AccountId: 011433970860
ContactId: 09f57541-cdfe-404e-913e-0af55a0ba062
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 370489 ms
Total Talk Time (AGENT): 182419 ms
Total Talk Time (CUSTOMER): 116616 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/09f57541-cdfe-404e-913e-0af55a0ba062_20250224T19:54_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], um, I was told by my
[CUSTOMER][NEUTRAL] By my MRI provider.
[CUSTOMER][NEUTRAL] That [PII].
[CUSTOMER][NEUTRAL] Was the person that um said that they will not pay the $500 co-pay?
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I think I just spoke with you. This is [PII].
[CUSTOMER][NEUTRAL] Why?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, good. I'm, I'm glad you got me back.
[CUSTOMER][NEUTRAL] OK, how did she do?
[AGENT][NEUTRAL] Now that was the note where we um it looked like that they were calling in for an office visit benefit.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, because United Health is going to take care of that.
[AGENT][NEUTRAL] OK, do you have the, what's that policy number again if you don't mind?
[CUSTOMER][NEUTRAL] Policy number 02555995.
[AGENT][NEUTRAL] OK, got you, yeah, Mr. [PII], do you have the provider's phone number?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] Let's do a 3 way call with them.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, that is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah, I, I spoke to the supervisor of, uh, I guess it's billing or something like that. I forgot the the girl's name. I'm sorry.
[AGENT][NEUTRAL] That's all right. Let's see if we can get somebody and I can just verify that that MRI is covered either in an outpatient facility, an MRI facility or a physician's office because.
[CUSTOMER][NEUTRAL] It's an MRI facility.
[AGENT][NEUTRAL] And you know we pulled up your policy certificate and that's what I read that from so and I don't know if you're aware but you can um if you have an active online account with us you can click on your policy number and you can view those benefits.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Directly online as well and you can also get claim status and stuff um print additional cards but let's call them if you don't mind holding just one moment let me get someone on the line and I'm gonna add you to the call, OK?
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] Yes, thank you.
[CUSTOMER][NEUTRAL] No, thank you.
[AGENT][NEUTRAL] All right. You're welcome. One moment, please.
[CUSTOMER][NEUTRAL] Thank you for calling Tesla MRI. For English, press one, para espanol precionados.
[CUSTOMER][NEUTRAL] To schedule an appointment, press 1. For billing, press 2. For all other questions, press 3.
[CUSTOMER][NEUTRAL] For quality assurance, this call may be recorded.
[CUSTOMER][NEUTRAL] [PII] how can I help you?
[AGENT][NEUTRAL] And I'm sorry, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], thank you. Hi, [PII], this is [PII] with APL um Insurance.
[AGENT][NEUTRAL] I have got an insured on the back line and we can get him if you need his information we'll add him to the call if that's OK with you as well. um, he was calling, he's got an MRI scheduled.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] He was told that it is not covered under his APL policy. It is in fact covered if it's an outpatient facility, an MRI facility or a physician's office. So can you help us with that?
[CUSTOMER][NEUTRAL] Yes, of course. Can I get date of birth of the patient?
[AGENT][NEUTRAL] Yeah, let me get Mr. [PII] on the line. Hang on just a second.
[AGENT][NEUTRAL] Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I have [PII] in the billing department on the line and she's going to assist us, OK? She needs your date of birth if you can verify your information with her.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Perfect. Can I get your first and last name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Allow me 1 2nd while I review the account.
[CUSTOMER][NEUTRAL] OK. I do see here the notes that were left.
[CUSTOMER][NEUTRAL] Um one second.
[CUSTOMER][NEUTRAL] Now, do we need prioritization for this or just with the actual um.
[CUSTOMER][POSITIVE] Good that we received is OK.
[AGENT][NEUTRAL] So [PII], we're secondary to his major medical with our policy, there's no prior authorization, we do follow the guidelines of the major medical.
[CUSTOMER][NEUTRAL] OK, perfect. And is there a co-payment?
[AGENT][NEUTRAL] Under his APL plan there's no copay, deductible or co-insurance.
[CUSTOMER][POSITIVE] Excellent. OK, perfect. I'm gonna go ahead and notate the account and I will let scheduling department know so we can go ahead and get this patient scheduled.
[AGENT][NEUTRAL] OK. And Mr. [PII], do you have anything else for [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, not at this time. I just, uh, call me back as soon as possible so we can get something scheduled.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. The scheduling department is gonna reach out to you. I'm gonna go ahead and reach out to them so they can go ahead and call you when they have um a second, OK?
[AGENT][POSITIVE] [PII], thank you, Mr. [PII], if you don't mind staying on the line for a quick moment. [PII], thank you so much for your assistance.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you, and I do apologize for all this.
[AGENT][POSITIVE] Oh, thank you. Take care. Bye-bye.
[CUSTOMER][POSITIVE] Thanks bye bye.
[AGENT][NEUTRAL] OK, Mr. [PII], if you have any more problem now, you give us a call back, OK? I'm putting it in the notes that we spoke with [PII] and gave her the, the, um, and advise that the MRI is a covered benefit under the plan.
[CUSTOMER][POSITIVE] Appreciate it. Thank you.
[CUSTOMER][POSITIVE] OK great thank you so much.
[AGENT][POSITIVE] My pleasure. And I'm so sorry for your, for, I don't know, I, I don't know what happened, but I do apologize and hopefully everything will go smoothly for you, OK?
[CUSTOMER][NEGATIVE] That worries.
[CUSTOMER][POSITIVE] Appreciate it thank you so much.
[AGENT][POSITIVE] Thank you. Bye-bye.