AccountId: 011433970860
ContactId: dc66c1e7-83ec-401e-89dc-2da956985ad4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 278779 ms
Total Talk Time (AGENT): 124519 ms
Total Talk Time (CUSTOMER): 66391 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/dc66c1e7-83ec-401e-89dc-2da956985ad4_20250530T17:00_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] M. My last name [PII], calling from Thomas Jefferson University Hospital.
[AGENT][POSITIVE] Yes, [PII]. How can I help you? I mean, [PII], how can I help you today?
[CUSTOMER][NEUTRAL] I would like to verify the eligibility of the member. Could you please help with that?
[AGENT][NEUTRAL] OK, you're needing to verify eligibility, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, [PII], I can help you with that and what is your callback number?
[CUSTOMER][NEUTRAL] [PII] with an extension of [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] 02294497.
[AGENT][POSITIVE] OK [PII] thank you one moment.
[AGENT][NEUTRAL] Any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Member's first name, [PII] and the last name, [PII]. His date of birth, [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Well, I do show that he is the subscriber on this limited benefit plan, [PII], and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Uh, could you please confirm whether this member had hospital benefits?
[AGENT][NEUTRAL] I'm sorry, you're also needing benefit information?
[CUSTOMER][NEUTRAL] Uh, I'm looking for this number is eligible for inpatient.
[AGENT][NEUTRAL] Inpatient, is that correct? An inpatient admission?
[CUSTOMER][NEUTRAL] inpatient, yes, inpatient.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So he has a hospital confinement benefit in the amount of $50 per day.
[CUSTOMER][NEUTRAL] So he does not have any hospital inpatient benefits, is that correct?
[AGENT][NEUTRAL] I just provided you with this limited benefit plan covers for an inpatient admission. He has a hospital confinement benefit.
[AGENT][NEUTRAL] Of $50 per day.
[CUSTOMER][NEUTRAL] So he has.
[CUSTOMER][NEUTRAL] Yeah. Thanks for the information. Uh, is there any, uh, could you please confirm that this patient requires authorization for the inpatient admission?
[AGENT][NEUTRAL] Uh, no, sir, because this is not major medical insurance, there is no prior authorization required.
[CUSTOMER][NEUTRAL] Yeah. Thanks for the help, [PII]. May I have the call reference number for this call?
[AGENT][NEUTRAL] Yes, sir. Yes, just a couple of additional pieces of information on this policy. The, that's
[AGENT][NEUTRAL] The hospital confinement benefit, um, shall not exceed 180 days for any one period of confinement.
[AGENT][NEUTRAL] And then as far as a call reference number you would use my name along with today's date.
[AGENT][NEUTRAL] And also [PII], if you will file a claim with us for this number on this policy, once it has been.
[AGENT][NEUTRAL] Reviewed and processed, we do have a portal that you should be able to check claim status in and that website for our portal is secured. [PII].
[CUSTOMER][POSITIVE] Yeah. Thanks for the information, [PII]. Have a great day.
[AGENT][POSITIVE] You're welcome. Well, you're very welcome, [PII]. So again, if that's all I can help you with, thank you for calling APL and I hope you have a nice day also.
[CUSTOMER][POSITIVE] Thanks, you too.
[AGENT][POSITIVE] Thank you, bye bye.