AccountId: 011433970860
ContactId: 365d9efa-f5e3-4570-9fc2-a72df65936b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285440 ms
Total Talk Time (AGENT): 116917 ms
Total Talk Time (CUSTOMER): 100994 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/365d9efa-f5e3-4570-9fc2-a72df65936b3_20250612T16:12_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] Uh hi, my name is [PII]. I'm calling from a uh provider hospital. Can I get your name again?
[AGENT][NEUTRAL] Sure, my name is [PII].
[CUSTOMER][NEUTRAL] [PII] OK, um, I am trying to get patients eligibility and benefits. Um, are you able to help me?
[AGENT][POSITIVE] Yes, I can assist you with the eligibility and benefits, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Absolutely it's [PII].
[AGENT][NEUTRAL] Thank you. And what's the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Oklahoma State University Medical Center.
[AGENT][NEUTRAL] OK, thank you. All right. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] It is 02576658.
[AGENT][NEUTRAL] Thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And what type of service is being rendered for benefits?
[CUSTOMER][NEUTRAL] Um, she was in the ER, so I was needing, um, eligibility and verification for data service 8.
[AGENT][NEUTRAL] Right yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEUTRAL] Oh, [PII]. OK, thank you.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] Before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage, and that's just for the disclaimer. We have an effective date of [PII]. It is active at the moment and this is a limited hospital indemnity policy.
[AGENT][NEUTRAL] And with this one we have the ER visit. We cover $50 per visit, maximum of 2 visits per covered person per calendar year. Again, this is a limited policy.
[CUSTOMER][NEUTRAL] $50 max per year.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] $50 per visit, maximum of 2 visits per year.
[CUSTOMER][NEUTRAL] That's 2 visits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] We need to send the claims.
[CUSTOMER][NEUTRAL] To is it gonna be attention IMA Inc.
[AGENT][NEUTRAL] Um, let me check and see exactly where you need to send it to. One moment.
[AGENT][NEUTRAL] OK, so this one will go to, yes, [PII].
[CUSTOMER][POSITIVE] Perfect, OK.
[CUSTOMER][NEUTRAL] And then just to confirm, it is a hospital indemnity plan.
[CUSTOMER][NEUTRAL] Um, $50 per visit max two visits per year.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. And does it, um, is it just for emergency room visits? Does the patient have to be admitted, anything like that?
[AGENT][NEUTRAL] Uh, that benefit amount is for emergency room only. If he's admitted, there is a different benefit. Um, let me give you that 11 moment.
[AGENT][NEUTRAL] OK, so for admission, um, we cover $500 and that's one time per cover person per calendar year, and then there's a $50 daily benefit up to 30 days.
[CUSTOMER][NEUTRAL] OK perfect that was the information that I needed. Do you have a call reference number?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's state if you will.
[CUSTOMER][POSITIVE] OK perfect well I appreciate your help today um and that was the information I needed.
[AGENT][POSITIVE] All right. Well, thank you for calling APR. You have a good day, Ms. [PII].
[CUSTOMER][POSITIVE] Mm thank you you too.
[AGENT][POSITIVE] You're welcome. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.