AccountId: 011433970860
ContactId: e04d9f44-cf55-40a7-917a-9d7377d00e85
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 437799 ms
Total Talk Time (AGENT): 169046 ms
Total Talk Time (CUSTOMER): 102304 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/e04d9f44-cf55-40a7-917a-9d7377d00e85_20250528T14:53_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], my name is [PII]. I'm calling from the PET imaging center in [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I have a patient that presented a card to us so at their appointments, so I'm just calling in to get some detail about their benefits.
[AGENT][NEUTRAL] OK. All right. Happy to check on benefits, [PII]. Uh, what is the policy number we have?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It is 781-027.
[CUSTOMER][NEUTRAL] Do you need our MPI or tax ID?
[AGENT][NEGATIVE] No, I don't, I shouldn't need it, no.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, [PII]
[CUSTOMER][NEUTRAL] Um, date of birth.
[CUSTOMER][NEUTRAL] I have is.
[CUSTOMER][NEUTRAL] I have [PII].
[AGENT][POSITIVE] All right, thank you so much, [PII]. So patients active on the plan. The effective date on here is [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me pull up the patient's policy.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Is it nearby? OK, be safe.
[AGENT][NEUTRAL] Sorry for the wait, [PII]. I'm just trying to find the schedule of benefits in here. Goodness, one second.
[CUSTOMER][NEUTRAL] Oh, that's OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's
[AGENT][NEGATIVE] I know it pays. It's a cancer policy, so I know it has coverage for a PET scan. I can't, where the heck is the freaking benefits in this thing? I'm sorry.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So with cancer problem, we don't.
[CUSTOMER][NEUTRAL] OK, but with cancer be uh cancer policies we don't file directly with you guys, right?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh, OK. Yeah, I mean, if you can't file directly you can or if not, um, the patient can always do it as well. I can give you the claim's mailing address and all of that information.
[CUSTOMER][NEUTRAL] Or do we?
[CUSTOMER][NEUTRAL] OK, well if we can file, OK.
[CUSTOMER][NEUTRAL] Yeah, that, so if we can follow directly.
[AGENT][NEUTRAL] OK, yeah, absolutely. So the claims mailing is um PO [PII].
[CUSTOMER][NEUTRAL] We sure will.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 248.
[AGENT][NEUTRAL] 950.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] OK, do you have electron uh.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Yeah, we have a payer ID in fax. Payer ID is 60801.
[CUSTOMER][NEUTRAL] Electronic pay ID.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then the fax number would be [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK, and you're [PII]?
[AGENT][NEUTRAL] Uh-huh. My name is [PII] and that's the call reference with today's date.
[CUSTOMER][NEUTRAL] OK, and this just picks up the balance after his insurance?
[AGENT][NEUTRAL] Um, yeah, so it's gonna pay, that's what I was looking for. Usually for these types of exams that pays just a set amount towards that actual testing.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um, because it's not an actual like secondary.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][POSITIVE] I'm gonna be right back one moment be right back with you.
[AGENT][NEUTRAL] OK, go ahead, [PII], yeah.
[CUSTOMER][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] [PII], I'll be out here when y'all call me. Have they? OK, so you haven't, you haven't been called back yet. I saw.
[AGENT][NEUTRAL] Medical imaging benefits, scheduled benefits, right, but where's the scheduled benefits page?
[CUSTOMER][NEUTRAL] To start your test
[CUSTOMER][NEUTRAL] I haven't called you back yet? Uh.
[CUSTOMER][NEUTRAL] I'll let them know you're waiting out here, OK? mhm.
[AGENT][NEUTRAL] Where's the schedule of benefits?
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][NEGATIVE] Yeah, I'm still here. I don't know why this policy, it looks like it's almost like missing the scheduled benefits page because it doesn't show the freaking, oh here we go. Good grief. OK.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Sound like you're having the same day as me.
[AGENT][NEUTRAL] It's like what's going on?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Imaging, imaging.
[AGENT][NEUTRAL] OK, so the diagnostic and prevention benefit, it looks like it's $60 per calendar year per person.
[AGENT][NEUTRAL] And then it does pay a medical imaging benefit with PET scan is listed underneath there. It's a $200 benefit per image maximum of $2 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And then we follow with them OK.
[AGENT][NEUTRAL] Anything else, [PII]?
[CUSTOMER][POSITIVE] I appreciate your help.
[AGENT][POSITIVE] You're welcome. Thanks for your patience. You have a good day.
[CUSTOMER][NEUTRAL] No, that'll do it.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.