AccountId: 011433970860
ContactId: 8b42ac19-c063-4c6c-83c0-9e2b8a981b69
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 227500 ms
Total Talk Time (AGENT): 79974 ms
Total Talk Time (CUSTOMER): 54830 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/8b42ac19-c063-4c6c-83c0-9e2b8a981b69_20250224T22:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm not sure that I have the right department, but I am a uh utilization management nurse and I am trying to find um where I call to start an authorization for a patient.
[CUSTOMER][NEUTRAL] He it has a multi-plan, but then the card says it's a 90 degree benefit. uh I'm just very confused.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's take a look, [PII]. Do you have the um policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have a member ID number of 02572295.
[AGENT][NEUTRAL] OK, let me pull this up.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right. What is the um patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] Date of birth [PII].
[AGENT][NEUTRAL] Alright, perfect. OK, so what the insured has is a limited benefit plan, um, just pays a set amount depending upon what they're being seen or treated for. No pre-op is needed under the plan is, are they being seen for something specific? I can look.
[CUSTOMER][NEUTRAL] Um, he was admitted for congestive heart failure.
[AGENT][NEUTRAL] OK, let's see what the
[AGENT][NEUTRAL] Um
[AGENT][POSITIVE] Gosh it gives a whole much. OK, so.
[AGENT][NEUTRAL] The hospital admission benefit on the plan.
[AGENT][NEUTRAL] Um, it looks like the daily confinement, the plan pays $100 per day that the insured is in the hospital.
[AGENT][NEUTRAL] Um, once they're admitted, there's a lump sum payment of 1500 towards the stay.
[AGENT][NEUTRAL] And then it has a surgical and anesthesia benefit if that were applicable also.
[CUSTOMER][NEUTRAL] Oh, OK, so far not.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. OK, wonderful. Thank you so very much.
[AGENT][NEUTRAL] You're welcome, [PII]. Did you need me to check on anything else?
[CUSTOMER][NEUTRAL] No, I don't think so, not at this time.
[AGENT][POSITIVE] Alright sounds good well thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thanks, [PII]. You too. Bye-bye.
[AGENT][NEUTRAL] Uh bye bye.