AccountId: 011433970860
ContactId: 5cec6456-f89f-4bac-93e5-f97636591d0f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1189880 ms
Total Talk Time (AGENT): 515029 ms
Total Talk Time (CUSTOMER): 423977 ms
Interruptions: 13
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/5cec6456-f89f-4bac-93e5-f97636591d0f_20250306T21:03_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, um, I know this is billing, but do you have any information on who we would call about an employee having trouble with her benefits?
[AGENT][NEUTRAL] That would be Las.
[AGENT][NEUTRAL] Um, I can see what I can do. Hold on just a moment. Let me see what I, what is your name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My name is [PII]. I'm with Renal Associates.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, do you want our account number?
[CUSTOMER][NEUTRAL] Let me see, I, I've got the bill here.
[AGENT][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] OK, what is a good call back number first just in case.
[CUSTOMER][NEUTRAL] 0 225 [PII].
[AGENT][NEUTRAL] 7120. OK, and that's 225.
[CUSTOMER][NEUTRAL] 207,120
[AGENT][NEUTRAL] OK, so that's [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, [PII]. And what is that group number?
[CUSTOMER][POSITIVE] It is um well.
[CUSTOMER][NEUTRAL] Should be on the bill, huh?
[AGENT][NEUTRAL] Uh, yes, ma'am. It should be.
[AGENT][NEUTRAL] It's gonna be down at the bottom part.
[CUSTOMER][NEUTRAL] I'm not seeing it.
[CUSTOMER][NEUTRAL] Uh, OK, I'm looking at the top. Let me pull it.
[AGENT][POSITIVE] That's all right. That's all right.
[CUSTOMER][NEUTRAL] Let me pull it down.
[CUSTOMER][NEGATIVE] It doesn't have it.
[CUSTOMER][NEUTRAL] It has an invoice number.
[AGENT][NEUTRAL] I can look it up by you.
[CUSTOMER][NEUTRAL] It has a confirmation number.
[AGENT][POSITIVE] OK, hold on, I can help you with that. I can help you with that. That's not a problem. What's that invoice number?
[CUSTOMER][NEUTRAL] I don't know what it is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, uh, 638-323-7.
[AGENT][NEUTRAL] 6383237.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] And you know what? I'm gonna type it on here when you give it to me.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] See.
[CUSTOMER][NEUTRAL] I put it on my spreadsheet.
[AGENT][NEUTRAL] And you, what's the name of that group is renal Association of, OK, so that is 2, OK, so that is 261.
[CUSTOMER][NEUTRAL] Reno.
[CUSTOMER][NEUTRAL] A Baton Rouge, yes.
[AGENT][NEUTRAL] 05
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's the group number. That's the group number.
[CUSTOMER][NEUTRAL] That's it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], can I verify some information real quick? Can you verify the um address that we have on file for your group?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] It should be [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much. And can you ver
[CUSTOMER][NEUTRAL] That's the wrong zip code, but I don't think it matters, but um, go ahead.
[AGENT][NEUTRAL] And what is your um
[AGENT][NEUTRAL] Email address. I'm sorry.
[CUSTOMER][NEUTRAL] The email address, uh, the billing comes to [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you so much for verifying that. And you said that you are calling on an insured about a claim, is that correct?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Well, it's not about a claim she's paying.
[CUSTOMER][NEUTRAL] Family coverage and that's what we're withholding from her check but she said she logged into her account and it told her that her family coverage is not active.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] So, OK. And what is her name?
[CUSTOMER][NEUTRAL] That it
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh huh and I think which, which he's uh.
[CUSTOMER][NEUTRAL] In particular is group accident and critical illness.
[CUSTOMER][NEUTRAL] So I wanna make sure she's being charged family coverage.
[AGENT][NEUTRAL] OK, so [PII].
[CUSTOMER][NEUTRAL] Oh, in hospital indemnity, yeah, mhm.
[AGENT][NEUTRAL] Um, so it shows that she's got 12345 policies.
[CUSTOMER][NEUTRAL] 1230 I'm showing 4.
[CUSTOMER][NEUTRAL] She's got
[AGENT][POSITIVE] 123, you're right, you're right. I mm it's been a long day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It sure has.
[AGENT][NEUTRAL] So what you
[CUSTOMER][NEUTRAL] It's kind of been a weird Thursday, so kind of like a Monday, it's Thursday.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Oh Lord, it's, it's, it's been a long week, to be honest with you.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] So anyway, she's apparently had an accident in the family, so I think the hospital indemnity, the critical illness, and the group accident are what's in question here.
[AGENT][NEUTRAL] No
[AGENT][NEUTRAL] The HI critical illness, and the ACC.
[CUSTOMER][NEUTRAL] But I, I, I would like to make sure her term life is.
[CUSTOMER][POSITIVE] Active as well.
[AGENT][NEUTRAL] OK, so I am showing that all of those policies are active.
[AGENT][NEUTRAL] And you said she is supposed to have um family coverage on?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see what she has.
[CUSTOMER][NEUTRAL] I've got a group here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Make sure they match.
[CUSTOMER][NEUTRAL] 86
[CUSTOMER][POSITIVE] Yeah, OK. Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I am showing that on the accident and the uh hospital indemnity that she has coverage uh couple coverage.
[AGENT][NEUTRAL] On the critical illness, it's individual.
[CUSTOMER][NEUTRAL] OK, I wonder if she had an error when she was enrolled, so she has family coverage on which one, the hospital?
[AGENT][NEUTRAL] She has couple coverage.
[AGENT][NEUTRAL] On the hospital.
[CUSTOMER][NEUTRAL] What do you mean couple coverage? Is that just her and her husband?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] That is what I'm showing.
[CUSTOMER][NEUTRAL] And then on the critical illness only her?
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] I'm on, I'm double checking this, so, so.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, that is what she's being billed for.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And has been.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Because when I pull up their benefits.
[CUSTOMER][NEUTRAL] Um, in our HR program.
[CUSTOMER][NEUTRAL] It tells me she has family.
[CUSTOMER][NEUTRAL] So that would be her and her husband and her children when that.
[CUSTOMER][NEUTRAL] Would that be correct?
[AGENT][NEUTRAL] If, um,
[AGENT][NEUTRAL] Wait a minute, just a moment let me see what we're looking at.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So all all everything I have shows her coverage level.
[AGENT][NEUTRAL] OK. Now, um,
[CUSTOMER][NEUTRAL] OK, that's family.
[CUSTOMER][NEUTRAL] As of
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] And that is critical illness.
[CUSTOMER][NEUTRAL] And hospital indemnity.
[CUSTOMER][NEUTRAL] Can you check back on that day and see if something changed?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I am looking at the hospital and hospital indemnity plan.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let's see what it says.
[CUSTOMER][NEUTRAL] And let's see, let me compare what she's paying.
[CUSTOMER][NEUTRAL] To what she should be paying.
[AGENT][POSITIVE] OK. Um, effective.
[CUSTOMER][NEUTRAL] And that could be a difference.
[CUSTOMER][NEUTRAL] She should be
[AGENT][NEUTRAL] Effective [PII] on the
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Which one am I looking at?
[CUSTOMER][NEUTRAL] Well that is not what they have in here so if they entered it wrong.
[AGENT][NEUTRAL] It says this child is, it says the child was removed per uh the file feed.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Per what?
[AGENT][NEUTRAL] Let's see her file.
[CUSTOMER][NEUTRAL] What was that word?
[AGENT][NEUTRAL] The file feed.
[AGENT][NEUTRAL] On the issue
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, I think it's electronics. Uh, hold on, let me double check.
[CUSTOMER][NEUTRAL] Oh, the file feed file feed, is that what you're OK.
[AGENT][POSITIVE] Yes, ma'am, the file feed. Yes, ma'am. I'm sorry.
[CUSTOMER][NEUTRAL] That's OK. I got that southern accent too, I know.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Yes, yes. And I, and it gets me in trouble a lot of times because I do say it but just like you said, but, um, right?
[CUSTOMER][NEUTRAL] What? Oh.
[CUSTOMER][NEUTRAL] Um, I, I think, I think, um, something came through wrong and we're withholding the higher amount.
[AGENT][NEGATIVE] OK. But you haven't been right, and you're not sending it, and you hadn't been sending it in, so.
[CUSTOMER][NEUTRAL] But I don't think that's what we're being charged.
[CUSTOMER][NEUTRAL] Like, um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, is there any fixed?
[AGENT][NEUTRAL] It looks like.
[CUSTOMER][NEUTRAL] It looks like we should be paying 101 18 for critical illness for family coverage, but we're only withholding $38.21 so that would probably be individual correct?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] OK. On the critical illness is the 38, you're paying 3821.
[CUSTOMER][NEUTRAL] Hospital indemnity.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] It's what she's been billed for.
[CUSTOMER][NEUTRAL] But it should be for group for a family should it be 101 18?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I would have to.
[CUSTOMER][NEUTRAL] Or you don't know? OK.
[AGENT][NEUTRAL] Uh, no, ma'am. Um,
[AGENT][NEUTRAL] So you're saying that the sun should
[CUSTOMER][NEUTRAL] I, I think that's what's, I think that's what's happened here is.
[CUSTOMER][NEUTRAL] But now hospital indemnity.
[AGENT][NEUTRAL] She's paying 3475.
[CUSTOMER][NEUTRAL] Uh, that, that's what's happened.
[AGENT][NEUTRAL] Let's see. Hold on.
[CUSTOMER][NEUTRAL] I don't see 3475. I see.
[AGENT][NEUTRAL] Hold on just a moment. Let me double check and see all this.
[CUSTOMER][NEUTRAL] Oh yeah she is she's paying 3475 and she should be paying 3903.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And that would cover her child as well because you said the hospital with her and her husband, right?
[AGENT][NEUTRAL] Right. So it looks like, like I said, it said that now the hospital indemnity and the accident has just her and her husband.
[AGENT][NEUTRAL] As the child was removed on both of those effective 11.
[CUSTOMER][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] And let's say the critical illness.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Critical illness 24.
[AGENT][NEUTRAL] 3. Wow.
[AGENT][NEUTRAL] If I can get my fingers to work in here.
[CUSTOMER][NEGATIVE] It's really hard to read on my side too.
[CUSTOMER][NEUTRAL] Um, but I think I see.
[AGENT][NEUTRAL] It, it's just the point in my.
[AGENT][NEUTRAL] Get my fingers working here.
[CUSTOMER][NEGATIVE] I see the problem like she's correct, she's paying the full amount.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] And um,
[CUSTOMER][NEUTRAL] Like accident you're saying the accident she's not paying.
[CUSTOMER][NEUTRAL] Enough either.
[AGENT][NEUTRAL] Removes spouse, removes the spouse and the child from the accident policy effective [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Only her. OK, well, let me, let me give this to my manager. I think we got enough we can work with now. Is there any way to make amends?
[AGENT][NEUTRAL] Um, you can.
[CUSTOMER][NEUTRAL] Like because we've been withholding this money from her.
[AGENT][NEUTRAL] Right. I, I mean, I, OK, and I understand that. Um.
[CUSTOMER][NEUTRAL] Uh, for the family coverage.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] And, and we're not showing that it's been sent in as that so um because it looks like the bills have been paying it been being paid in full.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] Yeah, I mean, I, I see the error. I just, I don't know a fix so I'm gonna, I'm gonna bump this up the ladder.
[AGENT][NEUTRAL] And that's not a problem. That's not a problem. All you would have uh you can do, I mean you can send us a an email letting us know, um, on hers and include her policy numbers and let us know what she's supposed to that she's supposed to have family coverage and that you've been deducting for this and that the file feed I mean it was wrong on the file feed.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I see.
[AGENT][NEUTRAL] Um, because that's where we're getting our information from, and that's the reason why it was changed. The coverage was changed.
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][NEUTRAL] And where would I, where would I send that?
[AGENT][NEUTRAL] You can send that to [PII].
[AGENT][NEUTRAL] At Am Public.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And just let us know that you have the premium you that you you have been collecting it but you haven't been you know you haven't sent it in um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But just let us know that that needs to be corrected, effective, you know.
[CUSTOMER][NEUTRAL] Make it effective [PII]? OK, all right.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct, I mean if that's the way, if that's what it was supposed to be.
[CUSTOMER][POSITIVE] Mhm OK all right well you've been very helpful and I appreciate it. What was your name?
[AGENT][NEUTRAL] All right, [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Alright, well thank you my lad. I appreciate your help.
[AGENT][POSITIVE] You're welcome, [PII]. Is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] Um, no, let me just get with my, uh, my boss, and he can let me know what he wants to, to do to help her out.
[AGENT][NEUTRAL] Oh right.
[AGENT][NEUTRAL] Well, that would be, I mean, if you can do that, we can get that taken care of and um then.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If if you've got the premium that's more than likely we'll need that premium, we'll have to have that premium to get that changed, so or.
[CUSTOMER][NEUTRAL] That's fine. Is it something I can go online and pay?
[AGENT][NEGATIVE] No ma'am, unfortunately it's not.
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] But I mean I mean we can get that changed but we would, you know, they would normally we would supplemental bill for that that premium, the premium difference but so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I, and I could send you a check, OK, alright.
[AGENT][NEUTRAL] Right, right, it'll be, well, it'll be included on your March bill since y'all pay in arrears, so it would be they would bill it on your, so if you get that in, then we can get that changed and they can supplemental bill you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][POSITIVE] And it would be effective in March, I mean as of January, but I could pay it in March when I pay the premium OK alright well I appreciate it.
[AGENT][NEUTRAL] They would put it on the, on the march.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] All right, [PII]. Well, again, thank you for calling APL. Is there anything else that I can help you with?
[CUSTOMER][POSITIVE] Um, no, ma'am, that's it. I appreciate it, thanks.
[AGENT][POSITIVE] All right. Well, thank you and you have a great day, OK?
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.