AccountId: 011433970860
ContactId: a91cf8e5-7316-4f04-8a6e-b5a8d649a53e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 195220 ms
Total Talk Time (AGENT): 88082 ms
Total Talk Time (CUSTOMER): 62754 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/a91cf8e5-7316-4f04-8a6e-b5a8d649a53e_20250403T16:30_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, Ms. [PII]. My name is [PII] and I'm calling to get some benefits on uh on the APL insurance for a patient for an MRI for a CT scan.
[AGENT][NEUTRAL] OK, [PII]. Do you have a phone number I can get in case we get disconnected I can call you back?
[CUSTOMER][POSITIVE] Yes, it's [PII] and that's correct.
[AGENT][NEUTRAL] And do you have a policy number?
[CUSTOMER][NEUTRAL] Yes, it is 01612907.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the patient's name?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And you want benefits for a CT scan outpatient?
[CUSTOMER][NEUTRAL] Yes, ma'am. The patient does have United Healthcare choice as primary.
[AGENT][NEUTRAL] OK, I can help you with that. The effective date is [PII]. Any benefits given over the phone is not a guarantee of payment?
[AGENT][NEUTRAL] This policy does coordinate with her primary. We only pick up what is applied to her deductible, co-pay or co-insurance and for outpatient.
[AGENT][NEUTRAL] We'll pay up to 5000 per calendar year and she has a deductible of 250.
[CUSTOMER][NEUTRAL] OK, so does the patient need to meet the $250 deductible with the APL before it covers?
[AGENT][NEUTRAL] Yes, ma'am. Let me check.
[CUSTOMER][NEUTRAL] Or how do we bill it?
[AGENT][NEUTRAL] You can just send the claim in and we'll take it out of the benefits when the claim comes in. Let me see if she's made any of it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No, she has not made anything, so yeah, it would be the 250.
[CUSTOMER][NEUTRAL] OK, so when the patient comes in for the for the CT scan, do we charge her just the 250?
[CUSTOMER][NEUTRAL] Or do we not charge or anything?
[AGENT][NEUTRAL] Um, it would be up to you all now when the claim comes in, whatever they apply to her deductible, co-pay or co-insurance, that's the only thing we're gonna pick up.
[CUSTOMER][NEUTRAL] OK, so then you'll just deduct the 250 from there.
[AGENT][NEUTRAL] Now if it's over.
[AGENT][NEUTRAL] Right. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I get it.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, Ms. [PII], and the initial of your last name?
[AGENT][NEUTRAL] [PII]. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, no, I think that'll be it and a reference call number?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK, thank you so much have a good day.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day as well.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye-bye.