AccountId: 011433970860
ContactId: f0960d2a-1f21-459f-bae3-7dd3ebe0dd8b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 284290 ms
Total Talk Time (AGENT): 143724 ms
Total Talk Time (CUSTOMER): 84141 ms
Interruptions: 0
Overall Sentiment: AGENT=2.6, CUSTOMER=2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/f0960d2a-1f21-459f-bae3-7dd3ebe0dd8b_20250225T14:48_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], and this is [PII] calling from Diagnostic Imaging Centers. How are you doing today?
[AGENT][POSITIVE] Mhm. I'm doing well, [PII]. Thank you for asking. How are you today?
[CUSTOMER][POSITIVE] I'm good. It's beautiful weather outside in the Midwest, so I am loving it.
[AGENT][POSITIVE] Well, I think the sun is gonna pee through here once all this fog goes away too, and I'm so ready for sunshine.
[CUSTOMER][POSITIVE] Yes, I definitely agree with that.
[AGENT][POSITIVE] How can I help you today?
[CUSTOMER][NEUTRAL] Yeah, I was calling um in regards to a patient that said to come into our offices in a few days for an exam and um he's coming in for a CT scan. I was needing to verify if prior authorization is required and to check benefits please.
[AGENT][POSITIVE] Well it would be my pleasure to assist you, [PII]. What is the callback number?
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah it's 02550286.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And just so you're aware, it looks like this is his um secondary policy to his um United Healthcare policy what looks like it's primary.
[AGENT][NEUTRAL] Yes, ma'am, and I can check that and verify that for you as well. Now, I'm showing that um [PII]'s policy is active as a 10-1-2024.
[CUSTOMER][POSITIVE] Great.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I was checking that to make sure we have United Healthcare as its primary.
[AGENT][NEUTRAL] With this policy, it is a secondary policy to United Healthcare. Because for secondary authorization is not required, we do follow the guidelines of the major medical.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And is, is this an uh imaging center or outpatient hospital?
[CUSTOMER][NEUTRAL] Uh, we're a freestanding, uh, outpatient facility. We build office code 11.
[AGENT][NEUTRAL] OK, let me check because it.
[AGENT][NEUTRAL] May only be covered in an outpatient facility, but I'm checking those benefits to verify that.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And I, I can give you our NPI or tax ID if you need that.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It will only be covered if it is a diagnostic testing in a hospital outpatient facility or MRI facility.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Is there any way you can check to make sure it'll be covered in our facility?
[AGENT][NEUTRAL] What's, and you said place of service 11?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm just looking at the policy and it just says hospital outpatient facility or freestanding outpatient center.
[AGENT][NEUTRAL] I mean, I'm sorry.
[AGENT][NEUTRAL] MRI facility.
[CUSTOMER][NEUTRAL] An MRI facility, wouldn't that be?
[AGENT][NEUTRAL] A diagnostic center. It could be covered. I mean, I would definitely submit the claim.
[CUSTOMER][POSITIVE] Mhm. OK, great.
[AGENT][NEUTRAL] And it is under his outpatient coverage.
[AGENT][NEUTRAL] And he has coverage up to $1500 per calendar year.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And that is a verification of coverage and not a guarantee of payment.
[CUSTOMER][NEUTRAL] Can you see if he's um used any of those benefits yet?
[AGENT][NEUTRAL] I can, let me check that.
[AGENT][NEUTRAL] For [PII], he has not used any of those benefits as of yet.
[CUSTOMER][POSITIVE] Great and I'm sorry, what was your first name and your last name initial?
[AGENT][NEUTRAL] Sure. My name is [PII]. And if you need a reference number, it would be my name and today's date.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I spell my name [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome well thank you very much [PII]. I appreciate your help today.
[AGENT][POSITIVE] It was such a pleasure to assist you and again, if you don't mind um notating that that is a verification of coverage and not a guarantee of payment. And [PII], is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Great.
[CUSTOMER][POSITIVE] No, ma'am, I appreciate your help.
[AGENT][POSITIVE] And thank you for calling APL. Hope you have a wonderful day and enjoy this weather.
[CUSTOMER][POSITIVE] You too thanks mm bye.
[AGENT][POSITIVE] Thank you, [PII]. Bye-bye.