AccountId: 011433970860
ContactId: 218f301b-2b74-43f3-8199-2c2862cf3562
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 627369 ms
Total Talk Time (AGENT): 196764 ms
Total Talk Time (CUSTOMER): 227440 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/218f301b-2b74-43f3-8199-2c2862cf3562_20250304T18:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I am calling in reference to an explanation of benefits that I received yesterday.
[AGENT][NEUTRAL] OK, are you calling from the provider's office or are you the insured?
[CUSTOMER][NEGATIVE] I am the insured and I am the administrator of the plan and I am baffled by the statement that's on the explanation of benefits.
[AGENT][NEUTRAL] OK, may I have your policy number?
[CUSTOMER][NEUTRAL] Sure it's 02286545.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And may I have your name and date of birth please?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you and what is your callback number for we're disconnected please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. Excuse me.
[AGENT][NEUTRAL] And verify your complete mailing address please?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the last thing to verify is your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Oh yes, oh, I'm sorry. OK, I'm sorry. I was gonna say that was a sweet email address. I'm sorry. I'm so sorry about that. OK, let me get those. What's that claim number please?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 356-819-4
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Excuse me one moment.
[AGENT][NEUTRAL] Almost there.
[AGENT][NEUTRAL] OK, excuse me.
[AGENT][NEUTRAL] OK, thank you for your patience excuse me, it shows that that claim is pending verification of eligibility, which we have not received it yet in our office. Uh, once we receive that, the processing of the claim will continue.
[CUSTOMER][NEUTRAL] OK, but it says that we're waiting for information from your employer association to confirm I'm the administrator of my company. What is it that you're waiting on?
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Waiting on
[AGENT][NEUTRAL] Payment
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Give me 1 2nd, please.
[CUSTOMER][NEUTRAL] They
[CUSTOMER][NEUTRAL] Well, I have an invoice in front of me that just came in this week which is our March bill. It does not show that we're in the arrears from what I can see.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 3
[CUSTOMER][NEGATIVE] So I'm really confused by this.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Miss [PII], OK, I see you are the administrator. OK, thank you for that. Let me just search for that.
[AGENT][NEUTRAL] I showed that the um policy of the plan is paid up until [PII] but you're saying that payment has been re.
[CUSTOMER][NEUTRAL] The statement, yeah, the statement I have in front of me, the invoice number is 0006383079, um, it's the March premium.
[CUSTOMER][NEUTRAL] That is due on [PII]. I show that there's the total due is 53932.
[CUSTOMER][NEUTRAL] I, I don't see anything on here about us owing any previous amount of money.
[AGENT][NEUTRAL] 2.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] May I place you on a brief hold please, Ms. [PII]?
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][POSITIVE] OK, thank you. Thank you, thank you, thank you, Miss [PII].
[AGENT][NEUTRAL] Now since you are the admin if you could just verify the email address please, please, I'm sorry.
[CUSTOMER][NEUTRAL] The email address for what that we have on file?
[AGENT][POSITIVE] For the app, yes, for your contract, yes ma'am.
[CUSTOMER][NEUTRAL] With you guys, uh, well, we could have several different ones. There could be [PII]. There could be [PII], uh, and [PII]. Hang on one moment, let me get to hers.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know hers off the top. I mean, I know it, but it's always prepopulates. [PII]. All three of ours could actually be on there.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes ma'am, and Ms. [PII], last thing is to verify the the address associated with the account.
[CUSTOMER][NEUTRAL] As far as the office address, it's [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, thank you. Now one moment please. I'm gonna place you on hold, OK? Thank you, Ms. [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. Can I help you?
[AGENT][NEUTRAL] Hi, this is [PII] in the claims department. I have the admin on the line with group number 25773, Ms. [PII].
[AGENT][NEUTRAL] Um, my initial M.
[AGENT][NEUTRAL] She's calling in regards she has actually she was calling in regards to a claim that she has this pending um eligibility um premium or payment. She says that she has an invoice in front of her for March, but it shows that they're paid up until [PII].
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She's calling about her own policy.
[AGENT][NEUTRAL] Well, she, she was calling to check claim status, but then I told her she read the remark associated with the ELB that states that we're waiting for information from your employer, but she is also the admin of the group.
[CUSTOMER][NEUTRAL] OK, let me look at her policy.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 678.
[CUSTOMER][NEUTRAL] Los Santos.
[CUSTOMER][NEUTRAL] Wow, with money taken out of the policy.
[CUSTOMER][NEUTRAL] August, OK.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Come on computer.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][POSITIVE] I appreciate it.
[AGENT][NEUTRAL] I have a callback number too so.
[CUSTOMER][NEUTRAL] Uh, yeah, we're probably gonna have to call her back, um.
[CUSTOMER][NEUTRAL] Cause this will take a little bit of research to figure out what's going on. Um.
[AGENT][NEUTRAL] OK, what can you explain it to her?
[CUSTOMER][NEUTRAL] Why is that? Hang on, what's in the world?
[CUSTOMER][NEUTRAL] What is the I's just going into the
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] September.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Oh computer.
[CUSTOMER][NEUTRAL] When does the premium change that's gonna be.
[CUSTOMER][NEGATIVE] Oh so ind passed away, so we've been effective 8 months so.
[CUSTOMER][NEUTRAL] 8179.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, so now.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] I don't understand why that didn't post, but
[CUSTOMER][NEUTRAL] February.
[CUSTOMER][NEUTRAL] And January.
[CUSTOMER][NEUTRAL] Alright, the policy is now paid to 31, so if there's a claim that's needs to be reviewed, it can now be reviewed.
[AGENT][NEUTRAL] OK, can you explain it to her though? I mean, I, I wasn't sure what to tell her. You were, I think were talking to me, but out loud but talking about it, so can you explain to her what happened then because that's what she wants to know. OK, thank you. One moment please.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hello Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, sorry about that. I have [PII] on the line she's going to explain to you what um what happened but um I'm sorry about the uh hold. Her name is [PII], she's in the billing department, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] In regards, you're welcome in regards to that claim, um, that should be able to be reprocessed, OK? But I just want her to explain to you what happened. OK, one moment here she comes. Thank you.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][POSITIVE] Thank you.