AccountId: 011433970860
ContactId: e357234e-1887-4c33-beb7-f95f3010b877
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 159009 ms
Total Talk Time (AGENT): 70865 ms
Total Talk Time (CUSTOMER): 52836 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/e357234e-1887-4c33-beb7-f95f3010b877_20250127T19:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Saint Elizabeth Healthcare. I've got a patient that I need to check and see if there's any benefits for hospital services, please.
[AGENT][POSITIVE] Alright, I'm happy to check benefits [PII]. What's the policy number?
[CUSTOMER][NEUTRAL] I have D as in David, 43729923.
[AGENT][NEUTRAL] Alright, I can't pull it with number do you have their name or social I can check that way?
[CUSTOMER][NEUTRAL] Um, you know what, I gave you the wrong number. Sorry, I gave, I'm sorry. It's [PII].
[AGENT][NEUTRAL] That's OK.
[AGENT][POSITIVE] Thank you so much. Give me just a sec, let me pull this up.
[AGENT][NEUTRAL] Uh, patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, the patient is [PII], 928-66.
[AGENT][POSITIVE] Alright, thank you so much. So patient plan is active. The effective date on this is [PII] still active.
[AGENT][NEUTRAL] And it looks like this is a limited benefit plan, so hospital indemnity, it's just gonna pay a set amount depending upon what the patient's being seen for um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If they're admitted into the hospital.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Uh, daily hospital confinement, that would be 18 hours or longer. The benefit amount is $100 a day, it looks like.
[CUSTOMER][NEUTRAL] Is there a um.
[CUSTOMER][NEUTRAL] Uh, limited to the days.
[AGENT][NEUTRAL] Uh, no, not, yeah, no, not showing a day limit.
[CUSTOMER][NEUTRAL] I mean a day limit, OK.
[CUSTOMER][NEUTRAL] OK, now they're currently inpatient. They've been here longer than 18 hours. OK. Are there, for whatever reason, the diagnosis could be considered an observation state does the does the patient have any observation charges?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let's see.
[CUSTOMER][NEUTRAL] I mean observation benefits.
[AGENT][NEUTRAL] Uh, let me see if I see anything in here under observation.
[AGENT][NEUTRAL] I don't see anything listed for a benefit for just observation.
[CUSTOMER][POSITIVE] OK, alright, I will make a note of it. I appreciate your help thank you.
[AGENT][POSITIVE] You're welcome, [PII]. Have a good one.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.