AccountId: 011433970860
ContactId: c18d70bc-9293-4084-bc41-bf905b095048
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 304239 ms
Total Talk Time (AGENT): 66897 ms
Total Talk Time (CUSTOMER): 122276 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/c18d70bc-9293-4084-bc41-bf905b095048_20250505T19:25_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 afternoon. This is [PII] calling from Thomas Jefferson Initiative. Uh, I'd like to check whether the author system is required for observation patient or not. Can you help me with that, please?
[AGENT][NEUTRAL] Yes, do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] Uh yeah, sure. It's [PII].
[AGENT][NEUTRAL] And patient uh policy number?
[CUSTOMER][NEUTRAL] Uh, uh, the member ID is you're asking about member ID, right?
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, it's D as in Delta 43301757.
[AGENT][NEUTRAL] And you have the last name of the patient?
[CUSTOMER][NEUTRAL] Uh, it's [PII], uh, let me spell it. [PII] [PII].
[AGENT][NEUTRAL] And first name?
[CUSTOMER][NEUTRAL] Uh it's [PII]
[AGENT][NEUTRAL] Do you have a group number for the policy?
[CUSTOMER][NEUTRAL] Um, yeah, sure, the group number is 02294497.
[AGENT][NEUTRAL] OK. And the date of birth of the patient?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and you were wanting to check on, did you say Benefit [PII] or was that, what were you checking on?
[CUSTOMER][NEUTRAL] Uh, I just want to, I just want to check benefits also, but I want, just want to check whether the authorization is required for observation or not. The patient was in observation today, so I just want to check whether the author is required or not for observation.
[AGENT][NEUTRAL] No, no authorizations required.
[CUSTOMER][POSITIVE] Uh, OK. Thank you so much. Uh, can you help me with the benefits, benefits like co-pay, coins, deductible and out of pocket which patient has met, yeah.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You can go ahead.
[AGENT][NEUTRAL] And this is not a guarantee of payment basic outline of the policy.
[AGENT][NEUTRAL] Um, so this is a very limited hospital indemnity plan. So for, so it was just outpatient hospital, is that right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So their benefit is a maximum payable of $75.
[AGENT][NEUTRAL] 5 times per year.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Uh, is there any separate co-pay, coins in and out of pocket for this patient?
[CUSTOMER][NEUTRAL] Can you spell it separately?
[AGENT][NEUTRAL] No, the most that we'll pay is $75 for an outpatient hospital visit.
[AGENT][NEUTRAL] So there's no deductible, copay or coin.
[CUSTOMER][POSITIVE] OK, thank you so much. I mean, I
[CUSTOMER][POSITIVE] OK. Thank you so much, uh.
[CUSTOMER][NEUTRAL] $75.
[CUSTOMER][NEUTRAL] One second, let me note it out.
[CUSTOMER][NEUTRAL] OK, let me repeat it from first. There is no copay coincidence that there and out of pocket, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you so much. May I know your good name for documentation process? Can you spell it for me, please?
[AGENT][NEUTRAL] Yes, it's [PII]. It's [PII]
[CUSTOMER][POSITIVE] Thank you so much, [PII]. May I know your last name's first initial, [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Thank you so much, sir. That is, uh, could you please provide me a call reference number for this call statement?
[AGENT][NEUTRAL] It's my name, [PII], with today's date.
[CUSTOMER][POSITIVE] OK. Thank you so much. Happy to speaking with you. Have a nice day. Bye-bye.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye bye.