AccountId: 011433970860
ContactId: 21fbcbc1-ce4b-434e-970f-c0834381ca75
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 583859 ms
Total Talk Time (AGENT): 171817 ms
Total Talk Time (CUSTOMER): 219122 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/21fbcbc1-ce4b-434e-970f-c0834381ca75_20250505T17:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. Who am I speaking with?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How you doing?
[AGENT][POSITIVE] Good how are you babe?
[CUSTOMER][NEUTRAL] I'm doing good. Um, OK. Can you, uh, well, I have somebody that wants to talk to you. Um, is policy number 604575?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 604.
[CUSTOMER][NEUTRAL] Mhm. [PII].
[AGENT][NEUTRAL] 575. OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The dental?
[CUSTOMER][NEUTRAL] So, yes.
[CUSTOMER][NEUTRAL] So it looks like there's 2 claims that we were.
[CUSTOMER][NEUTRAL] Supposed to pay to her and we pay to the provider.
[CUSTOMER][NEUTRAL] We're gonna get a refund on it.
[CUSTOMER][NEUTRAL] And she's under the impression that we stopped the check to her, but I don't see that we have sent her out a check yet.
[AGENT][NEUTRAL] Mm, I don't either.
[CUSTOMER][NEUTRAL] But I didn't tell her that. I just, uh,
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let me see calendar year maximum was met.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Is it the same data service in 20.
[AGENT][NEUTRAL] No, it's not the same data service.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] What the
[AGENT][NEUTRAL] OK, I don't know. Give me one second. I don't know dental that much.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] I don't even know what the max is.
[CUSTOMER][NEUTRAL] Oh hold on.
[AGENT][NEUTRAL] I got it look at the.
[AGENT][NEUTRAL] The policy
[CUSTOMER][NEUTRAL] Oh, hold on 25.
[AGENT][NEUTRAL] You can go ahead and put her through. I mean, she's just gonna have to wait until I figure it out.
[CUSTOMER][NEUTRAL] You're try you're trying to find the why did they keep doing this? Hold on the calendar year max for the policy?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It is $1000 with a $50 deductible.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is this for 20?
[AGENT][NEUTRAL] 2024, OK.
[CUSTOMER][NEUTRAL] Oh wait, hold on, 24 let me well let me see, I think it's the same. Let me just double check. Yeah, it's the same.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Where is my?
[AGENT][NEUTRAL] Calculate order.
[AGENT][NEUTRAL] 358727272 6270.
[AGENT][NEUTRAL] 22 72 76 she's already it's maxed out.
[AGENT][NEUTRAL] So something came in on.
[AGENT][NEUTRAL] Uh, [PII] paid $539 for [PII].
[AGENT][NEUTRAL] And then when by the time we voided it out for whatever reason.
[AGENT][NEGATIVE] [PII] voided these out.
[AGENT][NEUTRAL] Yeah it's already been maxed out.
[AGENT][NEUTRAL] But something was supposed to go to her?
[CUSTOMER][NEUTRAL] Yeah, she's saying this payment of the 5:39.
[CUSTOMER][NEUTRAL] And the 350 was supposed to be paid to her and in the notes it says that we were refunding it, we were refunding it from the provider.
[CUSTOMER][NEUTRAL] But I don't see, so she's under the impression that the voided check here is the voided check to her, but it's the voided check from
[CUSTOMER][NEUTRAL] The providers.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEGATIVE] And pay the provider not interested.
[CUSTOMER][NEUTRAL] It's how it's what I'm getting, but the
[CUSTOMER][NEUTRAL] Because what I saw was cleared.
[CUSTOMER][NEUTRAL] So that's
[AGENT][NEUTRAL] Any
[AGENT][NEUTRAL] Well, [PII] called her, check, blah blah. I called the insured, explained the provider.
[AGENT][NEUTRAL] Rep [PII] will pay insured her remaining balance, not APL, closed hub.
[AGENT][NEUTRAL] Going to request a refund from the buyer submitted a hub to claim to determine if this has been the insured wants to be called back call tomorrow when she asks the first.
[AGENT][NEUTRAL] She knows that the provider received their payment.
[AGENT][NEUTRAL] Claim entered 2 checks, voided, claim was filed correctly and paid the provider.
[AGENT][NEUTRAL] Was paid correctly and paid the provider, not insured claim check filed correctly.
[AGENT][NEUTRAL] I called the uh.
[AGENT][POSITIVE] I, I have no idea. All right, I'm ready when you are.
[CUSTOMER][NEUTRAL] OK, hold on one moment.
[AGENT][POSITIVE] Alright, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hello Ms. [PII]. Yes.
[CUSTOMER][POSITIVE] Thank you so much for holding. I apologize for that wait. I have.
[CUSTOMER][NEUTRAL] Hold on one minute before and.
[CUSTOMER][NEUTRAL] Come here.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] What? See that's what you're doing. Go let Papa look at it.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][POSITIVE] Yes, ma'am. I have [PII] on the line and she'll be assisting you further, OK?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Hi Ms. [PII], this is [PII]. um, I'm in the claims department. OK, can you explain to me what happened because from what it looks like.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I
[AGENT][NEGATIVE] Two checks were supposed to go to you, but they went to the provider instead?
[CUSTOMER][NEGATIVE] No, but see at first, that's what was the first original thing. I called it and they told me that when the check is made, they gonna send them to me and not to the provider.
[CUSTOMER][NEGATIVE] But in return, they sent them to the provider. And when they sent them to the provider, I called back and I told them, I said, well, when I talked to you, you told me the check don't come to me. I said, now they calling me telling me they got the check and they got to hold them so long so they can do this and do that. So when I called back and told them that, whoever it was said they gonna check into it. And when they checked into it, they called me and told me to say, uh, they can't use those checks.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I sent you 2 texts and you're taking um.
[CUSTOMER][NEGATIVE] You take those 2 checks and don't get the checks from them because they can't give you that.
[CUSTOMER][NEGATIVE] That's illegal. And so I took the check and deposited in my bank. Then I look at my statement it say uh that the check was returned, they stop payment on my check and they charged me $25 for each one of them.
[AGENT][NEUTRAL] OK, wow, alright, 20273.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, what a what?
[CUSTOMER][NEUTRAL] Yes,
[CUSTOMER][NEUTRAL] Damn, you walk like those socks on. That's why you snipping.
[CUSTOMER][NEUTRAL] Put your shoes on.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, uh, Ms. [PII], um, can I go ahead and get a callback number? I'm gonna have to get with the examiner on this, um, and then I can give you a call back after we, uh, see what happened here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] 774
[CUSTOMER][NEUTRAL] 7748068
[AGENT][NEUTRAL] [PII]. OK, is any time good to call?
[CUSTOMER][NEUTRAL] Whenever you call I have to talk.
[AGENT][NEUTRAL] OK, alright, just give me a little bit to uh to research it and then I'll give you a call back.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] OK, no problem, have a great rest of your day.
[CUSTOMER][POSITIVE] OK thank you bye you too bye bye.
[AGENT][NEUTRAL] Uh huh bye bye.