AccountId: 011433970860
ContactId: 437e4685-4bf3-412b-b783-1656a6a30f8e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 187750 ms
Total Talk Time (AGENT): 89179 ms
Total Talk Time (CUSTOMER): 53232 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/437e4685-4bf3-412b-b783-1656a6a30f8e_20250102T18:39_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I need to do an inpatient authorization for an emergency room admission.
[AGENT][NEUTRAL] OK, so you're just needing um pre-authorization for inpatient for a patient?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And may I ask who I'm speaking with?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], in case this call is disconnected, may I have your callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Um, I have a number that someone said you wouldn't take and that I should give you the social security number to look it up.
[AGENT][NEUTRAL] OK, what is their social?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, and that was [PII]?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And may I have the patient's first and last name?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, I show this is a limited hospital indemnity plan. Pre-authorization is not required under this policy. It's not a major medical plan. I do show it's currently active, effective [PII]. Would you like the policy number?
[CUSTOMER][POSITIVE] Yes please.
[AGENT][NEUTRAL] It is 02348888.
[CUSTOMER][NEUTRAL] OK, and, and you said there's no authorization required for an inpatient?
[AGENT][NEUTRAL] Correct. This is not a major medical plan.
[CUSTOMER][NEUTRAL] What what is it then?
[AGENT][NEUTRAL] It's a limited hospital indemnity plan.
[AGENT][NEUTRAL] So it covers limited benefits for hospitalization.
[CUSTOMER][NEUTRAL] And so.
[CUSTOMER][NEUTRAL] OK, so it so it doesn't cover the inpatient benefit?
[AGENT][NEUTRAL] It does cover inpatient, but it only covers limited benefits.
[CUSTOMER][NEUTRAL] So then does the hospital just send you the bill and then you just pay what's covered?
[AGENT][NEUTRAL] We pay according to the policy provisions. So for hospitalization, we pay a limited benefit of 1000 for under their hospital annual benefit. And for hospital confinement, there is a daily benefit. We pay a limited benefit of 100 per day, and there's a max of 30 days max.
[AGENT][NEUTRAL] And I just must advise that this is just a verification of coverage and benefits. It does not guarantee payment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, thank you so much. Oh, actually, can I get a reference number?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] It'll be just my name and that's [PII] spelled [PII] Is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, that's it thank you.
[AGENT][POSITIVE] OK, you're welcome thanks for calling APO you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thanks bye.