AccountId: 011433970860
ContactId: b5db5789-b55b-4127-a60a-797b4944fea5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 187619 ms
Total Talk Time (AGENT): 101803 ms
Total Talk Time (CUSTOMER): 79887 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/b5db5789-b55b-4127-a60a-797b4944fea5_20250429T14:53_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Contacting APL, my name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hi [PII]. My name is [PII], and um, I have a plan through my employer on Medlink select group med supplements, I guess it's like a supplementary gap insurance.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And, and I have a question about, about this plan. Um, does it, would it cover, uh, my daughter needs an MRI of her foot.
[CUSTOMER][NEUTRAL] And um,
[CUSTOMER][NEUTRAL] They, they said that they cannot process the claim, but would this insurance cover that?
[AGENT][NEUTRAL] Well, let's look at your policy. Um, what's your policy number?
[CUSTOMER][NEUTRAL] It is, I guess it's what it says the payer ID number here, is that what it would be? Oh no.
[AGENT][NEUTRAL] Well, it might have on, on your card, it might say outpatient or inpatient benefits and then it'll have uh.
[CUSTOMER][NEUTRAL] OK, I see it, yes, um, it's 023.
[AGENT][NEUTRAL] I just need one of those.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, 002353112 ML 7.
[AGENT][NEUTRAL] Thank you. And if I could just verify a name, a date of birth, and a phone number, please. I just want to make sure I have the right policy.
[CUSTOMER][NEUTRAL] No problem, [PII] and the date of birth is [PII], and the phone number is [PII].
[AGENT][NEUTRAL] I appreciate that. Thank you. So we do have your policy pulled up that you've had since [PII]. So for the type of service that you are talking about, having an MRI done, usually those are an outpatient hospital services. They, they will have like a stand-alone imaging uh um uh center or something like that, or it's done in your physician's office, one of those two things. Um, and what we will do is we will pick up the deductible, co-payment or co-insurance from your major medical.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Up to $2000. So this type of service is certainly covered. Um, now, if they are asking you to, uh, file the claim yourself, uh, there are many ways to do that. We do help you with that and uh we will pay the benefit to you. Um, otherwise, you can, when you do go in uh with your daughter for that MRI you can give them both this card and your major medical card.
[AGENT][NEUTRAL] So it is, it does look like it's gonna be covered. Uh, it's just, you know, it just depends on who's gonna be filing the claim, it looks like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, perfect, perfect, that's that's not a problem. I just wanted to double check that I appreciate your time and I'm, I've done claims online before, so I imagine that that would just be the same thing where you provide what the services were that were provided with the medical insurance covered and then whatever other records that that you guys would need, right?
[AGENT][NEUTRAL] Right, yes, that's, that's correct, yes. And then the diagnosis code, you know, the, the reason for the MRI. Now, is there anything else that we needed to look at? Um,
[CUSTOMER][NEUTRAL] No, no, that's, that's it.
[AGENT][NEUTRAL] Anything.
[AGENT][POSITIVE] OK, OK. Well, thank you very much. Thank you very much for contacting us. Uh if there's any other questions you have about your policy, please just let us know. Otherwise, have a very nice day. Thank you for calling us.
[CUSTOMER][NEUTRAL] That's it.
[CUSTOMER][NEUTRAL] You too bye bye.