AccountId: 011433970860
ContactId: 0b76520a-cdec-46fb-aa58-e4fd604fe165
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 164440 ms
Total Talk Time (AGENT): 70166 ms
Total Talk Time (CUSTOMER): 70822 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/0b76520a-cdec-46fb-aa58-e4fd604fe165_20250103T20:34_UTC.wav
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[AGENT][NEUTRAL] Calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] and I'm actually calling from Texas Health Fort Worth Hospital, calling to see if I could get benefits on a patient and to see if authorization is required.
[AGENT][NEUTRAL] OK, I can help you with that, [PII], and in case this call is disconnected, may I have your callback number?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and it is direct.
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, let me get that for you. I have 02574226.
[AGENT][NEUTRAL] Thank you. And that was 02574226?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And may I have the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] [PII], and I'm gonna spell the last name [PII] Date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You say you just need to verify if pre-authorization is required?
[CUSTOMER][POSITIVE] And I'm sorry and benefits for an inpatient ER admission.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I show this is a limited hospital indemnity plan. I do show the coverage is currently active, effective [PII]. Since this is not a major medical plan, pre-authorization is not required. For hospitalization, the plan does cover a limited benefit for hospital admission.
[AGENT][NEUTRAL] Of $500 per calendar year and for a daily hospital confinement benefit, it pays a daily benefit of $50 and there's a max of 30 days per calendar year and I just must advise that this is just a verification of coverage and benefits. It does not guarantee payment.
[CUSTOMER][NEUTRAL] OK, you said it was effective [PII] limited hospital indemnity plan with a $500 per calendar year benefit, daily benefit of $50 and a max of 30 days.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, so the $500 we'll get that and then plus the $50 of the daily benefit?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, OK, and no pre-authorization is required.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Alright, and is there a health network on this plan?
[AGENT][NEUTRAL] No, this is not a major medical plan.
[CUSTOMER][NEUTRAL] Right, OK, OK. Uh, I'm sorry, what was your name again?
[AGENT][NEUTRAL] [PII] and that's spelled [PII] Is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] Nope, that is all thank you.
[AGENT][POSITIVE] OK, you're welcome. Thanks for calling APO you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank