AccountId: 011433970860
ContactId: f2649135-3e70-4e51-9b1f-8f3aa9e78501
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 177289 ms
Total Talk Time (AGENT): 64361 ms
Total Talk Time (CUSTOMER): 114548 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/f2649135-3e70-4e51-9b1f-8f3aa9e78501_20250415T16:54_UTC.wav
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[AGENT][NEUTRAL] For calling American Public Life. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, uh, my name is [PII]. I'm calling from Amex Assurance Company. Uh, we're a subsidiary of American Express. We underwrite uh travel medical, uh, policies, and, uh, one of your clients or customers had a medical expense outside of the [PII] in February of this year.
[CUSTOMER][NEUTRAL] Um, we were told by the, uh, policyholder that they have no coverage, uh, with this plan outside of the [PII], um, and, um, I have the plan name and the, um.
[CUSTOMER][NEUTRAL] ID number or maybe you already know up front because I'm not familiar familiar with American public life um they're uh pri so the primary coverage is with UnitedHealthcare and I already uh already did determine that uh that they only provide coverage for life threatening, um, situations outside of the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me take a look at their policy.
[CUSTOMER][NEUTRAL] And so is this a simple middle plan?
[AGENT][NEUTRAL] Let me take a look at their policy and I can definitely answer those questions. Uh, you did say your name was [PII], correct?
[CUSTOMER][POSITIVE] Sure, thank you.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Oh, OK. Could I get a callback number for you?
[CUSTOMER][NEUTRAL] Sure, my direct line is [PII].
[AGENT][NEUTRAL] Thank you and what is the policy number you're calling on?
[CUSTOMER][NEUTRAL] Uh, let me grab, let's see, they have a group ID number. Let's see, oh, they did provide it's 02035264 and it looks like M as in Mary L and the number 8.
[AGENT][NEUTRAL] OK, and then
[CUSTOMER][NEUTRAL] Or it might be the letter B.
[AGENT][NEUTRAL] Oh OK, patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh patient's last name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], first name is [PII].
[CUSTOMER][NEUTRAL] And date of birth [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying the policy and you did say that you're calling to see if there would be coverage for out of state uh benefits or out of the country.
[CUSTOMER][NEUTRAL] Outside the [PII], out of country, correct.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK. So, this policy, uh, this is a supplemental gap policy, uh, that they have with us. It only pays secondary to their major medical. So if United Healthcare is not going to consider those charges, then we cannot consider the charges, correct.
[CUSTOMER][NEUTRAL] Then you don't.
[CUSTOMER][POSITIVE] So you're a gap plan got it perfect. That is all I needed to know.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, [PII], well, you have a wonderful day.
[CUSTOMER][NEUTRAL] So it looks like we'll be uh we'll be primary.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] You too, thank you. Take care.
[AGENT][POSITIVE] Thank you for calling APL. You have a wonderful day. Bye bye.
[CUSTOMER][POSITIVE] You also thanks for your help bye bye.