AccountId: 011433970860
ContactId: 54ed4cd7-ae3f-466d-a29f-0923a0221e60
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 312130 ms
Total Talk Time (AGENT): 133737 ms
Total Talk Time (CUSTOMER): 51355 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/28/54ed4cd7-ae3f-466d-a29f-0923a0221e60_20250428T19:28_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], my name is [PII]. I'm calling from Sharp Memorial Hospital. I was calling to verify eligibility and get some benefits for a number, please.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with the eligibility and benefits. And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Sure, it's [PII]. Policy number is 02495893.
[AGENT][NEUTRAL] Thank you. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII] [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII]. And what type of benefits did you want to go over today?
[CUSTOMER][NEUTRAL] Inpatient hospitalization.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And [PII], do you mind if I place you on just a brief hold while I pull up the policy benefits?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Alright, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. So this, um, so taking a look at her policy, or his policy, sorry, this is a hospital indemnity policy. So the only benefits that would um
[AGENT][NEUTRAL] Or could be used for an in-hospital stay would be the hospital confinement benefit. So any, um, let me make sure for this policy if confinement is 18 or 24, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for this policy, it's, um, the patient has to be admitted and in the hospital for at least 24 consecutive hours, and then the daily hospital, um,
[AGENT][NEUTRAL] Confinement benefit is up to $50 per day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh wow, OK.
[AGENT][NEUTRAL] There's also a
[CUSTOMER][NEUTRAL] Up to how many days?
[AGENT][NEGATIVE] Um, it doesn't give a max.
[CUSTOMER][NEUTRAL] OK, so just $50 per day coverage and then the rest is patient responsibility?
[AGENT][NEUTRAL] Well, we don't determine patient responsibility because we're not a major medical.
[AGENT][NEUTRAL] So if, if there are no other insurances, then it would just be um whatever your policies are for outstanding or remaining balances.
[CUSTOMER][NEUTRAL] OK, that's what I'm saying, like you guys only cover $50 per day max.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Correct. OK, that's what I just wanna verify. Do you guys require authorization?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Um, no, we don't require authorization because we're not the major medical. There's also a first occurrence hospital rider which would pay out um $500 the first time they are admitted, um, inpatient, so they could probably take advantage of that as well. But of course, we can't guarantee until we process. It's the first occurrence hospital rider?
[CUSTOMER][NEUTRAL] What's it called?
[CUSTOMER][NEUTRAL] OK. $500. OK. OK. Um, and then may I get a, a call reference number?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name and today's date. First initial of my last name is [PII].
[CUSTOMER][POSITIVE] Great. Thank you so much. Have a good day.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help with?
[CUSTOMER][POSITIVE] That's it. Thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL bye bye.