AccountId: 011433970860
ContactId: e5a82670-10a8-480c-b65b-fb56b0c0eaa1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 364880 ms
Total Talk Time (AGENT): 95368 ms
Total Talk Time (CUSTOMER): 134849 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/e5a82670-10a8-480c-b65b-fb56b0c0eaa1_20250515T20:43_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Hi, sir. Uh, my name is [PII]. I'm calling from facility for an year admitting patient eligibility benefits and authorization. Could you please help me with that?
[AGENT][POSITIVE] I'm happy to check on benefits and eligibility. What's the policy number?
[CUSTOMER][NEUTRAL] It's D as in Delta 43301757.
[AGENT][NEUTRAL] Do you see anything on the member's card that's a certificate number, not member ID?
[CUSTOMER][NEUTRAL] OK um.
[CUSTOMER][NEUTRAL] One moment, please, please give a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I see here like a medical ID number. It's this is um.
[AGENT][NEUTRAL] Starts with [PII].
[CUSTOMER][NEUTRAL] Yes, [PII] [PII] [PII].
[AGENT][NEUTRAL] What's the patient's name and date of birth? I can look them up by name.
[CUSTOMER][NEUTRAL] Or uh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, OK. It's [PII], first name is [PII] and the last name is [PII]. It's [PII]
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] What state does the patient reside in?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Date of birth?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Data service.
[AGENT][NEUTRAL] Are you just looking for eligibility?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Are you looking for a claim or eligibility? I'm sorry.
[CUSTOMER][NEUTRAL] For an eligibility.
[AGENT][NEUTRAL] All right, so patient plan is active. The effective date um on this again is going to be [PII].
[CUSTOMER][NEUTRAL] OK. It's [PII]. OK.
[CUSTOMER][NEUTRAL] Uh, could you please, uh, tell me the benefits, inpatient benefits for this member?
[AGENT][NEUTRAL] I am
[AGENT][NEUTRAL] What kind of benefits are you looking for? Is the patient being seen for an office visit?
[CUSTOMER][NEUTRAL] For inpatient medical services.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] To cancel.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][POSITIVE] Wow
[CUSTOMER][NEUTRAL] No, did you see this a call like I like.
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] So the patient plan has a daily hospital confinement benefit. Uh, it looks like it pays $50 a day.
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] If the patient is admitted to the hospital, there's a first occurrence benefit of $500.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. I need to know about uh deductible out of pocket co-pay and co-insurance.
[AGENT][NEUTRAL] This is not a major medical, so there is no co-pay, co-insurance or any of that. This is a limited benefit hospital indemnity plan. So it's only gonna pay that set amount depending upon what the patient's being seen for.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK. Thank you. Thank you for the information, ma'am. Uh, if you don't mind, uh, just a confirmation, it is not provide inpatient benefits, right?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm sorry, what was that again?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I mean, it's not covered inpatient benefits, right?
[CUSTOMER][NEUTRAL] Let me
[AGENT][NEUTRAL] It covers an in-hospital stay if that's what you're asking.
[CUSTOMER][NEUTRAL] Yeah, yeah, OK, yeah, I understand that. OK. Uh, OK, thank you. Could you please spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK initial.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Thank you. Can I get the call reference number, please?
[AGENT][NEUTRAL] That's my name and today's date.
[CUSTOMER][POSITIVE] OK, [PII]. Thank you. Thank you for the information and thanks for that and have a great day.
[AGENT][NEUTRAL] You as well bye bye.