AccountId: 011433970860
ContactId: c9476326-da19-4610-ae03-91cb5643d64c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284040 ms
Total Talk Time (AGENT): 99170 ms
Total Talk Time (CUSTOMER): 111578 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/c9476326-da19-4610-ae03-91cb5643d64c_20250626T15:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII].
[CUSTOMER][NEUTRAL] And I, I was given this insurance I signed up for it through my employer.
[CUSTOMER][NEUTRAL] Which is uh Legacy Healing Center.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm not
[CUSTOMER][NEUTRAL] So I just need a little clarity if you don't mind on how to use this insurance because
[CUSTOMER][NEUTRAL] I have like an MRI coming up.
[CUSTOMER][NEUTRAL] And I've been going through a whole lot of stuff with this uh whole process, so I'm just trying to figure out how to use this insurance with, you know, this procedure that I have coming up. How do I use it?
[AGENT][NEUTRAL] Let's take a look, [PII]. Do you have your policy number?
[CUSTOMER][NEUTRAL] Uh, policy number.
[CUSTOMER][NEUTRAL] I have an APL card. I have a payer ID group number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you see anything on there? Yeah, the inhospital number? What's that?
[CUSTOMER][NEUTRAL] In hospital
[CUSTOMER][NEUTRAL] So the in hospitals.
[CUSTOMER][NEUTRAL] Benefit
[CUSTOMER][NEUTRAL] Is 0261.
[CUSTOMER][NEUTRAL] 892 0.
[CUSTOMER][NEUTRAL] ML 7.
[AGENT][NEUTRAL] All right. And then for verification, can I get your date of birth and address, please?
[CUSTOMER][NEUTRAL] Sure, my date of birth is [PII]. My address is [PII].
[AGENT][POSITIVE] All right, thank you so much. OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, so this plan that you have with us is a secondary plan. The purpose of it is to cover any sort of deductible, co-pay or co-insurance that your primary doesn't.
[AGENT][NEUTRAL] MRI's are a covered benefit on the policy. So when you're having the procedure, you need to give them whoever your primary insurance is and then let them know that you have a secondary with APL and that once they bill the primary, they can bill us for anything remaining.
[AGENT][NEUTRAL] Your outpatient benefits on your plan are up to $5000 for the calendar year, so that's the most that we're gonna cover from January to December.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Well, that's pretty easy to understand.
[AGENT][NEUTRAL] Yep, so easiest thing is just for them to file the claims on your behalf with your primary and then follow up with us as your secondary.
[CUSTOMER][NEUTRAL] OK, so is there any times when um it's hard to get them to file claims or?
[CUSTOMER][NEUTRAL] Not
[AGENT][NEUTRAL] Yeah, I mean, most providers are willing to do that. So it's, yeah, it shouldn't be any sort of issue. Like I said, just give them both cards at the time when you're uh checking in for it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so just to be clear,
[CUSTOMER][NEUTRAL] So whatever, uh, like if let's just say if the MRI is $600 and the uh.
[CUSTOMER][NEUTRAL] The insurance provider UnitedHealthcare covers 50%.
[CUSTOMER][NEUTRAL] Is the other 50% covered by APL?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Is that correct?
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, well thank you for that information. I think you answered my question.
[AGENT][NEUTRAL] All right, [PII].
[CUSTOMER][POSITIVE] It was worth waiting for 20 minutes.
[AGENT][NEUTRAL] I'm sorry for the long hold today. I apologize. But yeah, if you have any other questions or concerns, feel free to reach out, OK?
[CUSTOMER][NEUTRAL] No, it's uh.
[CUSTOMER][POSITIVE] OK, thank you very much. Have a great day.
[AGENT][NEUTRAL] My. You too. Bye bye.