AccountId: 011433970860
ContactId: 1679e6ac-871a-4188-847b-0a0082b36b7d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 540309 ms
Total Talk Time (AGENT): 210841 ms
Total Talk Time (CUSTOMER): 145194 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/1679e6ac-871a-4188-847b-0a0082b36b7d_20250321T17:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I was hoping I can get some clarification on um possibly getting an MRI and what's covered.
[AGENT][NEUTRAL] OK, is this for yourself?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, can I have your policy number, please?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 025.
[CUSTOMER][NEUTRAL] 16
[CUSTOMER][NEUTRAL] 361
[AGENT][NEUTRAL] And can I get your name and date of birth?
[CUSTOMER][NEUTRAL] For [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your mailing address?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then lastly, could you please provide your email address that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK, and you're needing to get benefits for an MRI?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I called earlier and.
[CUSTOMER][NEUTRAL] Um, unfortunately, one of the neurologists that I see, he's not in network, but I was able to look up the other one as far as the neuro.
[CUSTOMER][NEUTRAL] The neuroscience department and that looks like it's covered so I guess just.
[CUSTOMER][NEUTRAL] Wanna make sure what's covered and what's not based on what I currently have for coverage.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, anything I quote is not a guarantee of benefits, it's just a basic outline of your policy.
[AGENT][NEUTRAL] So for us for this policy it's a hospital indemnity policy so we don't have a network that you have to utilize um you can see any provider that you like um so and under this policy, let me see what we've got for MRI.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Let me see, let me look up and see.
[AGENT][NEUTRAL] So diagnostic testing, you do have a $250 benefit for diagnostic testing.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes we've got MRI.
[AGENT][NEUTRAL] That would cover an MRI.
[AGENT][NEUTRAL] And make sure you don't have anything else.
[AGENT][NEUTRAL] Yeah, it looks like that's that's the benefit for the MRI.
[AGENT][NEUTRAL] That'd be $250.
[CUSTOMER][NEUTRAL] Uh, I would pay $250 correct?
[AGENT][POSITIVE] No, that's, that's the benefit that we would pay on it.
[AGENT][NEUTRAL] So based on who files the claim we potentially pay you or pay the provider $250.
[AGENT][NEUTRAL] So this just pays you or the provider $250. It's kind of this is like a supplemental policy.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] It's not like a major medical policy, yeah, it's just it's a hospital indemnity, so it's just a, just a supplemental.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Policy, pay certain dollar, certain dollar amounts to you or a provider for certain types of procedures and services.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Got it because um I'm just surprised how low that is because MRIs are thousands of dollars and.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] And I guess I'm curious why, why I'm even paying.
[CUSTOMER][NEUTRAL] For this insurance.
[CUSTOMER][NEUTRAL] I, I mean
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Wow, I didn't realize that. I thought.
[AGENT][NEUTRAL] There's other benefits that you have, yeah, so that's for a diagnostic test, but for instance, like if you ever, you know, were admitted to a hospital, it pays you 1500 for a first occurrence. Um, there's a benefit of 2000 if you ever needed surgical or anesthesia.
[AGENT][NEUTRAL] Um, so there are, there's kind of a list of benefits that it'll pay out for, but for that particular one for an MRI it's $250.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, um
[CUSTOMER][NEUTRAL] Even with, because I think I got the most expensive one.
[CUSTOMER][NEUTRAL] Like that's being offered.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] But again this is not a full health coverage this is just.
[AGENT][NEUTRAL] It's just supplemental. Yeah, it's not, not your major medical, so I'm not sure who your primary insurance or like your major medical.
[CUSTOMER][NEUTRAL] Supplemental.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Because that would be through a different carrier if you have that, but yeah, like I said this is just a supplemental.
[AGENT][NEUTRAL] And it just it has a list of benefits that it'll pay based on what you receive.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it. OK, um.
[CUSTOMER][NEUTRAL] OK, yeah, that's, well, um.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] I will
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Yeah, that that really doesn't do anything for me at this point.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] And you said.
[CUSTOMER][NEUTRAL] Um, scanning was included or not? I, I was confused on that.
[AGENT][NEUTRAL] Uh, so under the diagnostic, your diagnostic testing benefit MRIs is covered under that, um, it also covers.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] CT scan and.
[CUSTOMER][NEUTRAL] And when you say covered that's the.
[CUSTOMER][NEUTRAL] That's the 250 you're speaking of.
[AGENT][NEUTRAL] That's what I'm, yes, correct, that's what I'm referring to the 2 it will pay 250 for annually for an MRI, CAT scan, or a colonoscopy.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] Yeah, that's, is there any way to reduce what I have currently, but you know, as far as benefits because I was paying the the the most and I thought.
[CUSTOMER][NEUTRAL] At least something a lot more will be covered.
[AGENT][NEUTRAL] Sure, um, let me see.
[CUSTOMER][NEUTRAL] Well, how would I go about doing that?
[AGENT][NEUTRAL] I think this is, let's see, this is.
[AGENT][NEUTRAL] So this is through
[AGENT][NEUTRAL] Your employer
[AGENT][NEUTRAL] Um, you would speak to them about like changing your policy. Let me see, let me make sure I've got the right information. Can I place you on a brief hold?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, uh, hold on one moment, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Let's see, uh, change policy.
[AGENT][NEUTRAL] OK, thanks for holding. Yeah, it looks like so if you wanted to change your policy, you would need to contact um BI BIC, um, and I can give you their number if you like.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, their number is [PII].
[AGENT][NEUTRAL] And they can help you make um changes to your existing plan upgrade, downgrade, etc. so.
[CUSTOMER][POSITIVE] OK, alright, sounds good.
[AGENT][NEUTRAL] OK, is there anything else I can help you with today?
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] No, no, that'll be it.
[AGENT][POSITIVE] OK, thank you for calling APL have a terrific day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][NEUTRAL] You