AccountId: 011433970860
ContactId: 78ed83bb-100d-4c95-90cd-20a5a3c9d146
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316690 ms
Total Talk Time (AGENT): 146325 ms
Total Talk Time (CUSTOMER): 131889 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/78ed83bb-100d-4c95-90cd-20a5a3c9d146_20250129T15:23_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], we have an APL plan through our.
[CUSTOMER][NEUTRAL] City insurance our employ used to be our employer because we're retired and I have an appointment on Friday for an MRI and I'm trying to find out because when I called they said that um it's $600 so I'm trying to find out on the APL on our account what's left.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, or what APL will pick up.
[AGENT][NEUTRAL] OK, yeah, we could take a look at your benefits and see what might be covered for an MRI um what was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] And it's under my husband's insurance.
[AGENT][NEUTRAL] OK, that's fine. um, can I get a good call back number from you really quick, [PII], just in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, uh, [PII].
[AGENT][NEUTRAL] OK, thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] Uh, it says, uh, group.
[CUSTOMER][NEUTRAL] When um.
[CUSTOMER][NEUTRAL] I have a group number. It's the city of Homestead.
[CUSTOMER][NEUTRAL] That's all I can tell you. It says family coverage group 22392.
[CUSTOMER][NEUTRAL] Medin select group.
[AGENT][NEUTRAL] OK, if it's Medlink and you're looking at the card, um, on the bottom, do you see something that says in hospital or outpatient certification number? OK, if you could give me either one of those please.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 1 sorry 01611651 [PII] 7.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, thank you. All right, I'm just gonna verify some information really quick, [PII]. Can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address that we've got on file for you. uh, looks like it is a Yahoo account.
[CUSTOMER][NEUTRAL] Um, let me think, we have several emails, so, um.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] or [PII].
[AGENT][NEUTRAL] Yeah, we've got it [PII] OK, thank you for verifying that information, [PII]. All right, give me just a moment let me get your benefits pulled up here.
[AGENT][NEUTRAL] OK, and I know they quoted you that $600 but I do have to ask, is that before or after your major medical will be paying?
[CUSTOMER][NEUTRAL] After
[AGENT][NEUTRAL] It's after, OK, so that is going to be the remaining balance, OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] That's it they said that's a copay.
[AGENT][NEUTRAL] OK, I see. Alrighty, bear with me just a moment, let me get your policy pulled up here.
[AGENT][NEUTRAL] OK, um, and I know this might be kind of a silly question, um, where will the MRI be, uh, taking place? Is this going to be in a physician's office? Um, is it an actual MRI fac?
[AGENT][NEUTRAL] But
[CUSTOMER][NEUTRAL] Hello, um, it's, it's called vital imaging. It's, uh, like a testing center. It's not, not a hospital or anything.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Perfect. No, that's perfectly fine, um, that's, that would be considered an MRI facility. OK, so that is going to be covered under your outpatient benefit. um, let's see, your outpatient benefit is $1500 max per calendar year. um, I can check unless you know, um, but I can check to see if any of that.
[CUSTOMER][NEUTRAL] I don't, that's that's what what I need to find out.
[AGENT][NEUTRAL] Sure, if you have any remaining OK.
[AGENT][NEUTRAL] Alright, uh, yeah, I'm not showing that any has been used so far this year, so you do have that full benefit amount.
[CUSTOMER][NEUTRAL] OK, so I can just take the card and give it to them and then they will submit it?
[AGENT][POSITIVE] Correct, yes, um, if they have any questions if they're not familiar with uh APL, um, you can absolutely have them give us a call we do talk to providers all the time they can call us on the same number that you did and we can kind of explain the plan to them if there's any confusion.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty alright thank you very much uh huh.
[AGENT][NEUTRAL] Alright, yeah, did you have any other questions for me, [PII]?
[CUSTOMER][NEUTRAL] No, well, yeah, I do. So the $1500 is that per person or is that?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, it's 1500 per person, not just 1500 total, OK.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] That's correct per person per calendar year.
[CUSTOMER][POSITIVE] All right, all right perfect all right thank you uh huh.
[AGENT][POSITIVE] Yes, of course, yeah, thanks for giving us a call have a great rest of your day.
[CUSTOMER][NEUTRAL] You too uh huh bye bye.
[AGENT][POSITIVE] Thank you bye bye.