AccountId: 011433970860
ContactId: 0f636c10-b675-4231-a3be-164f102a4596
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 281100 ms
Total Talk Time (AGENT): 128526 ms
Total Talk Time (CUSTOMER): 93012 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/2025/05/30/0f636c10-b675-4231-a3be-164f102a4596_20250530T13:21_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], and I need to get benefits for a patient, please.
[AGENT][POSITIVE] Hi, [PII], I'm happy to check benefits. Can I get their policy number?
[CUSTOMER][NEUTRAL] D as in David 43732546.
[AGENT][NEUTRAL] Alright, um, unfortunately, [PII], I can't pull them with that number. Do you have their card? Is there any sort of like certificate number?
[CUSTOMER][NEUTRAL] I think hold on there's a picture of their card in here.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Let's see here.
[CUSTOMER][NEUTRAL] Certificate number?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 02580644
[AGENT][POSITIVE] Perfect, thanks.
[CUSTOMER][NEUTRAL] Is that what we need to have listed as their ID number?
[AGENT][POSITIVE] Mhm, yeah, you'll wanna use that.
[CUSTOMER][NEUTRAL] OK, somebody put that in wrong.
[CUSTOMER][NEUTRAL] But I will change it.
[AGENT][NEUTRAL] Nope, no problem. Can I just get their name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] Date of birth oh no sorry, excuse me, [PII] with [PII] in quotations, the [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. All right. So, uh, patient is active. Effective date is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] The benefits.
[AGENT][NEUTRAL] What did
[AGENT][NEUTRAL] What are they being seen for?
[AGENT][NEUTRAL] Is it just like, OK, it's a surgery. One second.
[CUSTOMER][NEUTRAL] Outpatient surgery.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Give me just a second here. I'm trying to pull her policy certificate.
[CUSTOMER][NEUTRAL] I'm curious, is this a supplemental insurance?
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] So uh because I see this is the only insurance they have on file.
[AGENT][NEUTRAL] OK, so it is a limited benefit plan, um, a hospital indemnity plan. It just pays a set amount depending upon what they're being seen or treated for. Um, it can be secondary, but we don't have any information if they have any other insurance, that would be something you would have to ask the insured.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so it looks like the plan pays $1000 for hospital admission benefit. That's $1000 per day. It's a maximum of 1 day per calendar year.
[AGENT][NEUTRAL] As far as hospital confinement, it pays $100 per day. It's a maximum of 30 days per calendar year per covered person.
[CUSTOMER][NEUTRAL] I know, hold on, let me back up. The first one you said the $1000 the admission, that's for inpatient, correct?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm. Correct, yeah.
[CUSTOMER][NEUTRAL] I need outpatient.
[AGENT][NEUTRAL] So the plan only pays for then the surgery, which is gonna be $500 per day, a maximum of 1 day.
[AGENT][NEUTRAL] And that's for surgery in a hospital?
[CUSTOMER][NEUTRAL] So they will only pay $500 on it.
[AGENT][NEUTRAL] Uh-huh. And that's for surgery in hospital or outpatient facility?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's what I need to know.
[CUSTOMER][NEUTRAL] So just $500 total, that's it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK and.
[CUSTOMER][NEUTRAL] Your name was [PII], correct?
[AGENT][NEUTRAL] Yes, ma'am, and that's [PII].
[CUSTOMER][NEUTRAL] No her name's there what we.
[AGENT][NEUTRAL] My name is [PII] as well. It's [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Y'all both [PII]
[CUSTOMER][NEUTRAL] And the first initial of your last name?
[AGENT][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And a call reference number for this call?
[AGENT][NEUTRAL] You can use my name with my initial and then just today's date.
[CUSTOMER][POSITIVE] Perfect. Well, thank you so much.
[AGENT][POSITIVE] You're welcome. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.