AccountId: 011433970860
ContactId: 892550c1-b4a3-4340-8f63-52a0534bb89b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 348279 ms
Total Talk Time (AGENT): 154000 ms
Total Talk Time (CUSTOMER): 110923 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/892550c1-b4a3-4340-8f63-52a0534bb89b_20250113T15:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning. Uh, my name is [PII]. It's spelled [PII] First initials, so my last name is [PII], and I'm calling today to verify eligibility and to obtain hospital inpatient benefits for a member.
[AGENT][NEUTRAL] OK [PII], so you need to verify eligibility and inpatient benefits for a member, is that correct?
[CUSTOMER][POSITIVE] That's correct, uh-huh.
[AGENT][POSITIVE] Yes, [PII], I can help you with those things. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] D like Delta 437707993.
[AGENT][NEUTRAL] OK, thank you, but [PII], that is not an APL policy number, that is a 90 degree policy number. Is there, there should be another number also on the ID card for APL.
[CUSTOMER][NEUTRAL] Oh, this is the only ID number I see on the card. hmm.
[AGENT][NEUTRAL] OK. Do you happen to have the full social for the subscriber?
[CUSTOMER][NEUTRAL] Uh, let's see. Uh, yes, I do. Um, it is [PII].
[AGENT][NEUTRAL] OK, thank you. So give me a moment to locate the member's information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you know what, now that I'm looking at it, I'm sorry, so I, I do see something that says um policy number just all numbers. Could that be it?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mhm. That's it. Is it 02311714?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] It is, yes, sorry about that.
[AGENT][NEUTRAL] OK. All right. That's all right. OK, so just one moment. Still getting some information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so any information that I do provide for you today, [PII] would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Um, it is in the urge. Um, date of birth is [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, thank you. So I do show that she is the subscriber on this hospital indemnity limited benefit plan.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And this policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And again, this is not major medical insurance, it's a limited benefit plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So she has a hospital admission benefit of $1000.
[AGENT][NEUTRAL] And then she has a hospital confinement benefit of $100 per day, maximum 30 days per calendar year.
[AGENT][NEUTRAL] Per covered person.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK, alright, and by it being unlimited medical plan authorization isn't required, correct?
[AGENT][NEUTRAL] Mhm. And then.
[AGENT][POSITIVE] That is correct. Uh-huh.
[CUSTOMER][POSITIVE] Perfect. Alright, let me.
[AGENT][NEUTRAL] And then I don't know if you already are aware of this more, but we do have a portal in which our claim status can be checked along with having access to the explanation of benefits with our company and our portal website is secured. [PII].
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII]. Perfect. OK, got it. Alright, and can I have your name again as well as the reference number for our call.
[AGENT][NEUTRAL] Yes, my name again is [PII]
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] First initial to my last name, [PII].
[AGENT][NEUTRAL] And my name along with today's date will be your call reference number.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] Perfect, thank you so much for all your help today.
[AGENT][POSITIVE] Well, you are certainly very welcome. So if that's all that I can help you with, thank you again for calling APO and I hope that you have a wonderful day.
[CUSTOMER][POSITIVE] I hope you do the same. Thank you so much. Bye-bye. Bye-bye.
[AGENT][POSITIVE] Thank, yes, ma'am. Thank you too. Bye-bye.