AccountId: 011433970860
ContactId: af851aa4-0c55-458c-b63f-3e05fca4aff4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 277040 ms
Total Talk Time (AGENT): 147923 ms
Total Talk Time (CUSTOMER): 90327 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/af851aa4-0c55-458c-b63f-3e05fca4aff4_20250211T15:20_UTC.wav
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[AGENT][NEUTRAL] You for calling. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] I don't make you.
[CUSTOMER][NEUTRAL] Uh, hi, uh, [PII], this is [PII] with the Loveless Regional Hospital, and I'm trying to verify current coverage and find out what kind of policy.
[AGENT][POSITIVE] OK, I can help you with that. Can I get a callback number for you?
[CUSTOMER][NEUTRAL] You can [PII].
[AGENT][NEUTRAL] Thank you. The policy number you're calling on?
[CUSTOMER][NEUTRAL] 02168825
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you so much for verifying the account and you are calling to to check the benefits and what type of benefit plan this is.
[CUSTOMER][NEUTRAL] Correct and if it needs authorization or anything like that.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Please be advised verifying benefits does not guarantee payment.
[AGENT][NEUTRAL] Uh, let's see, so this is a limited medical plan.
[AGENT][NEUTRAL] Uh, authorization would not be required for the policy. Uh, it is a non-contracted policy, so they are able to go to any physician. Um, and what type of service is the patient coming in for?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, this is gonna be for an inpatient hospital stay for [PII].
[AGENT][NEUTRAL] OK, let's see, and the policy has been effective since [PII].
[AGENT][NEUTRAL] And let me check those benefits and patient stay hospital admission.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So for a hospital admission, it looks like the policy only pays for, uh, inpatient admission. Uh, for the admission, the policy pays $2500.
[AGENT][NEUTRAL] Um, they do have 4 of these to use the calendar year, um, and then the policy will pay up to $50 a day.
[AGENT][NEUTRAL] Uh, and up to 5 days a calendar year.
[CUSTOMER][NEUTRAL] OK, so it'll pay a maximum benefit of $2500 a year, right?
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] For the inpatient?
[AGENT][NEUTRAL] It's per, uh,
[AGENT][NEUTRAL] For the inpatient, yes, $2500.
[CUSTOMER][NEUTRAL] Oh, per, OK. Per Advent.
[AGENT][NEUTRAL] So per admission, yes.
[CUSTOMER][NEUTRAL] OK, and then the $50 per day up to 5 days?
[AGENT][NEUTRAL] 5 days of calendar year.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it's the, the $2500 OK.
[CUSTOMER][NEUTRAL] It's a little confusing. And then um is there a call?
[AGENT][NEUTRAL] So the, the admissions, so let's just say they have multiple admissions in a year. The $2500 payment, they can receive 4 of those per year.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh got you OK.
[AGENT][NEUTRAL] But the $50 per day benefit.
[AGENT][NEUTRAL] Only pays up to 5 days a calendar year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I was just confused because it had a 25 max and then a $50 per day. So I guess, oh, I see, so they have multiple days.
[AGENT][NEUTRAL] Right, so they'll
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] The $50 per day benefit will only be paid up to 5 days in a calendar year. As far as the $2500 maximum benefit, um, they can receive up to 4 of those a calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I got you. Oh, OK.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] That makes sense.
[CUSTOMER][NEUTRAL] Um, just as if there was a call reference.
[AGENT][NEUTRAL] To reference the call, you will use my name, [PII] and today's date.
[CUSTOMER][POSITIVE] OK, I appreciate your help. Thank you so much.
[AGENT][POSITIVE] You're welcome. You have a wonderful day. Thank you for calling APL.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Mm bye bye.