AccountId: 011433970860
ContactId: 5bdc986f-7ace-4503-b4d2-f5da18870d2d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 675159 ms
Total Talk Time (AGENT): 242424 ms
Total Talk Time (CUSTOMER): 340214 ms
Interruptions: 2
Overall Sentiment: AGENT=2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/5bdc986f-7ace-4503-b4d2-f5da18870d2d_20250131T19:20_UTC.wav
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[AGENT][NEUTRAL] have.
[AGENT][NEUTRAL] How may I help you?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah, hi, my name is [PII]. I'm calling from the office and uh I need to verify patient details.
[AGENT][NEUTRAL] I can help you with that, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Allow me a second, let me check.
[CUSTOMER][NEUTRAL] So it is [PII].
[CUSTOMER][NEUTRAL] [PII] is the direct line number.
[AGENT][NEUTRAL] Thank you, [PII], and what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Policy number is 1080673.
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Uh [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Alright thank you and you're needing eligibility for [PII]?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right. Is it for dental eligibility?
[CUSTOMER][NEUTRAL] Yes. Yes.
[AGENT][NEUTRAL] All right, I can help you with that. Now, actually, [PII], his policy is no longer active.
[AGENT][NEUTRAL] The effective date on the policy was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And his policy termed on 10-1-2024.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] So no longer active.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, since I'm calling her time because, uh, this policy has been verified on November month on [PII], and we have got the benefit and it was active that time on [PII]. Can you please check like when will you get the information of termination because since we have already verified this patient on [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So how can it be possible like now I've been calling and this holiday terms on October month?
[CUSTOMER][NEUTRAL] And I do have the name and reference number for that representative as well.
[AGENT][NEUTRAL] Mhm. So when you called in November.
[AGENT][NEUTRAL] Uh, the policy did still show active. However, we received notification to turn the policy for 10-124.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Every
[CUSTOMER][NEUTRAL] OK, so, like, can you please confirm, like when will you get notified for any termination like for this patient, like when will you get the, uh, when was the time did you get the notification for this termination?
[AGENT][NEUTRAL] Uh, the notification came through.
[AGENT][NEUTRAL] Bear with me just a second.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] On [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Don't need 4.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Do you mind holding just one moment? Let me check something for you. Do you mind holding?
[CUSTOMER][NEUTRAL] OK, but
[CUSTOMER][POSITIVE] Sure, no issues.
[AGENT][POSITIVE] Alright thank you give me just one moment I'll be right back with you.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII] in the customer service department. How may I help you?
[AGENT][POSITIVE] Hey sweet [PII], it's [PII]. How are you doing?
[CUSTOMER][POSITIVE] I'm doing good. How about yourself?
[AGENT][POSITIVE] I'm doing good. It's Friday, woohoo, and the sun is out. Wow.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah, I know, right?
[AGENT][POSITIVE] And it's not freezing. Hey, it's a good day.
[CUSTOMER][NEUTRAL] Uh yes, ma'am. What you got for me?
[AGENT][NEUTRAL] a provider on the line checking for eligibility um on policy number 10, I'm sorry 1080673, which is to [PII].
[CUSTOMER][NEUTRAL] Say it in one.
[AGENT][NEUTRAL] 108.
[CUSTOMER][NEUTRAL] OK, that's what I was missing.
[AGENT][NEUTRAL] 0673
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] Now I'm seeing in [PII] that the participant was dropped.
[AGENT][NEUTRAL] But then when I go to PIBFT there's no termination date.
[CUSTOMER][NEUTRAL] This is CTBA.
[AGENT][NEUTRAL] It's big.
[CUSTOMER][NEUTRAL] Is it me?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, it's not. It's UTBA U R W A S U TBA.
[CUSTOMER][NEUTRAL] I think.
[AGENT][POSITIVE] Oh, that's right, that's right. Uh, I'm so sorry. I'm sorry.
[AGENT][NEUTRAL] I saw the S and saw, I saw a B.
[AGENT][NEUTRAL] This is URWS.
[CUSTOMER][NEUTRAL] Well, my nieces is not.
[CUSTOMER][NEUTRAL] And I was like, well, yeah, they're not really UTBA they're, it's hard to explain.
[AGENT][NEUTRAL] I've never seen that before, to be honest with you.
[CUSTOMER][NEUTRAL] Yeah, it's, it's kind of like a subgroup under them. It's not really with them it's just somehow I know it's an arrangement they have with another trucking company.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Never heard of that.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] So I'm seeing on the [PII].
[CUSTOMER][NEUTRAL] It was she turned him more.
[AGENT][NEUTRAL] Lapsed
[AGENT][NEUTRAL] 12:31.
[CUSTOMER][NEUTRAL] Oh, I know it's probably because of that other day. Hang on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I've got a provider on the line. They called in November and when I, uh, to get eligibility when I gave him the term date of 101, he's saying, well, we called in November and the policy was active. Can you tell me how that can be?
[CUSTOMER][NEGATIVE] If the premiums ain't paid, it gets canceled. That's how that works.
[AGENT][NEUTRAL] I can't tell him that, yeah.
[CUSTOMER][NEUTRAL] But um,
[CUSTOMER][NEGATIVE] It is canceled 11, hang on.
[CUSTOMER][NEUTRAL] So do I need to tell him that's what you're saying?
[AGENT][NEUTRAL] No, I'm just verifying that trying to verify, is it actually terminated because there's no termination date in PIBFT or?
[CUSTOMER][NEUTRAL] I'm fixing PI BFT. It does have a term date on one of them, but I guess it, what it did, it took the initial, somehow or another, it's got an initial effective date. And I don't know if somebody was in here trying to do something, but then it has another effective date of [PII].
[AGENT][NEUTRAL] Yeah, it's kind of crazy looking to me.
[CUSTOMER][NEUTRAL] I wonder if he had got change.
[AGENT][NEUTRAL] And I just wanna be able to
[AGENT][POSITIVE] Give him the correct information.
[CUSTOMER][NEUTRAL] Well, the correct information is that yes, it should be termed [PII] because that was the last payment we received and I'm fixing trying to fix PI BFT.
[CUSTOMER][NEUTRAL] I'm wondering though.
[AGENT][NEUTRAL] And he said, well, how come when I called in November?
[AGENT][NEUTRAL] It was still active. I, I can work around all that.
[AGENT][NEUTRAL] And wait a minute, laps on [PII].
[CUSTOMER][NEUTRAL] Well,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, but she, because of what it's paid to is what we go by as far as the term date.
[AGENT][NEUTRAL] A lot.
[CUSTOMER][NEUTRAL] Does that make sense?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But I am fixing the benefits to show.
[CUSTOMER][NEUTRAL] And I'm taking that other benefit out. I just can't explain how that other benefit got in there. It's crazy looking.
[AGENT][NEUTRAL] It is crazy looking.
[CUSTOMER][NEUTRAL] I don't know
[AGENT][NEUTRAL] So they called on the [PII] and told the policy was active at the moment.
[AGENT][NEUTRAL] And he's like, oh, when did you receive notification to turn the policy? I don't even know if I can tell them that.
[CUSTOMER][NEGATIVE] You can tell him he can have the insured contact his employer. They'll probably call them. They, they're not even really supposed to call UTBA UTBA don't even get anything on this, really. They just transfer the money over.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] If it's a discrepancy, they'll let us know.
[AGENT][NEUTRAL] They just
[CUSTOMER][NEGATIVE] But it looks like it was lapsed on [PII] due to nonpayment and that's standard for UTBA. They sometimes go to 2 to 3 months without payment and then the system terminates them.
[AGENT][NEGATIVE] I sure makes it hard when they call for eligibility and we give it to them and it ain't that.
[CUSTOMER][NEGATIVE] I think we're supposed to though when it's active it's active we're supposed to we can't do anything about that premium.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I mean, that's what we do. I'm just saying in my brain.
[CUSTOMER][MIXED] I know, it doesn't make sense to, but I guess because of the way this group is special.
[AGENT][POSITIVE] We got a lot of them special ones, don't we?
[CUSTOMER][POSITIVE] Girl, this one is ancient special. This one's been special since I got here, so I can tell you all about it.
[AGENT][POSITIVE] It's been special for a long time.
[CUSTOMER][NEUTRAL] Yes, OK, um, but yes, 101 is correct because that's what it's paid to and that was the last premium received and PIBFT is fixed, so if they do call again, it should be OK. And if it's an error, they'll let us know.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] You know, I just like to verify everything. I'm sorry.
[CUSTOMER][NEGATIVE] No, don't be sorry. I just wanna make sure. I mean, it would have threw me off within 2 days too, like we in the, and we in the, and then there's really no notation. I just can't stand that. I don't know why, but any who, that's not here there. Have a good day. Let me know if you need anything else.
[AGENT][NEUTRAL] I do, I do, I do.
[AGENT][NEUTRAL] Yeah, me too.
[AGENT][POSITIVE] Got you.
[AGENT][POSITIVE] Thank you, ma'am.
[AGENT][POSITIVE] All right. Thanks, sweetie. You have a great weekend. Appreciate your help. Bye-bye.
[CUSTOMER][POSITIVE] You too, hun. Thanks.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][POSITIVE] [PII], thank you for your patience. I did call customer service to verify that termination date of [PII]. If there's any discrepancy or any questions you would need to contact the, the patient.
[CUSTOMER][NEUTRAL] Please
[CUSTOMER][POSITIVE] Yeah we do well
[CUSTOMER][NEUTRAL] Can you please give me your name and reference number for this call?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] First initial last name, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the reference number would be my name in today's date.
[CUSTOMER][NEUTRAL] Today's date.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] you
[CUSTOMER][NEUTRAL] Mm, let me.
[CUSTOMER][NEUTRAL] [PII] and state. Am I correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and as you have confirmed me earlier that you got notified on [PII] for this termination.
[AGENT][POSITIVE] Mhm, correct.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, thank you so much. Have a good day.
[AGENT][POSITIVE] My pleasure to assist you, [PII]. Thank you for calling APL. Hope you have a great day as well. Take care.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye.