AccountId: 011433970860
ContactId: 79a58fce-2e48-4692-9835-23d0c94e6261
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305820 ms
Total Talk Time (AGENT): 131191 ms
Total Talk Time (CUSTOMER): 81318 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/26/79a58fce-2e48-4692-9835-23d0c94e6261_20250626T13:26_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I am calling to verify.
[CUSTOMER][NEUTRAL] Um, a patient's eligibility.
[AGENT][NEUTRAL] OK, sure, I can assist you with the eligibility, Miss [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the policy number?
[CUSTOMER][NEUTRAL] Um, the policy number is.
[CUSTOMER][NEUTRAL] D as in Delta 437
[CUSTOMER][NEUTRAL] 30531.
[AGENT][NEUTRAL] Um, do you see a policy certificate number? It's gonna start with 0 followed by 7 digits.
[CUSTOMER][NEUTRAL] Um, no, I do not.
[CUSTOMER][NEUTRAL] All I have is 02596460.
[AGENT][POSITIVE] Yeah, that sounds like us. Go ahead with that number one more time.
[CUSTOMER][NEUTRAL] So, um, 02.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 460.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Um, this is [PII] [PII], [PII].
[AGENT][NEUTRAL] Thank you. And you're calling from which facility for my notes, Miss. [PII]?
[CUSTOMER][NEUTRAL] This is Piedmont University Hospital.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right, and you say you need eligibility. We have an effective date of [PII]. It is active at the moment and this is a limited hospital indemnity plan.
[CUSTOMER][NEUTRAL] OK, so it does cover hospital stays.
[AGENT][NEUTRAL] For inpatient.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, do you need benefits?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK before I give you any benefit information, I need to let you know that this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer. We have a hospital admission benefit of 1000 and that's one time per covered person per calendar year. And then we have a daily hospital benefit of 100 up to 30 days.
[CUSTOMER][NEUTRAL] OK, so there's a one-time payment of $1000 for the hospital stay?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] That's the admission and then it's $100 daily for the hospital stay.
[CUSTOMER][NEUTRAL] OK, and that's per calendar year?
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][NEUTRAL] OK, has she used?
[CUSTOMER][NEUTRAL] The 1000 discount a year.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Let me check.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] As of today, she has not used her benefits, so she still have the full amount available.
[CUSTOMER][NEUTRAL] OK, and does this plan require any prior authorization?
[AGENT][NEUTRAL] No, because this is just a limited policy.
[CUSTOMER][NEUTRAL] OK, um, is there a call reference and I, I need your name again, I'm sorry.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date. My name is [PII], that's [PII]. That's initial [PII].
[CUSTOMER][NEUTRAL] OK, so one more question, um, for the claim benefits or do we pay, where do we send those to?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me check one moment.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] OK, so for this one, the claim will go to IMA before it comes to us they do any repricing and that's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm sorry, can you repeat the zip code? I'm sorry.
[AGENT][NEUTRAL] Sure, it is [PII].
[CUSTOMER][POSITIVE] OK. All right. Well, thank you again for your help today.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that's all, thank you.
[AGENT][POSITIVE] You're welcome. Thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye bye.