AccountId: 011433970860
ContactId: df6c0e74-0372-4bfc-8f91-d1aa5c442341
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 597520 ms
Total Talk Time (AGENT): 124234 ms
Total Talk Time (CUSTOMER): 172685 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/df6c0e74-0372-4bfc-8f91-d1aa5c442341_20250417T13:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] from Premier Radiology. I have a patient that has come in presenting your insurance. They're here now. I need to verify that this insurance is currently active with them.
[AGENT][NEUTRAL] OK, [PII], I can help you with eligibility. Do you have a good callback number, please?
[CUSTOMER][NEUTRAL] I do. [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] I do. We have, it starts with the letter, well, I don't know about policy. Let me scroll back over to the other side.
[CUSTOMER][NEUTRAL] I have employee ID.
[AGENT][NEUTRAL] Um, OK, we can try that.
[CUSTOMER][NEUTRAL] Does that work?
[AGENT][POSITIVE] Yeah, we can
[CUSTOMER][NEUTRAL] It's uh D.
[CUSTOMER][NEUTRAL] As in David, 41601846.
[AGENT][NEUTRAL] Um, do you have the last name or social?
[CUSTOMER][NEUTRAL] Last name is um is [PII].
[CUSTOMER][NEUTRAL] Patient's first name is uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Looks like they have two last names, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And her first name was, I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] Uh, looks like [PII], but it has [PII] at the end of it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I'm probably pronounced the name wrong. I apologize.
[AGENT][NEUTRAL] Oh, no, you're fine.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, looks like I found her policy. Um, let me give you this policy number. It's um 259.
[AGENT][NEUTRAL] 7877.
[CUSTOMER][NEUTRAL] So that that member ID is not the correct ID?
[AGENT][NEUTRAL] Now, this is
[CUSTOMER][NEUTRAL] That's the only thing that's on this card.
[AGENT][NEUTRAL] Yeah, um, let me see, so.
[AGENT][NEUTRAL] We administer their um supplemental benefits, um, so let me, uh,
[AGENT][NEUTRAL] This is a group accident policy.
[AGENT][NEUTRAL] So it's very specific on like diagnosis that she has to be seen for or that can be reimbursed on.
[AGENT][NEUTRAL] Um, let me
[CUSTOMER][NEUTRAL] OK. So not health insurance?
[AGENT][NEUTRAL] Is she getting
[AGENT][NEUTRAL] No, it's not a major medical plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She's coming in for a chest X-ray.
[AGENT][NEUTRAL] This X-ray? OK.
[AGENT][NEUTRAL] Um, let me see if there's any benefit.
[AGENT][NEUTRAL] Do you know what the diagnosis might be?
[AGENT][NEUTRAL] By any chance?
[CUSTOMER][NEUTRAL] Um, hold on.
[CUSTOMER][NEUTRAL] A non-specific reaction to gamma.
[CUSTOMER][NEUTRAL] Interim response without active tuberculosis.
[AGENT][NEUTRAL] OK, that doesn't sound like an accident, um.
[CUSTOMER][NEUTRAL] R 76.112
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] Not a guarantee of payment basic outline of the policy. It has to be an accident diagnosis. So if, if this, and I'm not sure if that is, um, but there is a $100 maximum benefit payable for medical imaging.
[AGENT][NEUTRAL] Um, so that would be the max that would pay if it's determined that it's an accident.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hold on just a second.
[CUSTOMER][NEUTRAL] So, is this, this is, what kind of insurance is this though, when I'm messaging the.
[CUSTOMER][NEUTRAL] My front desk. What do I need to tell them?
[AGENT][NEUTRAL] It's a supplemental policy, like a supplemental accident policy.
[CUSTOMER][NEUTRAL] OK, this is a supplemental accident policy, not major medical. They will only pay.
[CUSTOMER][NEUTRAL] If there is an accident.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK, per, what's your name so whenever I'm putting this note in.
[AGENT][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] There we go. I put in [PII]. I just realized what I did.
[CUSTOMER][NEUTRAL] [PII]. I just typed in [PII]. Oh, boy. OK.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Almost Friday.
[CUSTOMER][NEUTRAL] So I can leave it as active.
[CUSTOMER][POSITIVE] Yeah, I can leave it as active.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] But you guys may not pay, correct?
[AGENT][NEUTRAL] Yeah, so we, we would have to see the claim and then um determine from there if if it would be processed under this policy.
[AGENT][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Copy and paste this into my stop sign.
[CUSTOMER][NEUTRAL] And I would use your name and today's date as the reference. Is that correct?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So do you guys get to close any day for like Good Friday or anything like that?
[AGENT][NEUTRAL] Oh, we don't, um, but that's, you know, it is.
[CUSTOMER][NEGATIVE] Unfortunately, we don't either and we don't get we don't get an [PII] off for like Monday where they might close down because it fell on a Sunday. No, we don't get that.
[AGENT][NEUTRAL] Right
[AGENT][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEGATIVE] Like, well, that sucks.
[AGENT][POSITIVE] I know, right? Live for, I love those extra days, you know what I'm saying?
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Yeah, all of them I can get.
[AGENT][NEUTRAL] Yep.
[CUSTOMER][POSITIVE] Um, alrighty, well, thank you so much for your help. I put that note in.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] I'm putting it in the, um,
[CUSTOMER][POSITIVE] Insurance alert as well. All right, thank you so much. Bye-bye.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, thanks for calling APL. Have a great weekend.
[CUSTOMER][POSITIVE] You too. Happy [PII].
[AGENT][POSITIVE] Happy [PII].