AccountId: 011433970860
ContactId: 49bb2fb4-0069-4bf4-aac2-15a037850238
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 186399 ms
Total Talk Time (AGENT): 87391 ms
Total Talk Time (CUSTOMER): 62651 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/49bb2fb4-0069-4bf4-aac2-15a037850238_20250417T19:46_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], this is [PII] with OBGYN Specialty in [PII]. I have a a patient with this. I, I don't, I've never dealt with your kind of insurance. Is it like a secondary insurance to her primary? Is that how that works?
[AGENT][NEUTRAL] Um, well, I have to look and see what type of policy they have, but I'll be more than happy to help you with the coverage. Um, and you said your name is [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Um, yes, it's 02603050.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, yes it's gonna be [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. Um, so I'm showing the policy is active, it's been effective since [PII]. So this is actually a hospital indemnity policy. So it's a limited medical policy. Um, hold on one moment, I'm pulling up the benefits so I can go over them with you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so the policy has a hassle admission benefit which would pay up to $2000 per day with a max of 4 days per calendar year.
[AGENT][NEUTRAL] Um, there's also a hospital consignment benefit which will pay up to $50 per day with a max of 5 days per calendar year.
[CUSTOMER][NEUTRAL] OK, so do we do, do we have to notify upon admission or does the patient fill all that out with you guys?
[AGENT][NEUTRAL] Um, no, you.
[CUSTOMER][NEUTRAL] Cause she is gonna have she's gonna have inpatient surgery.
[AGENT][NEUTRAL] OK, so yes, you will file the claim with us.
[AGENT][NEUTRAL] I mean, she has the option to file it, but providers typically file it.
[CUSTOMER][NEUTRAL] OK. Do.
[CUSTOMER][NEUTRAL] Do we get prior authorization from you guys or anything like that or is it once she's admitted they call?
[AGENT][NEUTRAL] No, prior authorization is not required for any APL policy because we're not a major medical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] That's all I needed to know, thank you. Is there a call reference number?
[AGENT][NEUTRAL] You're very welcome, [PII]. Um, so no, there's no call reference number, but you can use my name in today's date, and again, that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome and thanks for calling APL. I hope you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.