AccountId: 011433970860
ContactId: b900dcf7-91c7-4830-88c2-3a3da58698bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219600 ms
Total Talk Time (AGENT): 98710 ms
Total Talk Time (CUSTOMER): 89056 ms
Interruptions: 3
Overall Sentiment: AGENT=0.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/b900dcf7-91c7-4830-88c2-3a3da58698bf_20250417T15:02_UTC.wav
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[AGENT][NEUTRAL] Yeah, this is [PII].
[CUSTOMER][NEUTRAL] Hi, I'm so sorry you're breaking up. You said your name was [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Hi, I am, I am calling for eligibility and inpatient benefits.
[AGENT][NEUTRAL] OK, and may I have your name, please?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII], thank you, and your callback number is disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. May I have the policy number, please?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, yes, it's 02587813. M as in Mary, L as in Lima, 7.
[AGENT][POSITIVE] Thank you very much. One moment, please.
[AGENT][NEUTRAL] Verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, that's [PII] [PII], [PII].
[AGENT][NEUTRAL] Thank you very much for that information, [PII]. Excuse me, and you're calling for eligibility and inpatient benefits, is that correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Um, yes, correct.
[AGENT][NEUTRAL] OK. All right, thank you. I can help you with both. And this number shows effective as of [PII] policy shows active. And for inpatient benefits, one moment, please.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you. Please note verification of benefits provided does not guarantee payment. We pay up to $3000.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That's per confinement.
[CUSTOMER][NEUTRAL] And that's per calendar here?
[AGENT][NEUTRAL] That per consignment.
[CUSTOMER][NEUTRAL] OK. What does per confinement mean? Sorry.
[AGENT][NEUTRAL] That means, uh, no problem. That means if the member is in the hospital, um, we'll say today and he's there until, um, maybe, oh my gosh, this is OK, bad example. OK, so today is Thursday. If he's there until like Monday, that's one confinement for an illness. We'll pay the max of $3000. And if he goes into the hospital next week or next month, um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] With
[AGENT][NEUTRAL] It's a per consignment, so each time he's in the hospital it's per confinement per confinement.
[CUSTOMER][NEUTRAL] So, um, basically, the amount of time that they're in, uh, as an inpatient for a certain procedure.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Perfect, thank you. Um, and OK, so that just, is that just like, uh, what he has in total for all the confinements of the year or is that each time he
[CUSTOMER][NEUTRAL] Goes and has been admitted he has the 3000 so it's what I'm trying to get to is like is there anything used towards that 3000.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] He has used nothing towards impatience for this year.
[CUSTOMER][POSITIVE] OK. Perfect. So he has the full amount, so it's OK.
[CUSTOMER][POSITIVE] Thank you so much. Um, can I get a reference number for this call?
[AGENT][NEUTRAL] You're welcome, [PII]. We do not provide reference numbers. You can use my name [PII]. Last initials [PII] and today's date. Do you need any information as far as claim submission?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Um, no, thank you so much.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a good day. Take care. Bye bye.
[CUSTOMER][NEUTRAL] You too. Bye bye.