AccountId: 011433970860
ContactId: 9a427b39-3840-414b-819d-27e3d9f30852
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 273899 ms
Total Talk Time (AGENT): 139033 ms
Total Talk Time (CUSTOMER): 117543 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/9a427b39-3840-414b-819d-27e3d9f30852_20250206T14:31_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] Um, you said [PII]?
[AGENT][POSITIVE] Yes, so [PII].
[CUSTOMER][NEUTRAL] OK, thank you. I'm [PII] with Marshall Browning Hospital in [PII], and we have a patient who was admitted here to our hospital and I was just trying to figure out his insurance and if this was uh some type of insurance.
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, sure, I can assist you with eligibility and benefits, Miss [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Certainly [PII], that's my direct line.
[AGENT][NEUTRAL] OK, thank you. I didn't quite catch the name of the hospital. What's the, the name of the hospital?
[CUSTOMER][NEUTRAL] Marshall Browning Hospital.
[AGENT][NEUTRAL] Marsh, OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Let's see if we have a policy. You is it medical ID? Would that be the policy number?
[AGENT][NEUTRAL] I can try that.
[CUSTOMER][NEUTRAL] I don't have. I just have this oh here it is. I see it excuse me 02569825.
[AGENT][NEUTRAL] All right. And may I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] and his date of birth is [PII].
[AGENT][POSITIVE] Perfect. Thank you. All right.
[AGENT][NEUTRAL] And let's see, for the eligibility, we have an effective date of [PII].
[AGENT][NEUTRAL] It is active at the moment and this is one of our hospital indemnity plans. And before I give you 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. And is this for hospitalization or what type of service?
[CUSTOMER][NEUTRAL] Um-hum.
[CUSTOMER][NEUTRAL] Um, he is here in the observation.
[AGENT][NEUTRAL] OK. Is it gonna, has it been less than 24 hours or more?
[CUSTOMER][NEUTRAL] Yes, it's been less he just um got here at uh looks like one.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Um, hold on, let me tell you the exact time. I apologize, um, actually, yeah, he got here at [PII], um, this morning.
[AGENT][NEUTRAL] Alright and um.
[AGENT][NEUTRAL] It was through the ER.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. All right, let me go ahead and give you the benefit, and this is not a guarantee of payment, just a verification of coverage. And again, this is a limited policy. So this one has flat amounts and the ER visit amount is $75. That is what it covers $75 for the ER visit and um if he becomes um
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Like inpatient or confinement.
[CUSTOMER][NEUTRAL] What about um
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, he is in, he's inpatient, but we put him as observation.
[CUSTOMER][NEUTRAL] So he stayed, he's been admitted.
[AGENT][NEUTRAL] Yeah, if it
[AGENT][NEUTRAL] Oh, he's been admitted? OK. Well, if he's been admitted, usually it counts 24 hours or more. Um, so the admission is gonna be uh $500 and that's up to 4 times per year.
[AGENT][NEUTRAL] And then a $50 daily confinement.
[CUSTOMER][NEUTRAL] So that's what you pay is $500 and then a $50 confinement.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Yes, daily confinement.
[CUSTOMER][NEUTRAL] Do I need any kind of pre-certification?
[AGENT][NEUTRAL] No, because it's just a limited policy. It's not a major medical, so pre-certs are not required.
[CUSTOMER][NEUTRAL] OK, OK, so it will pay some, um, but not, um, maybe not the whole amount. Well, that's good to know. OK, I will um let everybody know that he he should be good for a little bit but then he may end up with a bill, so that's good. OK, well thank you for your time.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Got a hold on yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Miss [PII]?
[CUSTOMER][POSITIVE] No, that's perfect thank you.
[AGENT][POSITIVE] OK, you're welcome and thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] Mhm bye bye.
[AGENT][NEUTRAL] Yeah