AccountId: 011433970860
ContactId: bd30ff0b-d340-463a-9131-9e9b8bee4345
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 339480 ms
Total Talk Time (AGENT): 79244 ms
Total Talk Time (CUSTOMER): 118484 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/04/bd30ff0b-d340-463a-9131-9e9b8bee4345_20250604T14:12_UTC.wav
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[AGENT][NEUTRAL] For calling my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi. Hi, [PII]. I was calling to check on.
[CUSTOMER][NEUTRAL] The claims or I was trying to figure out which type of.
[CUSTOMER][NEUTRAL] Account this was for, like if it was accidental and medical things like that.
[AGENT][POSITIVE] I'll be happy to assist. May I have the policy number, please?
[CUSTOMER][NEUTRAL] Yes, um, one sec, call number.
[CUSTOMER][NEUTRAL] Oh here it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] And you know if I can get a good contact number for you.
[CUSTOMER][NEUTRAL] [PII] and that's a direct line.
[AGENT][POSITIVE] Thank you for that information
[AGENT][NEUTRAL] Please be advised verification of the cover. It's not a guarantee of payment. And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, yes. Patient's name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][NEUTRAL] And so the policy is currently active effective date is [PII], and are you calling for inpatient or outpatient benefits?
[CUSTOMER][NEUTRAL] Um, it's an ER visit.
[AGENT][NEUTRAL] OK, I'm showing ER is covered under the outpatient and outpatient has a calendar year maximum of 1000. Patient does have an ER deductible of.
[CUSTOMER][NEUTRAL] 300. OK, um, is this for like accidental like what they came in for like what vehicle accident or something?
[AGENT][NEGATIVE] Sick or
[AGENT][NEUTRAL] Sickness or injury
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Sickness or injury.
[CUSTOMER][NEGATIVE] I can't hear you. It's breaking up.
[AGENT][NEUTRAL] sickness or injury is covered.
[CUSTOMER][NEUTRAL] I was saying though, is there a way that you could tell me what they came in for?
[CUSTOMER][NEUTRAL] Like which type of insurance is this for?
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] This is their gap, we're their gap insurance, so we work in conjunction with their major medical, but unless I have a claim, I can't see why they came to the
[CUSTOMER][NEUTRAL] Oh, so this is workers' comp.
[AGENT][NEUTRAL] I'm sorry, maybe I don't, so you're not a provider calling to verify benefits?
[CUSTOMER][NEUTRAL] No, I am a provider, but I'm trying to figure out is this a worker's comp claim commercial because I looked up this insurance on the claim that I have. I'm looking at this insurance online and I can't differentiate whether this is for a worker's claim or commercial because y'all specialize in all of that. That's why I was calling to figure out which one it was for.
[AGENT][NEUTRAL] Oh no, we, yeah, we just worked with, with his gap insurance. We just worked with his, um, major medical.
[CUSTOMER][NEUTRAL] Gap insurance for auto, right?
[AGENT][NEUTRAL] No, gap insurance for medical, medical insurance.
[CUSTOMER][NEUTRAL] OK, um, is there a way that I can get the ELB faxed to me?
[AGENT][NEUTRAL] What's the date of service you please?
[CUSTOMER][NEUTRAL] Date of birth [PII].
[AGENT][NEUTRAL] Data service, state of service.
[CUSTOMER][NEUTRAL] Oh, date of service [PII].
[AGENT][NEUTRAL] And what's the tax ID?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and that
[CUSTOMER][NEUTRAL] The what?
[AGENT][NEUTRAL] The fax
[CUSTOMER][NEUTRAL] 0 513.
[CUSTOMER][NEUTRAL] 964.
[CUSTOMER][NEUTRAL] 372 3.
[CUSTOMER][NEUTRAL] So yeah.
[CUSTOMER][NEUTRAL] Wait, I'm sorry, can you repeat that?
[AGENT][NEUTRAL] I said you should receive that fax in the next 15 minutes. Is there anything else I can assist with today?
[CUSTOMER][NEUTRAL] Um, no, thank you. May I, may I just have your name and reference number, please?
[AGENT][NEUTRAL] Reference is just my name [PII]
[CUSTOMER][POSITIVE] OK, thank you so much, [PII].
[AGENT][NEUTRAL] Yeah