AccountId: 011433970860
ContactId: 1b5fb040-15fe-427a-b176-4a6bf0c19a01
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 129479 ms
Total Talk Time (AGENT): 82545 ms
Total Talk Time (CUSTOMER): 37978 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/17/1b5fb040-15fe-427a-b176-4a6bf0c19a01_20250317T17:29_UTC.wav
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[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] It's [PII] with Imaging Center. I need to get benefits.
[AGENT][POSITIVE] I can certainly help with benefits. What's that policy number, please?
[CUSTOMER][NEUTRAL] 02563023
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, I appreciate that. Um,
[AGENT][NEUTRAL] And if there's a callback number I could have please event that we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Our policy went into effect on [PII]. It is active. This policy will pick up the deductible, co-payment or co-insurance for in and out of hospital settings only for outpatient hospital, that is up to $2800 per calendar year. For inpatient hospital, it is uh $3500 per uh per occasion, um, excuse me, uh, also per calendar year, I apologize. There's a $100 deductible.
[AGENT][NEUTRAL] That must be met uh prior to the, the policy paying out, and it doesn't look like that has been done, but this is for hospital settings only.
[CUSTOMER][NEUTRAL] OK, so it only covers hospital now.
[CUSTOMER][NEUTRAL] Outpatient facilities and all just hospital.
[AGENT][NEUTRAL] Uh, well, no, outpatient facilities are covered, um.
[CUSTOMER][NEUTRAL] OK, well, we're not a hospital, we're outpatient clinic, free standing clinic, we're not a hospital.
[AGENT][NEUTRAL] This is the ER urgent care.
[AGENT][NEUTRAL] OK, so, uh, with that, so, um, do you normally bill as a physician's office or do you just bill, um, as an outpatient, uh, just an outpatient?
[CUSTOMER][NEUTRAL] Now we, now we build office settings.
[AGENT][NEUTRAL] OK, yes, I'm
[CUSTOMER][NEUTRAL] I'm the heir.
[AGENT][NEUTRAL] I understand. Um, that's not going to be covered under this policy. This is, this is for hospital only.
[CUSTOMER][NEGATIVE] Not covered.
[CUSTOMER][NEUTRAL] OK, alright, and what was your name?
[AGENT][NEUTRAL] My name is [PII] and we're gonna use my name and and today's date as a reference. Is there anything else at all that I may help with while we're on the phone?
[CUSTOMER][POSITIVE] Mm, that's it thank you.
[AGENT][POSITIVE] OK, thanks for contacting AT