AccountId: 011433970860
ContactId: 19d0b3bc-c899-4f4d-9bdf-ed410b94d16b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 183720 ms
Total Talk Time (AGENT): 83652 ms
Total Talk Time (CUSTOMER): 38728 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/19d0b3bc-c899-4f4d-9bdf-ed410b94d16b_20250225T20:50_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm with Reyes Radilogy. I'm calling to see if a member requires prior authorization for an exam.
[AGENT][POSITIVE] OK, sure, I can assist you with um Miss [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02571694
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK. Perfect. Thank you.
[AGENT][NEUTRAL] OK, Ms. [PII], um, OK, Mr. [PII] has uh one of our limited hospital indemnity policies. Pre-authorization is not gonna be required on this one.
[CUSTOMER][POSITIVE] OK, perfect. Now will anything be covered at our facility? We're considered an outpatient free standing facility.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK. Um, what type of test is being performed?
[CUSTOMER][NEUTRAL] It's an MRI
[AGENT][NEUTRAL] OK, let me check and see if we cover MRI.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] OK, so he does have the diagnostic imaging benefit. Um, it's gonna be $200 per day maximum of 1 day per covered person per calendar year. So the maximum we'll pay is $200 for an MRI.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is everything I needed. Oh, can I get a reference number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's state if you will, Miss [PII]. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Uh, spelling of your name please.
[AGENT][NEUTRAL] Sure, that's [PII]. Last initial [PII].
[CUSTOMER][POSITIVE] OK, that's everything I needed.
[AGENT][POSITIVE] All right. Well, thank you for calling APL. Have a good afternoon.
[CUSTOMER][POSITIVE] Thanks you too bye bye.
[AGENT][POSITIVE] You're welcome, thank you, bye bye.