AccountId: 011433970860
ContactId: 5379004c-a8e4-49af-aeb3-f0f95d9bd200
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 211960 ms
Total Talk Time (AGENT): 103806 ms
Total Talk Time (CUSTOMER): 56523 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=3.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/5379004c-a8e4-49af-aeb3-f0f95d9bd200_20250609T12:43_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, I have a member of yours who was admitted into the hospital under observation status, and I just needed to know what your guys' policy and protocol is.
[AGENT][NEUTRAL] OK, so you have a member that you're needing to verify eligibility and benefits on, is that correct?
[CUSTOMER][NEUTRAL] Uh, uh, or I need to do a prior authorization for an observation stay at a hospital.
[AGENT][NEUTRAL] OK, yes ma'am. Well, I can help you with that and who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII]. Last initial is [PII]
[AGENT][NEUTRAL] All right, [PII], thank you. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] 02586238.
[AGENT][NEUTRAL] OK, [PII], thank you one moment please while I get the member's information pulled up.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, [PII], and any information that I do provide would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do show that Mr. [PII] is a subscriber on this hospital indemnity limited benefit plan. And because this is not major medical insurance, [PII], there is no prior authorization required, but his policy is active with an effective date of [PII].
[CUSTOMER][POSITIVE] Perfect. And then, can I have a reference number for this call?
[AGENT][NEUTRAL] Yes ma'am, you would actually use my name that I gave you along with today's date and then one last thing, [PII], once the claim, if you will end up filing a claim on this member, once it has been processed, we do have a portal that you all should be able to check claim status and.
[AGENT][NEUTRAL] And the website for our portal is located at [PII].
[CUSTOMER][POSITIVE] Alright perfect and you guys don't need clinicals or anything sent in for this, correct?
[AGENT][NEUTRAL] Now, ma'am, again, we're, this is not major medical insurance. It's a hospital indemnity limited benefit plan. So, no, ma'am. That would not be required.
[CUSTOMER][POSITIVE] OK, OK, perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, that is what I needed.
[AGENT][POSITIVE] OK, well then if that is all I could help you with this morning, thank you again for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you, you as well.
[AGENT][POSITIVE] You, thank you so much. Uh-huh.
[CUSTOMER][POSITIVE] Thanks bye bye.
[AGENT][NEUTRAL] Bye-bye.