AccountId: 011433970860
ContactId: f743b3c2-c05b-4a56-b234-83f6dc26b3c1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247710 ms
Total Talk Time (AGENT): 112287 ms
Total Talk Time (CUSTOMER): 76411 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/f743b3c2-c05b-4a56-b234-83f6dc26b3c1_20250204T15:02_UTC.wav
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[AGENT][POSITIVE] Thank you for calling. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], my name is [PII]. I'm with Tiff Regional Medical Center. I've had a patient that's in our facility and observation, and I need to verify benefits and see if an authorization is required.
[AGENT][NEUTRAL] OK, I can help you with this um Miss [PII], can I please get your call back number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, ma'am. And then, what is the patient's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you. And what is her policy number, please?
[CUSTOMER][NEUTRAL] 02572273
[AGENT][NEUTRAL] OK. And one more time, I got Regional Medical Center, but I missed the first part of your uh facility.
[CUSTOMER][NEUTRAL] It's it's T as in Tango I as in indigo, F as in Foxtrot, T as in Tango.
[AGENT][POSITIVE] OK, thank you so much I appreciate you giving me that information. Let me look up her policy.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, I do show that [PII] does have an active policy. Her effective date is.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] She has a limited and this is just to verify her coverage it's not a guarantee of payment. She has a limited uh hospital indemnity plan.
[AGENT][NEUTRAL] That helps with the hospital admission of 18 hours or more.
[AGENT][NEUTRAL] She's, let me pull it in for me, just one second. It's for accident or sickness?
[AGENT][NEUTRAL] She has a hospital admission benefit amount of $1000.
[AGENT][NEUTRAL] And then she has.
[AGENT][NEUTRAL] Let's see. I'm looking to see what she has per day. She has a hospital confinement benefit per day of $200.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK. And you said for sickness that um she was admitted in the
[CUSTOMER][NEUTRAL] She's not, she admitted, admitted in the observation so she hasn't truly been admitted as inpatient and it's for chest pain.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Yes, ma'am. It's, yes.
[CUSTOMER][NEUTRAL] So that's gonna be.
[CUSTOMER][NEUTRAL] How hard?
[AGENT][NEUTRAL] Uh, depends on the, uh, diagnosis code and the procedure code that'll be on the itemized statement. Uh, it is her is for accident and sickness.
[CUSTOMER][NEUTRAL] OK. All right. So is there a pre-start that's required, even, um, I mean, I know most indemnity plans don't, but
[AGENT][NEUTRAL] No, ma'am. There's not because we're not the major medical.
[CUSTOMER][NEUTRAL] Is he showing any other major medical?
[AGENT][NEUTRAL] No, ma'am. I don't have a major medical for her.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's why I was to say we, I don't have anything else listed for her either. That's why I was just trying to make sure I didn't.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] If she had
[CUSTOMER][NEUTRAL] OK, and is there a reference number for our call, [PII]?
[AGENT][NEUTRAL] Yes ma'am you can use my name [PII] and today's date.
[CUSTOMER][POSITIVE] All right, perfect. You have a great day.
[AGENT][POSITIVE] You too, Miss [PII], you have a good rest of your week and thanks for calling APL.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.