AccountId: 011433970860
ContactId: 354a3fb4-20de-470b-93cf-1d78b6d253ea
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 573960 ms
Total Talk Time (AGENT): 189609 ms
Total Talk Time (CUSTOMER): 254457 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/354a3fb4-20de-470b-93cf-1d78b6d253ea_20250401T18:34_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. Can I help you?
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. Can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] over in customer care. How are you?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm good thanks um I have somebody on the line who has an inquiry about a check. It was a premium refund for a group. Can I give you the group number?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Group number is 26142.
[CUSTOMER][NEUTRAL] Should come up as City of [PII].
[AGENT][NEUTRAL] Um, for $80.52.
[CUSTOMER][NEGATIVE] Yeah, so she, I pulled up the correspondence. I saw all that and she's saying that this 8052 should not have been sent to them, that she's contacted us I guess multiple times and she said something about um the age on these insured and so this is that we shouldn't have sent this to them um.
[CUSTOMER][NEUTRAL] So yeah that's why she was calling.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Oh, let me find my other screen.
[AGENT][NEUTRAL] And who, who's this on the farm?
[CUSTOMER][NEUTRAL] We're talking to [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Come on here alright.
[AGENT][NEGATIVE] None of my your screens won't work.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Alright, let's
[AGENT][NEUTRAL] To match benefits summary page, I don't even know what that means. Um, you can send her to me.
[CUSTOMER][NEUTRAL] OK, do you wanna take down her uh call back number just in case?
[AGENT][NEUTRAL] Is it the same one that's in EMPL in EMPL? OK, what is it?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, it's different.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Has everything else been verified?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Uh, um, OK, send her to me.
[CUSTOMER][NEUTRAL] OK, here she comes.
[AGENT][NEUTRAL] This is [PII]. Can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII] with the city of Goose Creek. How are you?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] Good, I don't want to cover anything that you're aware of so I don't know do you are you aware of what I'm calling over or not?
[AGENT][NEUTRAL] Um, yeah, the, the refund check for $80.52.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEGATIVE] And you're saying that it should not have come back to you or it should not be premium overpayment?
[CUSTOMER][NEUTRAL] Correct, so, um, what this was is we had some individuals that changed age groups.
[CUSTOMER][NEUTRAL] Um, at open enrollment and from what I understand is just because they change in the age group.
[CUSTOMER][NEUTRAL] Their premium doesn't change because it's based on when they signed up.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So with that being said, we had some people that were [PII] in [PII] hits, they are I'm sorry, they were [PII] when they signed up. They're about [PII] hits they have now had a birthday. They now are in that [PII] age group.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And for whatever reason.
[CUSTOMER][NEUTRAL] That particular age group.
[CUSTOMER][NEGATIVE] Hit a wall at open enrollment and it essentially looked like they had canceled coverage.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we went through payroll processing um thinking that they had canceled their coverage when in actuality they did not.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I spoke with like our representative I guess is the broker.
[CUSTOMER][NEUTRAL] And spoke with this loose. I emailed.
[CUSTOMER][NEUTRAL] And they all have been, these individuals have been reinstated with no lapse in coverage.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So in
[CUSTOMER][NEUTRAL] So we're surprised to see this refund check because.
[CUSTOMER][NEUTRAL] I don't think they were over. I don't think we overpaid for them.
[AGENT][NEUTRAL] OK, let me, let me take a look at it. So on the January invoice that we received.
[AGENT][NEUTRAL] Make sure all my I's are dotted and crossed.
[CUSTOMER][NEUTRAL] Let me, let me also log into APL so that we're looking at those invoices together.
[AGENT][NEUTRAL] Yeah, so on the.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] [PII] invoice it has where uh for just for that first one [PII] um where we received 5976 and the comment says to match benefits summary page. Well that's the premium she's locked in at with the age.
[CUSTOMER][NEUTRAL] OK, wait, wait, wait, you're, you're talking about the invoice ending in 257?
[AGENT][NEUTRAL] No, the January.
[CUSTOMER][NEUTRAL] OK, I thought you said [PII]. I just wanted to make sure.
[AGENT][NEUTRAL] Um, ending in ending in 8059.
[CUSTOMER][NEUTRAL] OK, 8059 to match benefit summary right for [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, so that's where that overpayment is coming from because her premium is actually 3983.
[CUSTOMER][NEUTRAL] OK, so it was over by [PII]. Let me look at this. I just wanna, I just.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] So then I am assuming that that's probably going to be the same for.
[CUSTOMER][NEUTRAL] [PII] and [PII] as well, let's see.
[AGENT][NEUTRAL] Yes, ma'am. Let me, let me double check and look at the, the invoices.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, cause February is probably going to be taking a credit.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] No, February, um, paid 7968 for [PII] and 4148 for.
[AGENT][NEUTRAL] Toy.
[CUSTOMER][NEUTRAL] So but [PII].
[AGENT][NEUTRAL] The list is was from January.
[CUSTOMER][NEUTRAL] I show 39.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And then the other two are from the February invoice.
[CUSTOMER][NEUTRAL] Alright, let me coverage.
[CUSTOMER][NEUTRAL] So [PII], we paid 7968 for January and February payments.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So the 39
[CUSTOMER][NEUTRAL] Because she was not she was not on the January invoice.
[AGENT][NEUTRAL] Yes, ma'am, she was.
[CUSTOMER][NEUTRAL] Did I miss her?
[AGENT][NEUTRAL] 8, the invoice ending in 8059, yes ma'am. [PII] was on that invoice and it's gonna be the same thing for [PII].
[AGENT][NEUTRAL] Y'all double paid him when he was actually on the invoice, but let me double check [PII].
[AGENT][NEUTRAL] Uh, where is he? Right.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Oh, my eyes are going there he is, OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] Yeah, so [PII] was on that, yeah, [PII] was on the January invoice as well, so when the February invoice, um, was paid, um, [PII] and [PII] were both double paid, so that's what the other two premium overpayments are.
[CUSTOMER][NEUTRAL] OK, so let me think about this, so they were paid.
[CUSTOMER][NEGATIVE] But y'all didn't receive funds for them.
[CUSTOMER][NEUTRAL] Because they were not deducted, so.
[CUSTOMER][NEGATIVE] So it was paid but it wasn't collected.
[CUSTOMER][NEUTRAL] Should then we collected it OK.
[CUSTOMER][NEUTRAL] All right, so that makes.
[CUSTOMER][NEUTRAL] That makes more sense.
[CUSTOMER][NEUTRAL] OK, so these are just overpayments for those amounts that were paid on this January and February invoices, but the coverages for those individuals have not been canceled.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] All 3 policies are still active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's what I needed to know.
[AGENT][POSITIVE] Yes, ma'am. Is there anything else I can help you with today, [PII]?
[CUSTOMER][POSITIVE] I appreciate it.
[CUSTOMER][NEUTRAL] No, that'll be all.
[AGENT][POSITIVE] All right, thank you for calling APL and you have a good afternoon.
[CUSTOMER][NEUTRAL] You do the same thing