAL] Um, I don't know, it just says IMA.
[CUSTOMER][NEUTRAL] OK, can you tell me if authorization is required?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, can I have a call reference number?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial S as in Sam, and the date and time of the call. Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] My name [PII]
[CUSTOMER][NEUTRAL] Yeah, did you say that was [PII] or [PII]?
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][POSITIVE] [PII], OK, alright, thank you so much for your help.
[AGENT][POSITIVE] Thank you for calling APL. You have a good day.
[CUSTOMER][POSITIVE] Thank you for calling
[CUSTOMER][NEUTRAL] You too bye.