AccountId: 011433970860
ContactId: 0f6fe248-ef8b-45fe-9918-ce6be2c3bfe3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 983710 ms
Total Talk Time (AGENT): 369447 ms
Total Talk Time (CUSTOMER): 381136 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/0f6fe248-ef8b-45fe-9918-ce6be2c3bfe3_20250130T22:15_UTC.wav
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[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Um, how are you doing? I'm calling to see, I just wanted to verify my coverage with you guys.
[AGENT][NEUTRAL] OK, yeah, I can help with that. Do you have a policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, well, I have, uh, a group number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Does that help?
[CUSTOMER][NEUTRAL] It's 24141.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK let's see here.
[AGENT][NEUTRAL] And what is your first and last name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][POSITIVE] Thank you, [PII]. Let's see.
[AGENT][NEUTRAL] And is your employer the um is it food for the poor is that who that your employer is?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, OK, I just want to make sure I have the right group pulled up. Are you new with a group? Is this like new coverage for you?
[CUSTOMER][NEUTRAL] No, no, I've had it.
[CUSTOMER][NEUTRAL] Or I've been paying for it for a a few years now, but I've never used it until now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] What is your
[CUSTOMER][NEUTRAL] So I'm trying to
[AGENT][NEUTRAL] Date of birth. Go ahead.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[CUSTOMER][NEUTRAL] It's, it's [PII].
[AGENT][NEUTRAL] And then if you could just verify with me [PII] what would be the address we would have on file for you?
[CUSTOMER][NEUTRAL] OK, so that would be my employer address, right?
[CUSTOMER][NEUTRAL] Or home address.
[AGENT][NEUTRAL] Um, no, it's probably your home address.
[CUSTOMER][NEUTRAL] OK. It's [PII].
[AGENT][POSITIVE] Yeah, that's what we have here. OK, thank you so much.
[CUSTOMER][POSITIVE] Oh, good. OK. All right.
[AGENT][NEUTRAL] All right, so I was able to locate um a plan. It was a secondary insurance which would cover like a lot of people call it gap insurance which would cover like deductible, co-pay, co-insurance, any of that. Um, I do show that the plan ended for you though on [PII].
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, because I retired, but I, I, I, I, uh, so I'm on Cobra right now.
[AGENT][NEUTRAL] So it's
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEGATIVE] And I've every month, every month I'm paying for APL.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, so you continued your coverage through your employer with Cobra.
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] All right. OK.
[AGENT][NEUTRAL] Well, I may need.
[CUSTOMER][NEUTRAL] Cause I figured, you know, I, I'll use the Cobra until I have to get my own insurance, you know.
[AGENT][NEUTRAL] Right, um.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] Let me see because I don't see any other.
[AGENT][NEUTRAL] Oh let's see here let's see.
[CUSTOMER][NEUTRAL] No, it's showing on the WhatsApp that I use.
[CUSTOMER][NEUTRAL] No, but I pay I pay it directly.
[AGENT][NEUTRAL] All right, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, let me, um, I'm gonna reach out to my help desk on this and see what's going on because um I see the notes about like that you continued through COBR so let me see if I can figure out what's going on with this. Do you mind holding for just a moment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, not at all. Thank you.
[AGENT][POSITIVE] Alright, thank you so much.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Hopefully I'm calling the right department. We're gonna call customer service.
[CUSTOMER][NEUTRAL] S
[CUSTOMER][NEUTRAL] Thank you for calling the EPL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey, [PII], this is [PII] over in customer care. How are you today?
[CUSTOMER][NEUTRAL] I'm fine. How are you?
[AGENT][POSITIVE] I'm good, dear, thank you so much. Um, I was wondering if you could look at a policy with me can I give you that number?
[CUSTOMER][NEUTRAL] Certainly.
[AGENT][POSITIVE] Thank you. Whenever you're ready let me know.
[CUSTOMER][POSITIVE] I'm ready, dear, go ahead.
[AGENT][NEUTRAL] OK. It's 186-7002.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Uh, let me finish out what I was doing real quick it'll let me. I'm sorry.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] OK, let me get if I get this straight now.
[CUSTOMER][NEUTRAL] 1867002.
[CUSTOMER][NEUTRAL] OK, any day now. [PII].
[AGENT][NEUTRAL] Yeah, so we're speaking with Mr. [PII], um, and let me preface this by saying I hope I called the right department.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So he, so he was calling to check on his policy because he's like I've never used it. What kind is it? And of course I'm looking at it and it's lapsed. Well, he says that he retired and continued his policy through COA.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEGATIVE] And so I'm just confused on because it's not showing active.
[CUSTOMER][NEGATIVE] No, it's definitely not.
[AGENT][NEUTRAL] And he says he
[CUSTOMER][NEUTRAL] Did you, did
[AGENT][NEUTRAL] Pays through it through COR I guess or something.
[CUSTOMER][NEUTRAL] He said he was.
[CUSTOMER][NEUTRAL] Well that would go through his employer and to us, right, if I'm, I'm mistaken.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm not mistaken, that's how it works um.
[AGENT][NEUTRAL] I don't even know if y'all can do anything for him or.
[CUSTOMER][NEUTRAL] I don't either because it's been almost a year and I don't know how long. Alright, OK, alright, um.
[CUSTOMER][NEUTRAL] Let me speak to Mr. [PII]. I don't know, I, I don't know what else to do.
[AGENT][NEUTRAL] Are you sure?
[CUSTOMER][NEUTRAL] Other than
[AGENT][NEUTRAL] I mean, yeah,
[AGENT][NEUTRAL] Yeah, I mean, it just all the information I found was just that meddling policies can be continued with their employer on COBR as long as the employer continues the group's major medical but I couldn't find anything else.
[CUSTOMER][NEUTRAL] Oh, she stayed, yeah.
[CUSTOMER][NEUTRAL] Yeah, as long as he continued on the group's major medical, he could continue it, but.
[AGENT][NEUTRAL] And guru
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, um, did he, did he say if he continued on the major medical?
[AGENT][NEUTRAL] Mhm, yeah, he says that he's paying for it.
[CUSTOMER][NEUTRAL] Oh God.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Excuse me. Oh my goodness, I'm gonna start coughing.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] and insure the cobra info on meddling.
[CUSTOMER][NEUTRAL] APL or a group. OK, let's see, do we have any notes that [PII].
[AGENT][NEUTRAL] The only
[CUSTOMER][NEUTRAL] Last week last thing I see with added with code oh wait a minute with
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Per Hub request deleted future laps they and added Cobra. Holy moly, and then.
[AGENT][NEUTRAL] I know.
[CUSTOMER][NEGATIVE] Oh no, oh no. Oh no. Oh my God.
[AGENT][NEUTRAL] That's why, that's why I was confused, [PII].
[AGENT][NEUTRAL] We had a boo boo, it seems like.
[CUSTOMER][NEUTRAL] Um, let me get with [PII], is this [PII]?
[CUSTOMER][NEUTRAL] [PII] well my screen it't got it, yes, notes notes. All right, I am going to have to have [PII].
[CUSTOMER][NEUTRAL] Research this [PII] researched this.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And get back with him.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So let him know that we um
[CUSTOMER][NEUTRAL] Just let him know that we are going to research this and that we will have someone give him a call back and did he call um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's uh let me get his phone number. Is he calling from [PII]?
[AGENT][NEUTRAL] Mhm, yup.
[CUSTOMER][NEUTRAL] Also, so it's the phone number we have on file. OK, great. Tell him we will have someone give him a call back. It will more than likely be.
[CUSTOMER][NEGATIVE] What's tomorrow Friday? Oh dear God, tomorrow is Friday. Crap, I hate when things are so close like that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, can you let him know that we're gonna have somebody research this and I'm going to start the customer service uh thing right now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, OK, [PII], will do, I will.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] You are wonderful. Thank you so much.
[AGENT][POSITIVE] Oh no, thank you for helping me figure that out. I appreciate you.
[CUSTOMER][POSITIVE] Uh well, I'm not sure who's supposed to be doing what at this point, but you know, I need, yeah, we need this checked out. So, OK, thank you, [PII]. Have a great day, honey.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. You too, dear. Bye bye.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Oh Lord.
[AGENT][NEUTRAL] Mr. [PII].
[CUSTOMER][NEUTRAL] Yes, hi.
[AGENT][NEUTRAL] I'm so sorry for that long hold. This is [PII] um so I was speaking with my help desk and a supervisor and I'm having them look into this and research this and so somebody is going to give you a call back and she said it would probably be tomorrow it's end of day for us unfortunately we're on I don't know what time zone you're on we're on Central time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] We, we're in Eastern, yeah, yeah.
[AGENT][NEUTRAL] OK, yeah, um, and, uh, so she had given it to a supervisor to look into and I had spoken with [PII] and she said that [PII] should be calling you back.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]? OK.
[AGENT][NEUTRAL] Mhm, yeah.
[CUSTOMER][NEUTRAL] Does [PII] have a number I could uh just in case or?
[AGENT][NEUTRAL] Um, I don't have a direct line unfortunately. You're more than welcome to take my name and um last initial to my name and I'm also gonna notate your policy just regarding our conversation.
[CUSTOMER][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] My first name is [PII], which is [PII]
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And the last initial to my name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] And uh so somebody should be calling you back um tomorrow um regarding all this, get it straightened out for you, OK, Mr. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I appreciate it, [PII].
[AGENT][POSITIVE] Yeah, my pleasure. Did you have anything else I can do for you?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Hey yes
[CUSTOMER][NEUTRAL] Yeah, you know, just some questions about um the, the, how this works. Um, you know, I, I have, um, I, I have a procedure I'm gonna be doing on my nose. I guess I had a carcinoma on my nose, so they're gonna remove it, and I'm gonna have a plastic surgery done in there and do for reconstructive. I is that covered through you, the co-pay on that, or?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The deductible?
[AGENT][NEUTRAL] Let me look at the, yeah, let me look at the certificate and see the policy itself and see if there's anything in there that speaks.
[AGENT][NEUTRAL] To, um, plastic surgery or anything.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The closure of a of a.
[CUSTOMER][NEUTRAL] Yeah, it's, you know, once they do the most, um.
[CUSTOMER][NEUTRAL] Yeah, but tell me so.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the only thing I see in the policy under the exclusions is if it's considered like elective cosmetic surgery.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] So this, this would technically be covered then.
[AGENT][NEUTRAL] Yeah, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The the the the the uh deductible after. What [PII].
[CUSTOMER][NEUTRAL] Yeah, well, the well, the gap deal with the deduct my deductible right now because of my, it's like over $2000 so I, you know, I could file that with you guys and um.
[CUSTOMER][NEUTRAL] Get reimbursed is that and I have to do it directly with you, right?
[AGENT][NEUTRAL] Mhm or you can actually you can give actually the provider um the policy number and let them know that you have a secondary so they can actually bill your primary and then bill us um if they're willing to do that for you it's much easier so you don't have to you know go through the whole rigmarore of just filing claims.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][POSITIVE] Oh yeah definitely OK so hopefully by tomorrow I'll get this cleared up with you guys and I can just move forward with that then.
[AGENT][POSITIVE] Yeah, absolutely, absolutely, so.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. Thank you, sir. You've been very helpful. I appreciate it.
[AGENT][POSITIVE] Oh, my pleasure. I hope you have a nice evening.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Uh-huh, bye bye.