AccountId: 011433970860
ContactId: 37beb07a-0995-4632-8dce-5944a5bf490e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 198779 ms
Total Talk Time (AGENT): 65872 ms
Total Talk Time (CUSTOMER): 130306 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/37beb07a-0995-4632-8dce-5944a5bf490e_20250109T17:10_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with the care team. How are you doing today?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][MIXED] Hey I'm doing really great. I got into a situation and I um just need maybe a little direction I'm probably not in the right place um but I don't know who I'm supposed to reach out to.
[AGENT][POSITIVE] OK, I can help.
[CUSTOMER][NEUTRAL] OK, perfect. I have a gentleman on the line. He's no longer on the line with me. Um, his policy number is 2519478.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Um, he's calling because his claim was denied, um, and it says that his policy was terminated, so like is he no longer had coverage. What he's concerned about is he has a COR letter stating that his coverage would be in place till [PII] and he didn't leave his employer until [PII].
[CUSTOMER][NEUTRAL] But the note in here is that there is a cancel policy bookkeeper's request that came in on the [PII] to cancel his policy for [PII] and so he doesn't understand how his employer can retroactively cancel his policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, why they can cancel his policy when Cobra said that his health insurance would stay in effect until the end of the month and like all these things he just had all these questions for me and I don't know who to escalate, like send a request to to like get him some information. I didn't want to tell him he could appeal the claim unless I could give him any other information. I mean he can always appeal it, but.
[CUSTOMER][NEGATIVE] He was just upset and I didn't know if there was somebody I should reach out to.
[AGENT][NEUTRAL] Yes, uh, billing is the one that cancels canceled that, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I guess there would be the first place to go and then he maybe wanna get with his employer because we don't have any cover information on this one.
[CUSTOMER][NEUTRAL] OK perfect um and I guess I don't understand maybe you know maybe you don't, it's OK, but like if somebody does elect to get COR, do we get notified that they're continuing their stuff with COR?
[AGENT][NEUTRAL] No, um, if, if we get, uh, a COBR form from the employer, uh, we just reactivate it, set it up on COR, and they, they give the premium to the group and then the group sends it in with their premiums for the month.
[AGENT][NEUTRAL] Uh, but we don't, we don't send out any notice or anything that it is on COA. We do when it gets, when, uh, it ends in 18 months, but.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] But not otherwise, not unless they send in OK alright so let me start with group billing then and I will give them a call and I just appreciate any direction so.
[AGENT][NEUTRAL] But not otherwise.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right. And, and since this is meddling, if he did go on COR, he would have had to have gone on cover with his major medical as well?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] With that group. Now you can't do another major medical and keep ours. It has to be with that group. Just yeah, just in case that comes up.
[CUSTOMER][NEUTRAL] With that group, OK.
[CUSTOMER][POSITIVE] OK, perfect. I appreciate hearing that. I will go ahead. I'll call group billing and I'll see what information I can get before I um try to reach back out to the insured.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you thank you I appreciate your time.
[AGENT][POSITIVE] Alright thank you [PII] have a good day.
[CUSTOMER][POSITIVE] My pleasure you too bye bye.
[AGENT][NEUTRAL] Right.