AccountId: 011433970860
ContactId: 684fe4e9-37e2-44d8-ba8d-ff6a3b4a644a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316880 ms
Total Talk Time (AGENT): 136433 ms
Total Talk Time (CUSTOMER): 83807 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/684fe4e9-37e2-44d8-ba8d-ff6a3b4a644a_20250220T13:38_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII], good morning. My name is [PII], um and it's spelled [PII], and then [PII] is the first initial of my last name. And I am calling today, I guess, to verify eligibility for members and to get their hospital inpatient benefits.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist 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, the, um, call back number is [PII].
[CUSTOMER][NEUTRAL] And then for the policy number I have 023.
[CUSTOMER][NEUTRAL] 11714
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh-huh, it is in, uh, the urge. His date of her date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So I'm actually showing this policy is no longer active. It turns on [PII], but there is an active policy. Let me give you that number. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it's policy number 258.
[AGENT][NEUTRAL] 649-3.
[AGENT][NEUTRAL] And this policy has been active since [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect. Uh, I didn't want me put it in there. Let's close that.
[AGENT][NEUTRAL] And then you said inpatient.
[CUSTOMER][NEUTRAL] Uh-huh, hospital inpatient.
[AGENT][NEUTRAL] So again, just for the call, all the information provided is a verification of benefits, not a guarantee of payment. So hold on one moment, I'm just waiting for the benefits to populate for.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Emo, do you mind if I place you on just a brief hold?
[CUSTOMER][POSITIVE] Oh, no, that's no problem. Thank you.
[AGENT][NEUTRAL] OK, hold on one moment, you're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yes, I'm here.
[AGENT][POSITIVE] Thank you so much for holding. I apologize for that wait. So for this um policy, for inpatient, um there's the hospital confinement benefit, which would pay up to $100 a day for confinement. And
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] I should have checked to see, hold on, I'm checking. OK, for this policy, confinement is at least 24 consecutive hours.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, you said.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, go ahead, I'm sorry.
[AGENT][NEUTRAL] So the benefits that they have that would could apply to inpatient would be the hospital confinement benefit, which is any time in the hospital for 24 consecutive hours or more, the policy will pay up to $100 per day. Um, there's also the intensive care rider, which will pay up to $400 a day if they are, if they do have to go to the intensive care unit.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And then if there is an admission for the first occurrence hospital rider, the policy would pay up to $1500 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect got it um and is authorization required for this number or no?
[AGENT][NEUTRAL] No authorization or pre-s research required.
[CUSTOMER][NEUTRAL] No. OK, perfect. Alright, and, and then, do we have a reference number for our call?
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much for all your help.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help with today?
[CUSTOMER][POSITIVE] Uh, no, that was all I needed. Thank you again.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL Shamo. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye.