AccountId: 011433970860
ContactId: 49575203-88c3-4e7b-ad4c-a0249a31327c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 617760 ms
Total Talk Time (AGENT): 175375 ms
Total Talk Time (CUSTOMER): 324615 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/23/49575203-88c3-4e7b-ad4c-a0249a31327c_20250423T19:26_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]. My name is [PII], and um I was with uh Fidelity um of Texas and wrote a group called um Communication Workers of America 9413.
[CUSTOMER][NEUTRAL] And one of my guys just called and said that um he tried to file a claim on his hospital plan.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hang on. And um he said that you guys told him that his policy wasn't in effect. But I went in to pay Logics, who's the third party administrator, and his $48 and some change for his whole family has been coming out the whole time.
[AGENT][NEUTRAL] OK, and he has
[CUSTOMER][NEUTRAL] Um, so I'm not.
[AGENT][NEUTRAL] He has a policy with.
[CUSTOMER][NEUTRAL] He has a hospital plan.
[AGENT][NEUTRAL] OK, uh, with American Public Life?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Do you have the policy number?
[CUSTOMER][NEUTRAL] Um, hold on just a minute.
[CUSTOMER][POSITIVE] Hang on, I'll pull it back up. I got it right here.
[AGENT][NEUTRAL] OK. And you're the broker, is that right?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so where's the policy number?
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] It was.
[CUSTOMER][NEUTRAL] I'm not sure if they rewrote it or not. Um, it was 02488014.
[CUSTOMER][NEUTRAL] And then he canceled that one and we rewrote it on [PII].
[CUSTOMER][NEUTRAL] And the deductions have been coming out. We actually wrote it in January and the deductions started coming out on the [PII].
[CUSTOMER][NEUTRAL] ACH so he's had [PII].
[CUSTOMER][NEUTRAL] He's had
[CUSTOMER][NEUTRAL] 45 deductions for that hospital plan so far.
[AGENT][NEUTRAL] And what was the name of the member?
[CUSTOMER][NEUTRAL] Uh, the member's name is [PII]
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] And um what is your email address, [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well, it, it's different than it was before because the company moved, um.
[CUSTOMER][NEUTRAL] The email that used to be on it was um.
[CUSTOMER][NEUTRAL] [PII], shoot, I don't even remember anymore what it was. Um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Do you, can I give you my personal? It was, yeah, it was Fidelity.
[AGENT][NEUTRAL] That's what I
[AGENT][NEUTRAL] Yeah, I, I see that.
[AGENT][NEUTRAL] OK, um, I, well, I'm looking in here, let's see, so I show.
[AGENT][NEUTRAL] This policy terminated [PII]. Let me see if there's a different number.
[AGENT][NEUTRAL] Um, let's see. No, that's the most recent one. That's the hospital indemnity. Um, let me look at the notes.
[CUSTOMER][NEUTRAL] Yeah, he had an accident.
[CUSTOMER][NEUTRAL] And hospital indemnity.
[CUSTOMER][NEGATIVE] And then he canceled them, and then he called back and I have all sorts of notes between me and PayLogic because I needed them to undo him and pay Logic so I could re-enroll him. And we did that, and now I'm showing that I have a feeling PayLogic is the one who screwed this up. So here's the issue then if that's what PayLogic did.
[CUSTOMER][NEUTRAL] This guy's been paying for that hospital plan. Um, it, it went into effect on [PII], and he's been paying every payday since then.
[CUSTOMER][NEUTRAL] Um, I have a feeling that PayLogic failed to send you guys APL, the file, to process that, that, um, that new policy. That's what it looks like to me. So,
[CUSTOMER][NEGATIVE] At this point, what do I do? Because it definitely is a policy. It was written and Pay logic has it. I just don't think they ever sent it to you guys.
[AGENT][NEUTRAL] So is he still with his employer or did he port the policy?
[CUSTOMER][NEUTRAL] Oh no, he's still with the employer and everything.
[AGENT][NEUTRAL] OK, with CWA.
[CUSTOMER][NEUTRAL] He's on the mara.
[CUSTOMER][NEUTRAL] Yeah, 9413 in [PII], yep.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] Yeah, he never left.
[AGENT][NEUTRAL] Uh, let me look at something real quick.
[CUSTOMER][NEGATIVE] The most, yeah, so most likely pay logic is holding all that money. And I'm like, you know, I, I hate having to babysit third parties. It's like doing your freaking job.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Uh, I'm trying to figure out where, so I don't, I, I can't, I don't think I can help you, but I'm trying to figure out which, um, department I to send you to because I'm on the care team we just deal with benefits eligibility or benefits, um eligibility verification, um, but not the actual billing part of it. So let me see, um, let's see.
[AGENT][NEUTRAL] Let me try our billing department and see if they'll be able to help and then contact Payogics. Do you mind if I get you transferred over there?
[CUSTOMER][POSITIVE] Oh no, I'd appreciate it. Thank you.
[AGENT][POSITIVE] Yeah, absolutely. uh, what's your callback number, [PII]?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, let me get him back there. OK, OK, hold on one moment, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] Deferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Um [PII], this is [PII] on the care team, and I've got a broker on the line who was checking on eligibility status for a member. So she's saying that I I show the policy terminated in [PII], but she's saying that PayLogix was the third party who's collecting his premium.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And she says he should still be active, so I'm trying to figure out who I can get her to to help sort this out because I'm not sure if it's billing or customer service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me look at the policy. What's the policy number?
[AGENT][NEUTRAL] Uh, policy number is 2488014.
[CUSTOMER][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, so I see that it lapsed. It looks like it has a, had a future lapse date on it. Let me see who added that.
[CUSTOMER][NEUTRAL] Um, OK, looks like Mole did. Hang on just a second. Let me see if I can find what she received to.
[CUSTOMER][NEUTRAL] To do that.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Oh, it looks like she
[AGENT][NEUTRAL] And that
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Um, OK. Did she happen to leave you her phone number?
[AGENT][NEUTRAL] She did. Um, it's [PII].
[AGENT][NEUTRAL] [PII]. She's broker [PII], she was with Fidelity, so she was with the group that wrote the policy for this employer um and and I I do show the group is still active, but this particular policy terminated back in [PII] so and she's adamant that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Premiums have been deducted ever since then and she thinks Pay logic's dropped the ball, but uh I can't tell if there's a third party if maybe that's their third party enrollment platform.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, since she hung up, I'll make sure that we get back to her. I do actually have uh a notice here some correspondence that was uploaded on base from [PII] asking to cancel this member's policy effective [PII], so it looks like we had written communication to do so, um, so, um, I'll make sure that we call her back and let her know, um.
[CUSTOMER][NEUTRAL] Not sure what we'll need to do after that if she's saying the policy is supposed to be active um but we'll we'll address that I guess um she I'm assuming she'll need us to provide us with this correspondence that we have but um like I said I'll give her a call back and see if we can get it sorted out.
[AGENT][POSITIVE] OK, well, I appreciate you so much. Thank you so much.
[CUSTOMER][POSITIVE] Yeah, absolutely, no problem. Thank you.
[AGENT][NEUTRAL] All right, bye.
[CUSTOMER][NEUTRAL] Uh huh bye bye.