AccountId: 011433970860
ContactId: 27fb45d1-2732-4452-9d12-c431c0a26f0e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279200 ms
Total Talk Time (AGENT): 118093 ms
Total Talk Time (CUSTOMER): 109000 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/27fb45d1-2732-4452-9d12-c431c0a26f0e_20250610T15:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK, so they didn't give me no instructions how to contact you guys and get eligibility and numbers or whatever, so I have a patient that's getting admitted to the hospital and I see that she has Medicare and this American Public life insurance.
[CUSTOMER][NEUTRAL] Um, but I see that on our end we can't verify it, so they told me to call you guys to verify it and to get the eligibility and see if it was a supplement for the Medicare.
[AGENT][POSITIVE] OK, I can help you with the eligibility. Can I get your name and a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] OK, it will be um [PII]
[CUSTOMER][NEUTRAL] And my callback number is [PII].
[AGENT][NEUTRAL] And you don't have the policy number?
[CUSTOMER][POSITIVE] Yeah, I have it right here.
[AGENT][NEUTRAL] 00, you do, OK.
[CUSTOMER][NEUTRAL] Yeah, yeah, um, it would be, oh, it's, oh, OK, there you go, 02617356.
[AGENT][NEUTRAL] Alright, give me just a moment to look that up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Um, her name is, her last name is [PII], and her birthday is [PII].
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] And you're calling from a hospital?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alright, give me just one moment because that is her dental policy.
[CUSTOMER][NEUTRAL] Oh, it's a dental policy.
[AGENT][NEUTRAL] Um, and is she, you said she's in the hospital, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I am showing a hospital indemnity policy. Um, I have that policy number whenever you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] It's 02.
[AGENT][NEUTRAL] 61
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 7351.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and what is this?
[AGENT][NEUTRAL] This is a hospital indemnity policy.
[CUSTOMER][NEUTRAL] OK, got the policy alright.
[AGENT][NEUTRAL] And it has an effective date of [PII].
[CUSTOMER][NEUTRAL] April
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, got it.
[CUSTOMER][NEUTRAL] And anything else I need because I'm not sure it's my first time doing this.
[AGENT][NEUTRAL] Um, do they, they want any benefits or anything like that to see if anything is covered?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, so, uh, this is just a verification of benefits and not a guarantee of payment. Um, it looks like she has a hospital admission benefit of up to $500 per day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, a hospital confinement benefit of $50 per day.
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It looks like she also has an outpatient accident and sickness treatment benefit. Um, are you an emergency room or an urgent care or just a hospital? OK.
[CUSTOMER][NEUTRAL] Emergency room, it's uh emergency room.
[AGENT][NEUTRAL] OK, she has an emergency room treatment benefit of up to $50 per day.
[AGENT][NEUTRAL] With a maximum of 2 days per year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] She also has some diagnostic testing benefits.
[AGENT][NEUTRAL] And then outpatient prescription drug benefit?
[AGENT][NEUTRAL] Um, and if she was there through an ambulance, she does have an ambulance benefit as well, um, for ground, it would be $50 per day with a maximum of 1 per calendar year.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Okey dokey.
[CUSTOMER][NEUTRAL] I think all I needed was an admit one.
[AGENT][POSITIVE] OK, that's all good.
[CUSTOMER][POSITIVE] I think that's pretty much, yeah, yeah, OK, thank you.
[AGENT][POSITIVE] Great, thank you for calling APL. If there's nothing else, I hope you have a great day.
[CUSTOMER][NEUTRAL] Alright you too.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Bye.