AccountId: 011433970860
ContactId: 0a27a01d-68e4-45b7-9414-40b6069e97ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 534409 ms
Total Talk Time (AGENT): 332484 ms
Total Talk Time (CUSTOMER): 155667 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/0a27a01d-68e4-45b7-9414-40b6069e97ea_20250107T15:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] [PII], can I help you?
[CUSTOMER][NEUTRAL] Hey this is [PII] with the care team. How are you doing?
[AGENT][POSITIVE] I'm good, how are you?
[CUSTOMER][NEUTRAL] Hey um I just had a call, um, and I couldn't speak to the caller. She wasn't authorized, um, but there was something that was kind of funky on the billing and I just wanted to call and like bring it to somebody's attention, um, it is her group number LA 0300.
[AGENT][NEUTRAL] LA 0300.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Grace nursing Home?
[CUSTOMER][NEUTRAL] Yep yep, um, so the lady who called, she had said that the last invoice they received that they were set for paper invoices, um, the last invoice they received was in August.
[CUSTOMER][NEGATIVE] Um, and they haven't had one since and then she was calling to check on it, and I explained to her she wasn't on the policy and I couldn't talk to her, but while I was waiting for my next call I like kept looking into it and it looks like the last invoice we sent them was in August we never sent them another invoice but we did end up like lapsing the group because they never paid any further invoices so I was just wondering like um like is there invoices we should have been like should have been sent out to them.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Let's see. According to the notes, it
[AGENT][NEGATIVE] Looks like it got lapsed at the end of July because they were over 90 days of, well, that's not right. Uh.
[AGENT][NEUTRAL] Why did that get
[AGENT][NEUTRAL] Mm, OK, let's see. May we sent the April skipped overdue notice no email.
[AGENT][NEUTRAL] On file so it got mailed.
[AGENT][NEUTRAL] And then,
[AGENT][NEUTRAL] In July we sent this, I mean in June we sent the same thing, then in July we sent the overdue notice of the April.
[AGENT][NEUTRAL] How did it
[AGENT][NEGATIVE] Why did it get what? I mean, technically at the end of July, it still wouldn't be overdue by 90 days.
[AGENT][NEUTRAL] And there's there's only one policy active.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, all good. What is it?
[AGENT][NEGATIVE] Just for one skipped invoice it's not overdue 90 days because they were still paying the invoice.
[AGENT][NEGATIVE] I don't know why they would have laps to me.
[AGENT][NEUTRAL] Be over 90 days it wasn't.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] They were only a month behind because of the April.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] This will have to be sent up the chain of command and escalated to [PII] because I'm not sure why.
[AGENT][NEUTRAL] We would have lapsed the group for being over 90 days past due at the end of July.
[AGENT][NEUTRAL] When the only outstanding invoice was April but they were continuously paying the invoices so with that being said.
[AGENT][NEUTRAL] Technically, the guy, the only guy that's on the policy is the one that we have as the contact. So, um,
[CUSTOMER][NEUTRAL] He the.
[CUSTOMER][NEUTRAL] Yeah, his email address, OK, so I think his last name spelled wrong on one of them because one says [PII] and one says [PII], but his email address is listed on his individual policy and I don't know if like that would be an appropriate way to reach out to him. I didn't feel comfortable because there was a misspelling because she did ask me to like email him and let him know that I needed him to directly reach out to me, but because like the name was misspelled, I was worried that I would like break confidentiality by doing that, so I didn't.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, 9 times out of 10, I, I'm about 99% sure it's the same guy who's listed on the EMPL as the only active policy, um, so that I would, I would be OK with saying, well, we have [PII] or that's how we have it listed, but the only active one that we have is [PII], whatever his name is, um, but this.
[CUSTOMER][NEUTRAL] Yeah, that's what she told me, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] This particular one we gonna have to get [PII] involved because again I don't know why we would have lapsed the group for being over 90 days when they only had one outstanding invoice and they were regularly still paying every month so I don't.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't think that the policy should, I don't think that at the group level, I don't think the group should be um terminated. But at an individual look at it, this is a dental policy, so the insured can technically just continue it on its, on their own anyway. um.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] Yeah, I'm, uh, more than likely we'll probably have to reactivate the group and just back invoice for the things because again I don't know why.
[AGENT][NEUTRAL] The group was lapsed for being over 90 days past due when.
[AGENT][NEGATIVE] Technically they weren't, they were one month behind.
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Yeah, I just, I noticed it. I mean I don't really know much about billing and I didn't have access to all the screens, but it looked a little funny to me so I just wanted to like bring it to someone's attention.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Yeah, I'll um I'll shoot [PII] at IM and see how she would wanna handle this one because yeah again I don't.
[AGENT][NEUTRAL] Of
[AGENT][NEUTRAL] Done what we did because yeah, they weren't 90 days past due, they were 1 month behind um so really they were only 30 days past due.
[AGENT][NEGATIVE] Continuously, like every month, they still were only 30 days past due. They weren't, yeah, I don't, uh.
[CUSTOMER][NEUTRAL] They were like
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And then if I see something like this in the future like I know that they want us to like dial out less as far as like calling y'all um like is it appropriate for me to call you or should I be, should I have done this as a hub request instead?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] With this one looking as um weird as it does, I would.
[CUSTOMER][POSITIVE] Like that human touch, like being able to explain it.
[AGENT][NEUTRAL] Yeah, I would, I would, um, get the person's information well one I would let the caller know if they, if they weren't the contact let the caller know hey you're not the contact on file we have so and so if they no longer are there or it needs to be changed, they need to reach out to us so we can get this updated so we can speak to you um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The contact is there he's just on vacation.
[AGENT][NEUTRAL] Oh, OK, um.
[CUSTOMER][NEUTRAL] Which is why she asked me to send the the follow up email saying that he had to call us.
[AGENT][NEUTRAL] Yeah, um, yeah, with those kind of things, um, I would just take their information and send a hub request because this one, yeah, [PII]'s gonna have to take a look at this one and see what, see what the heck's going on and what we're gonna do about it because more than likely we'll probably just totally lapse the group and send [PII].
[AGENT][NEGATIVE] A mess or uh yeah, and just let them pay for it on its own because it could be that this is one of those policies that has to have um
[CUSTOMER][NEUTRAL] A continuation.
[AGENT][NEUTRAL] So many people
[AGENT][NEUTRAL] On the policy, but I don't, yeah, with dental, I don't think that's the case, but I'm not really sure. So yeah, I'm gonna shoot [PII] and I am on this one and see how she wants to handle it and um and we'll go from there.
[CUSTOMER][NEUTRAL] Instead of just one.
[CUSTOMER][POSITIVE] Perfect. Well, hey, thank you so much for like taking the time to look at it with me and I'm glad I glad I sent it your way because it was a fun one.
[AGENT][POSITIVE] No problem.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, it's definitely interesting because yeah, I'm not really uh I don't, I don't know. I've slept since July, so I don't know. I didn't do it that's what I know. I didn't do it, so.
[CUSTOMER][NEUTRAL] Who knows.
[CUSTOMER][NEUTRAL] No, when like, I mean that's the wonderful thing like we're all humans. I said wonderful like, but it really is, we're gonna make mistakes and at least we all have jobs and we're not replaced by computers, so like you just got to accept the mistakes when they happen.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Amen.
[AGENT][POSITIVE] Yep, yup, you are correct.
[CUSTOMER][POSITIVE] So well I really appreciate your time and thank you so much.
[AGENT][POSITIVE] No problem.
[CUSTOMER][POSITIVE] All right. You take care.
[AGENT][NEUTRAL] Alright, you too.
[CUSTOMER][NEUTRAL] Bye.