AccountId: 011433970860
ContactId: 24448852-9556-47c9-88fc-0a2a736c56df
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 236039 ms
Total Talk Time (AGENT): 131313 ms
Total Talk Time (CUSTOMER): 64298 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/24448852-9556-47c9-88fc-0a2a736c56df_20250417T19:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling for an inpatient authorization former member that came to our facility ER.
[AGENT][NEUTRAL] OK, I can help you with authorization. Um, Ms. [PII], may I get your callback number, ma'am, just in case the call is dropped.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] UPMC Pinnacle Health Hospital.
[AGENT][NEUTRAL] OK, and can I get the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Sure, [PII], [PII].
[CUSTOMER][NEUTRAL] Policy number is 02595576.
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[AGENT][POSITIVE] OK, thank you very much for holding for me. I do see that [PII] does have an active policy. The effective date is
[AGENT][NEUTRAL] [PII]. No authorization is required. Um, this is not the major medical insurance.
[AGENT][NEUTRAL] Uh, they do have a hospital admission benefit, and this is just to verify benefits. It's not a guarantee of payment. That first day is a $500 benefit and then for hospital confinement.
[AGENT][NEUTRAL] Uh, they get 30 days per calendar year and it pays $50 per day.
[CUSTOMER][NEUTRAL] OK, we need to not.
[AGENT][NEUTRAL] Ma'am?
[CUSTOMER][NEUTRAL] He came in on the [PII] and he's still currently in house.
[AGENT][NEUTRAL] OK, that's been 5 days.
[AGENT][NEUTRAL] They get 30 days per calendar year.
[CUSTOMER][NEUTRAL] So you're saying not an authorization is not needed?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK, can you give me a call?
[AGENT][NEUTRAL] This is not the major medical insurance.
[CUSTOMER][NEUTRAL] Uh, on the insurance that he has showing.
[AGENT][NEUTRAL] OK, yes ma'am.
[CUSTOMER][NEUTRAL] Is there a
[AGENT][NEUTRAL] And yes
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] I can give you a confirmation number.
[AGENT][NEUTRAL] I know you were asking for that. OK, you can use my name [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And today's date.
[AGENT][NEUTRAL] And what I can do
[CUSTOMER][NEUTRAL] OK, and you said no.
[CUSTOMER][POSITIVE] Go ahead ma'am. I'm sorry.
[AGENT][NEUTRAL] What I what I can do is uh we can transfer over to multi plan to make sure you guys are in network with this um insurance.
[AGENT][NEUTRAL] And I'm going to give you that phone number just in case the.
[CUSTOMER][NEUTRAL] Will they obtain an off?
[CUSTOMER][NEUTRAL] Multipla you say?
[AGENT][NEUTRAL] I may need an authorization. I'm not sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, multi plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but I can transfer you over real quick and let you speak to them to make sure that you guys are uh a provider that's in network, OK?
[CUSTOMER][NEUTRAL] Give me your number that you're calling please.
[AGENT][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK, I'll hold for transfer. thank you so much.
[AGENT][POSITIVE] You're very welcome is everything I can help you with before I transfer you on over?
[CUSTOMER][POSITIVE] No, you have a good one, OK?
[AGENT][POSITIVE] You too you have a happy [PII] and thanks for calling APL.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] For questions about your privacy.