AccountId: 011433970860
ContactId: 546d171e-520f-4758-a224-e8d67c1b8fc4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 849109 ms
Total Talk Time (AGENT): 382751 ms
Total Talk Time (CUSTOMER): 270510 ms
Interruptions: 3
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/546d171e-520f-4758-a224-e8d67c1b8fc4_20250220T19:18_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], how you doing?
[AGENT][NEUTRAL] I'm fine, but I can barely hear you.
[CUSTOMER][NEUTRAL] Hi, um, I was calling to, um, take on a.
[CUSTOMER][NEGATIVE] Um, a refund from my.
[CUSTOMER][NEGATIVE] Short term disability from last week, I mean, I'm sorry, last month from January, they charged me for my health insurance, my premium, and my job pays my premium when I'm out.
[AGENT][NEUTRAL] OK, so you're inquiring on a refund regarding an overpayment of premium, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am. They took it out of my payment.
[AGENT][POSITIVE] OK, yes ma'am. Well I can uh look at that for you. I can help you and who am I speaking with?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, I didn't understand you.
[CUSTOMER][NEUTRAL] Breakfast me.
[AGENT][NEUTRAL] Did you say [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, thank you. And Ms. [PII], what is your callback number?
[CUSTOMER][NEUTRAL] Um, I'm sorry. I had to take this Bluetooth out. That's probably why you couldn't hear me.
[AGENT][POSITIVE] That's much better. Whatever you did, that's much better.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I'm sorry. My, my date of birth, you ask?
[AGENT][NEUTRAL] Now, your phone number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then what is your policy number, Ms. [PII]?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] I don't know about her.
[AGENT][NEUTRAL] OK, what is your full social and I can look it up.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And Miss [PII], I will need to verify several things with you first and also any information that is provided would be a verification of excuse me, benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And your home mailing address, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. The phone number we show on file for you is the same as the one you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you. And then the last thing would be your email address, please.
[CUSTOMER][POSITIVE] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Uh one moment.
[AGENT][NEUTRAL] OK, and this was for the January payment you said, is that correct? Or the payment that was processed?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I don't even know what my payment was for February. It um says 3611.
[CUSTOMER][NEUTRAL] But I was wondering what the total amount was before they took the.
[CUSTOMER][NEUTRAL] They probably took the premium out of that.
[AGENT][NEUTRAL] They did, yes, ma'am. So, because your premium is being deducted, it was, yes, the total benefit paid was 3611.43.
[CUSTOMER][NEUTRAL] Also.
[AGENT][NEUTRAL] Now, as to, I'm trying to see if I can determine why the premium.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's being deducted directly. So give me just a second.
[CUSTOMER][NEGATIVE] Yeah, I, I don't understand it because my job, I didn't know they that they were doing it the last time I was out until I got back to work.
[CUSTOMER][NEUTRAL] Then I had an overpayment.
[AGENT][NEUTRAL] OK, so what I need to do first off is I'm going to try and connect you with one of the examiners because I see that this has happened before.
[AGENT][NEUTRAL] To see if they can determine why the premium.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If they can explain as to why the premium was being deducted because I do show that you are on a payroll deduction also they may end up having to connect you to another department also Ms. [PII], but when I transfer you, I'm gonna give them your policy number and let them know the reason for your call because I can see that you have called several times.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so have you received any refund payments at this point?
[CUSTOMER][NEUTRAL] Yeah, I did um I did receive a payment for 3611.
[CUSTOMER][NEUTRAL] Um, on Tuesday.
[AGENT][NEUTRAL] Yes, that's the, but as far as a refund of premium, not your benefits. OK. So, OK. OK, so give me just one moment and
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No. No.
[AGENT][NEUTRAL] Is there anything else today, Ms. [PII] that I can help you with before I transfer you?
[CUSTOMER][NEUTRAL] Um, uh, one more question. If I have a claim for um hospital group indemnity, would I talk to Web CPA about that claim?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Yes, ma'am. That is a yes, that policy would be one you would speak with Web TPA about. Yes, ma'am. And do you have their phone number, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK, so it should also be on your ID card that you have for that insurance, but the phone number for Web TPA is [PII].
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I have it.
[AGENT][POSITIVE] OK, alright then, well, again, if that is all I can help you with, if you will give me just one moment, I will get you connected and thank you again for calling APL. I hope you have a very nice afternoon.
[CUSTOMER][POSITIVE] OK thank you you too.
[AGENT][POSITIVE] Yes, ma'am. Thank you very much. So one moment, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How may I help you?
[AGENT][NEUTRAL] Hey, [PII]. It's [PII]. How are you?
[CUSTOMER][NEUTRAL] Doing well [PII] how are you?
[AGENT][POSITIVE] I'm so glad it's Thursday.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I hear that.
[AGENT][POSITIVE] Mhm I'm so glad it's [PII].
[CUSTOMER][NEUTRAL] Almost Friday. Almost Friday.
[AGENT][POSITIVE] Oh, even better. Yay for you, [PII].
[AGENT][NEUTRAL] Well, I have an insured on the line. He's called several times. Um, it's on policy 215.
[AGENT][POSITIVE] 0345 M. [PII], very nice lady.
[AGENT][NEUTRAL] Um, she's calling because we've been deducting premium out of her disability payments.
[AGENT][NEUTRAL] And she's on
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] She's on a group plan.
[AGENT][NEGATIVE] And she's not been refunded anywhere I mean she's pay it's being payroll deducted and then she's having it directed.
[AGENT][NEUTRAL] Uh, taken out of her benefits.
[AGENT][NEUTRAL] For the last 2 months, for sure.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK, uh, I have no idea what to do with that one.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] They wouldn't, right? Me either. So we didn't take it out and when she was out.
[AGENT][NEUTRAL] Oh, that's, that's an no claim, sorry. I will hit the wrong button.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yeah, we've taken it out both times for this most recent, for 2 payments.
[AGENT][NEUTRAL] On this be on this claim.
[CUSTOMER][NEUTRAL] Well, it does say in a previous note that she would get refunded once we receive reimbursement, so.
[AGENT][NEUTRAL] Yeah, and I don't really know why that came, where that came from. And then I see where I talked to her and I don't know what was going on that day, but I just kind of see where I kind of followed suit on that. So I don't really, and based on I read off the the notes that are on this policy, I don't know why I would have told her that first off, but anyhow.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] I mean, I don't know why I would have just read that other note and followed on.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Well, I guess.
[AGENT][NEUTRAL] And say, well, that was a year ago.
[CUSTOMER][NEUTRAL] Let me look at.
[CUSTOMER][NEUTRAL] Gonna pull the claim up claim documents for that latest claim.
[AGENT][NEUTRAL] OK, being deducted.
[CUSTOMER][NEUTRAL] Sometimes, um, sometimes the, uh,
[AGENT][NEUTRAL] So we did that last year and billing had to get involved.
[CUSTOMER][NEUTRAL] Yeah and that's what I'm thinking that uh I'm thinking it must be a billing thing but.
[AGENT][NEUTRAL] But I don't know why.
[CUSTOMER][POSITIVE] I can ask [PII] usually [PII] is really good about putting notes in as to why she.
[CUSTOMER][NEGATIVE] You know, why something was done that doesn't really make sense.
[AGENT][NEUTRAL] Oh wait, what did I do?
[CUSTOMER][NEUTRAL] Because I'm not certain I'm thinking that it might be a billing thing as well because.
[CUSTOMER][NEUTRAL] I think that that's where that comes from when the uh examiner has to do that function.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] I, I don't know.
[CUSTOMER][NEUTRAL] And that's her call back there. I might have to reach out and and ask um.
[AGENT][NEUTRAL] [PII], yeah, [PII].
[CUSTOMER][NEUTRAL] Yeah I might have and she's been verified?
[AGENT][NEUTRAL] She has. Mhm.
[CUSTOMER][NEUTRAL] OK, because I might.
[AGENT][POSITIVE] She's a really nice lady.
[CUSTOMER][NEUTRAL] I might need to reach out. I'm thinking that it's gonna be.
[CUSTOMER][NEUTRAL] And it's been done all along, so I'm thinking I'm gonna reach out and ask uh [PII] and then have to, I may just call her back when I have an answer in case I can't get a hold of [PII] right away, but I'm gonna attempt to do that now.
[AGENT][POSITIVE] Goodness.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, well you're the best. Um, can you just, would you let me know what she says on this? I was just looking back to see why we would have ever done that, but I see that when she filed a claim back in [PII], there was also.
[AGENT][NEUTRAL] In early [PII], it was also the same thing where there was looks like premium.
[AGENT][NEGATIVE] Was refunded back.
[AGENT][NEUTRAL] February of last year.
[CUSTOMER][NEUTRAL] Yeah, because I see, I see that, and then in March they say premium overpayment 277 45, and that was made by uh [PII], I think she, yeah she billing.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah she is, but see I don't even see well I don't know what claim that was on as far as.
[CUSTOMER][NEUTRAL] Yeah, it doesn't say
[AGENT][NEUTRAL] Where that amount come from because it wasn't taken out of her.
[CUSTOMER][NEUTRAL] Well, there's two different ones. There's 277, there's another one in February that was 240 43, so I think.
[AGENT][NEUTRAL] I don't, I don't know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you're looking at last year, right? Not 24, yeah, OK.
[CUSTOMER][NEUTRAL] That that's
[CUSTOMER][NEUTRAL] Uh huh, [PII], yep, mhm.
[AGENT][NEUTRAL] So, yeah, I don't.
[AGENT][NEUTRAL] I, I mean, I, I don't know. I don't know where that amount came from.
[CUSTOMER][NEUTRAL] It looks like [PII], yeah, [PII] had talked to her in [PII] and had transferred her to billing because there was an overpayment on the premium, so um.
[CUSTOMER][NEUTRAL] That's what I see here. So I guess we'll, we'll have you transfer her to me, um, and then I'll do some kind of research and then, um, hopefully be able to direct her to the right place.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, because I told her that there was a possibility, you know, that she might end up having to be transferred again. I've already given her that information but again she's really nice and if you would just let me know since I don't know why we're taking.
[CUSTOMER][NEUTRAL] Oh well.
[AGENT][NEGATIVE] I don't understand that. I even looked at the policy while we when she's on payroll deduction why we would be taking it out of her benefits.
[CUSTOMER][NEUTRAL] Yeah that would be a
[AGENT][NEGATIVE] I don't understand that.
[CUSTOMER][NEUTRAL] I don't either, but I will definitely try to find out and I'll let you know so what I'll do is once I receive a um a response, I'll just let you know I'll send you a team's message.
[AGENT][POSITIVE] OK. You're so sweet. OK.
[AGENT][NEUTRAL] Oh,
[AGENT][POSITIVE] Yeah, awesome, yeah, that'll be fine. OK, [PII], thank you. All right, well are you ready for Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I am mhm.
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Bye bye.