AccountId: 011433970860
ContactId: 35f505dd-c293-43a8-a495-15a4570eee9c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 309600 ms
Total Talk Time (AGENT): 115649 ms
Total Talk Time (CUSTOMER): 65054 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/35f505dd-c293-43a8-a495-15a4570eee9c_20250602T16:41_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so my name is [PII], utilization review coordinator of Barnes Jewish Hospital. Um, I have a patient admitted to the hospital. I just need to check for pre-certification is required.
[AGENT][POSITIVE] OK, sure, I can assist you with information. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. May I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 02221072
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. And what type of service is being rendered?
[CUSTOMER][NEUTRAL] Inpatient hospital.
[AGENT][NEUTRAL] Inpatient.
[AGENT][NEUTRAL] And I'm sorry, can I get the spelling of your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Thank you, Miss [PII]. All right, so pre-cert is not gonna be required on this one. This is a limited hospital indemnity policy.
[CUSTOMER][NEGATIVE] Oh, that's not good.
[CUSTOMER][NEUTRAL] Do you know what the benefits are?
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, I can give you the benefits and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. And let's see, so we have a daily hospital confinement benefit of $100 and we have a admission benefit one time per year of $1000.
[CUSTOMER][NEUTRAL] So it's 1000 are being admitted and then it's $100 a day.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] Is there a max amount of days?
[AGENT][NEUTRAL] For the hospital confinement, let's see.
[AGENT][NEUTRAL] Looks like it says 4, but let me double check because it may be a little bit more than that. I don't think it's gonna be 4. Let me, let me pull the certificate information. One moment.
[AGENT][NEUTRAL] OK, here it is.
[AGENT][NEUTRAL] Let's
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] To the benefits of 30 days per period of confinement.
[CUSTOMER][NEUTRAL] So for a maximum of 30 days.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] And when does it like reset? How, how long does he have to stay out of the hospital?
[AGENT][NEUTRAL] So basically it's going to be uh every 30 days because it says a total benefit of 30 days for one period of confinement.
[AGENT][NEUTRAL] So basically, if he's 30 days and then he goes back in a couple of days, just another 30 days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. So he just has to stay out for a few days.
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Correct, yes. Mhm.
[CUSTOMER][NEUTRAL] OK. OK, great. And your name's [PII]?
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[CUSTOMER][POSITIVE] OK wonderful thank you for your help.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today, Miss [PII]?
[CUSTOMER][NEUTRAL] No, there is not.
[AGENT][POSITIVE] OK. You have a good day. You're welcome. Bye-bye.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too