AccountId: 011433970860
ContactId: f9db97a7-e425-4bea-ac97-6f8a995a61b2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 206059 ms
Total Talk Time (AGENT): 82799 ms
Total Talk Time (CUSTOMER): 71778 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/f9db97a7-e425-4bea-ac97-6f8a995a61b2_20250502T16:39_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]. I'm calling with Mercy Hospital pre-registration, um, and I was calling to verify, um, benefits on a member.
[AGENT][NEUTRAL] OK, yeah, I can check that if it's for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] It is [PII]. It's spelled [PII]
[AGENT][NEUTRAL] Got it. So, can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, callback number is [PII].
[AGENT][NEUTRAL] Thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Um, I do policy on card shows 02582808.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Member shows [PII] uh date of birth is [PII].
[AGENT][POSITIVE] Perfect. Thank you for verifying that. Uh, so this policy is active. Effective date was [PII].
[AGENT][NEUTRAL] And this is a limited indemnity medical plan, so it pays a set dollar amount per coverage procedure or office visit. Uh, what kind of benefits were we need to check today?
[CUSTOMER][NEUTRAL] The patient is on the schedule to have an MRI of the knee.
[AGENT][NEUTRAL] MRI? OK, one moment please.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, hospital outpatient billing.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] And it'll be at the hospital, the hospital outpatient.
[AGENT][NEUTRAL] OK, gotcha.
[AGENT][NEUTRAL] OK. And of course, I will let you know verification of coverage is not a guarantee of payment for claims. Uh, so the MRI would be covered under the diagnostic testing benefit for medical imaging. Uh, that benefit is $100 per day, maximum of 1 day per calendar year.
[CUSTOMER][NEUTRAL] Has she used that benefit this year?
[AGENT][NEUTRAL] Give me just a minute, let me take a look.
[AGENT][NEUTRAL] And this was just for [PII] correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, she has not.
[CUSTOMER][NEUTRAL] OK, so she still has her one benefit for the year.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, and um the networking that'd be multi plan is that correct?
[AGENT][NEUTRAL] Yes, this is a part of a multi plan.
[CUSTOMER][NEUTRAL] OK, and no prior authorization needed?
[AGENT][POSITIVE] Right, that's correct.
[CUSTOMER][NEUTRAL] OK, so just $100 per day, only 1 per calendar year and she still has that benefit, so her plan will only pay the $100 towards that MRI.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect and I'm sorry, what did you say your name was?
[AGENT][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] And was there anything else I could help you with?
[CUSTOMER][NEUTRAL] Thank you Ms. [PII]. Uh, no, ma'am, if there's a call reference number for the call.
[AGENT][NEUTRAL] Sure, it would just be my first name, last initial, and today's date, uh, so my last initial is A.
[CUSTOMER][POSITIVE] OK, OK, and today's date, thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, well thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][POSITIVE] Alright, well thank you, Ms. [PII]. I do appreciate.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thanks. Bye-bye.