AccountId: 011433970860
ContactId: 6ee34148-e0b1-4c5a-80ee-c83384c288da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 935619 ms
Total Talk Time (AGENT): 268192 ms
Total Talk Time (CUSTOMER): 419492 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/6ee34148-e0b1-4c5a-80ee-c83384c288da_20250613T20:51_UTC.wav
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[AGENT][NEUTRAL] APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII]. Um, I work through Focus, uh, Man temp agency, and I'm supposed to have insurance through you guys.
[CUSTOMER][NEUTRAL] But my pharmacy just um called and stated that you guys.
[CUSTOMER][NEUTRAL] Cut my insurance um last month and I'm still working there so I'm a little confused and I was wondering if you can give me some information about it.
[AGENT][NEUTRAL] Yeah, let's take a look. Do you have your policy number?
[CUSTOMER][NEUTRAL] Um, give me a second.
[CUSTOMER][NEGATIVE] Cause the lady had uh pulled it up and sent it to me today cause I was supposed to receive a card but I never received anything. Um, it's showing that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The policy is 026.
[CUSTOMER][NEUTRAL] 169.
[CUSTOMER][NEUTRAL] 86
[AGENT][POSITIVE] I'm so sorry, read that back to me one more time.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] The policy slasher number is 026.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh hold on.
[CUSTOMER][NEUTRAL] 02616986
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] And it's saying the effective date was [PII]. So, and they said that it expired last month.
[CUSTOMER][NEGATIVE] So I'm not understanding why it was only covered for a month.
[AGENT][NEUTRAL] OK, yeah, I just need to verify for security please [PII], your date of birth and then address.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] Um, my date of birth is [PII], and my address um is [PII] sorry.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. OK.
[CUSTOMER][NEUTRAL] [PII], or it's [PII]. I can't let me double check.
[CUSTOMER][NEUTRAL] [PII] sorry.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] All right, [PII], so did they call us to verify your benefits as far as verification?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, they just got off the phone with you guys. I'm still at Walmart pharmacy now.
[CUSTOMER][NEGATIVE] And they had told me that you guys told them that I was not covered, that my benefits ended last month.
[AGENT][NEUTRAL] I show the policy is active, it's not terminated. So I don't know where they got that information from.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Yeah, I mean, I show that you're active and that everything is still active. Nothing has lapsed.
[CUSTOMER][NEUTRAL] That means
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, because he, um he had just gotten off the phone with them and told me that I needed to call you guys.
[CUSTOMER][NEGATIVE] And see what's going on with the insurance because that my I was, I no longer was covered by you guys. So um let me go back.
[CUSTOMER][NEUTRAL] And see
[AGENT][NEUTRAL] Yeah, I don't, I don't know who they contacted or
[CUSTOMER][NEUTRAL] Mhm yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Give me just a second, let me see if I can get some.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hi, I'm on the phone with the insurance and they said it's not lapsed.
[CUSTOMER][NEUTRAL] That's what I told them. Hello, hello.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hi, hi, this is [PII] with American Public Life Insurance.
[CUSTOMER][NEUTRAL] Hey
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So, um, [PII]'s trying to pick up a prescription and.
[CUSTOMER][NEUTRAL] Her insurance is saying it's not active.
[CUSTOMER][NEGATIVE] Would you happen to have processing information? Maybe I'm running the wrong thing.
[AGENT][NEUTRAL] I show the effective date is [PII], status on my end is still showing active.
[AGENT][NEUTRAL] Um, did you call LucyRX? Is that who you contacted for the prescription because that's who they go through?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yeah, I called, uh, I called the number they had her on file but they said.
[CUSTOMER][NEUTRAL] That it was inactive starting on [PII], so a month ago.
[AGENT][NEUTRAL] Hm, yeah, that's not what I show. Do you need the BIN number, group number? What information do you need?
[CUSTOMER][NEUTRAL] Yeah, if you wanna, yeah, give, yeah, I'll need, uh, I'll take it all just, uh, yeah, OK, what's VIN number first?
[AGENT][NEUTRAL] VIN number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Group number.
[CUSTOMER][NEUTRAL] And uh yep.
[AGENT][NEUTRAL] It's going to be [PII].
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] 943 2.
[AGENT][NEUTRAL] And then there's a [PII] [PII].
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK, and you have a member ID?
[AGENT][NEUTRAL] So the policy certificate number for the insured is 02616986.
[CUSTOMER][NEGATIVE] Yeah, I tried to I tried to process that and it did not, it didn't work.
[AGENT][NEUTRAL] Did you try their
[CUSTOMER][NEUTRAL] It's just, it comes back saying.
[AGENT][NEUTRAL] OK. Do you wanna try them?
[CUSTOMER][NEUTRAL] I tried that number and I tried there's a medical ID on the card as well. I tried both.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] And it's just not
[CUSTOMER][NEUTRAL] Yes, I don't, I'm not sure.
[AGENT][NEGATIVE] It's not pulling up as valid or?
[CUSTOMER][NEGATIVE] Yeah, so when I submitted it says um coverage outside submitted date of service no patient match found.
[CUSTOMER][NEUTRAL] I'm not worried about
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me try.
[AGENT][NEUTRAL] Yeah, I don't
[AGENT][NEUTRAL] I don't know why it would show that cause we don't show any lapse in the coverage.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, give me one second, let me try one more thing here.
[AGENT][NEUTRAL] OK. Yeah, I mean, the only other thing I know to tell the insured to do is because prescriptions go through this LucyRX is there has to be something not aligning or something.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] Yeah, that didn't work here. I was trying to take that G off like the hyphen G and see if that did anything, but I'm getting the same rejection.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Yeah, so,
[AGENT][NEUTRAL] You can, I don't, I don't, I'm not sure what else to give you. Um, I'm looking at the card and so I'm just giving you.
[CUSTOMER][NEUTRAL] Yeah, they're, yeah, I don't have anything else to that's generally all we need is what you gave and that's what was on her card so.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I don't know. That's why I called them because it generally sometimes ID number is different or something like that and um but they said she wasn't active so I don't know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Um, yeah, we'll have to contact them then. That's, you know, that's all we can do at this point. So if you want to give the phone back to [PII].
[CUSTOMER][NEUTRAL] OK, yeah.
[AGENT][POSITIVE] Thanks.
[CUSTOMER][POSITIVE] Thank you. Hello?
[AGENT][NEUTRAL] Hey [PII], I don't, I don't, I don't know why the information isn't pulling up. Um, the only thing we can do at this point is call Lu CRX and see why it's saying that you're not valid.
[CUSTOMER][NEUTRAL] 3 days.
[CUSTOMER][NEUTRAL] Um, do I need to call or do you guys call?
[AGENT][NEUTRAL] Well, I need you to stay on the line cause I, you know, um, they, they may, yeah, they may need to verify some stuff. So give me just a second, one moment.
[CUSTOMER][NEUTRAL] Oh, OK, that's fine.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling the pharmacy and member help desk. This call may be monitored or recorded for quality and training purposes. If this is a medical emergency, please dial [PII]. Please listen closely, as our menu options have changed. espanol numerocinco. If you are a member, please press 1. If you are calling from a pharmacy, please press 2. If you are calling for a prior authorization or from a prescriber's office, please press 3. If you are a broker, employer, or client, please press 4.
[CUSTOMER][NEUTRAL] Please hold for the next available agent.
[CUSTOMER][POSITIVE] Hi, good afternoon, thank you for calling the pharmacy and member help desk. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII]. My name is [PII] and I'm calling you from American Public Life Insurance. We have a mutually insured on the line. Her name is [PII]. Reason for the call today is she's trying to fill a prescription at the pharmacy and they're stating that her policy is not active, which is not what I see on our side. So wondering if you can help with that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, definitely do you have the ID number or her member number?
[AGENT][NEUTRAL] Yeah, so I have policy er number or medical ID. Which one do you need?
[CUSTOMER][NEUTRAL] Um, let's try the policy number.
[AGENT][NEUTRAL] OK, policy er number is 02616986.
[CUSTOMER][POSITIVE] OK perfect let's see.
[CUSTOMER][NEUTRAL] Alright, can you verify uh first name, last name, and date of birth?
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you, let's see here.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All right, so.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Alright, so I just want to uh verify with [PII] that is that it is OK if I release uh the information.
[CUSTOMER][POSITIVE] Yes ma'am. OK perfect uh so it looks like this uh.
[CUSTOMER][NEUTRAL] This termed on [PII], so there is, uh, it's not active at this moment.
[CUSTOMER][NEUTRAL] May I ask why?
[AGENT][NEUTRAL] So do you know what
[CUSTOMER][NEUTRAL] Um, we have no, no reason as to why, uh, we just kind of see what the screen here tells us. I would maybe reach out to, um, who you got the plan through, uh, maybe there was, uh, something that needed to be completed that wasn't, or maybe they haven't processed something, but, uh, it looks like the the end date was [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is, is there a reason why on my side it would be showing active with no lapse and then on your side it's showing something completely different, do you know?
[CUSTOMER][NEUTRAL] Uh, offhand, I, I wouldn't, I would not know as to why, no, I would recommend reaching out to, uh, is it the possible insurer is she insured through an employer?
[AGENT][NEUTRAL] Yeah, you're probably [PII] gonna have to reach out to your employer since they're the ones that are like funding the plan.
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Alright, well.
[CUSTOMER][POSITIVE] Alrighty, well, they're closed at the moment, thank you so much for you guys' help.
[AGENT][POSITIVE] I think that's all we needed from you.
[CUSTOMER][POSITIVE] Of course you have a great afternoon.
[AGENT][NEUTRAL] [PII], so yeah, what I would do then is just reach out to them like I'm sorry I don't know.
[AGENT][NEUTRAL] I don't know what else to do, unfortunately, you know, um, they, they would be the only ones kind of at this point that can remedy any of this. I don't understand why it's showing two different things.
[CUSTOMER][NEGATIVE] Yeah, I don't understand why cause I'm still through the company and this is my 2nd month working there, so it should be active. And what, what's upsetting me is these are new scripts that I need to be on and it's coming.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] Out of my check. Every week I pay for my insurance. So if I'm not even having insurance, my medicines not being covered, why am I even paying for it, you know?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] No, I definitely, I get it. I understand. Um, like I said, everything on my side shows active, so I, yeah, that was my confusion on it. I apologize, um.
[AGENT][NEUTRAL] There's nothing else I can, yeah.
[CUSTOMER][POSITIVE] It's not your fault. I, I really appreciate your help.
[AGENT][POSITIVE] Yeah, no, not a problem, [PII]. Sorry about that, and I'll notate this if you need any more help Monday, please feel free to call us. We're happy to help.
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] Mhm. Take care.
[CUSTOMER][POSITIVE] You have a wonderful day.
[AGENT][NEUTRAL] You too. Bye-bye, ma'am.