AccountId: 011433970860
ContactId: 76433f7b-8c43-49ef-94d6-192b958d8bdc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 510940 ms
Total Talk Time (AGENT): 195186 ms
Total Talk Time (CUSTOMER): 157254 ms
Interruptions: 2
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/76433f7b-8c43-49ef-94d6-192b958d8bdc_20250107T18:19_UTC.wav
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[AGENT][NEUTRAL] Contacting ATL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, my name is [PII]. I just recently enrolled in, uh, Gap Medical. Do you guys?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Uh, on, uh, I guess it was beginning the [PII] of the year [PII].
[CUSTOMER][NEUTRAL] Well, on the [PII] of the year, uh, my son had some surgery which I paid a co-pay for.
[CUSTOMER][NEUTRAL] On that date
[CUSTOMER][NEUTRAL] My enrollment had not yet hit your system.
[CUSTOMER][NEUTRAL] So what I'd like to do, and I wanna verify that I'm now enrolled.
[CUSTOMER][NEUTRAL] And then #2, uh, submit a claim for reimbursement.
[AGENT][NEUTRAL] Yes, I understand. Um, [PII], do you have your policy number there with you?
[CUSTOMER][NEGATIVE] No, I don't, I don't even have a policy number.
[AGENT][NEUTRAL] Oh, I see. OK. OK.
[CUSTOMER][NEUTRAL] I'm a new enrollee as of [PII].
[AGENT][NEUTRAL] Oh, well, normally they, they would send something to you before then, so we'll fix that as well. And how do you spell your last name, please, sir?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And your first name is [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Should be the Medlink 9 gap insurance. I'm looking at the plan it shows.
[CUSTOMER][NEUTRAL] So we just did our delegations, um, December of last year, so that's probably why you guys don't have it or didn't have it at that point.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] [PII] OK. And what company do you work for, um, if you don't mind my asking?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] A polylift USA.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] The reason I'm asking is because at the moment, I'm not.
[AGENT][NEUTRAL] Seeing you in our system at all so I'm just trying to see what happened.
[CUSTOMER][NEGATIVE] Yeah, that's the problem.
[CUSTOMER][NEUTRAL] They told me it would probably be done within a week.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. If you'll excuse me just one moment please, I'll be right back. Excuse me just a moment, I'll see what's going on.
[CUSTOMER][NEUTRAL] All right. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, the only thing I, I can tell you is that we don't show that that it it could be that they're still in negotiations. Um, I'm not really sure, but, uh, I don't show that the that the policies have actually started yet, um, and that's probably why normally whenever something like that happens, uh, whenever we go ahead and initiate a group, we immediately send out cards and things like that, and I would be able to find you in our system.
[AGENT][NEUTRAL] Um, I'd be able to find Polylift USA, uh, on, on our, uh, we have a list of employers, um, that we, uh, cover, and I'm not able to find that at all. Um, so the only thing that I can guess is that the policies is not activated yet.
[AGENT][NEUTRAL] Now once they do we have a website um that you can submit a yeah yeah.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Yeah, I'm on the website, yeah, but, but who do I, so who do I chase down for this at this point?
[AGENT][NEUTRAL] You would want to check with your HR department. Uh, they would be the ones that we would be in negotiations with, um.
[AGENT][NEUTRAL] Yeah usually they're the ones who uh will pick the benefits of the group.
[CUSTOMER][NEUTRAL] Well, like I said, we, we just finished, we just finished, right, we just finished the open enrollment and I did my elections, uh, I did my elections on [PII].
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And what
[CUSTOMER][NEUTRAL] When I look in through our uh.
[CUSTOMER][NEUTRAL] Our notices like the compliance and company documents we use a portal called ease.
[CUSTOMER][NEUTRAL] Uh, in that portal.
[CUSTOMER][NEGATIVE] When I click on my benefits it has my dental, you know, United Healthcare, all this other stuff, medical and gap medical effective date [PII], it shows myself, my wife, my children, it shows the cost.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And then uh a little pamphlet.
[CUSTOMER][NEUTRAL] And says enrolled [PII], all of our family members.
[AGENT][NEUTRAL] That's why I don't know why I'm not finding you in our system because under normal circumstances I would, I, and it's, and it's listed under you, that's correct. It is listed.
[CUSTOMER][NEUTRAL] Uh, uh, maybe, uh, [PII] is the agent, would that be?
[AGENT][NEUTRAL] Uh, she is the, she is your recruit, the one who actually coordinates the benefits. She's um
[CUSTOMER][NEUTRAL] Mhm yeah.
[AGENT][NEUTRAL] Uh, and so, uh.
[AGENT][NEUTRAL] But she's, she is not someone that we are in contact with. She, she is the negotiator, um.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So that's probably
[CUSTOMER][NEUTRAL] So like I said, so who do I.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Chase down to get this information I'd like to get, you know, I just pulled $3000 out of pocket.
[AGENT][NEUTRAL] Yes, I understand.
[CUSTOMER][NEGATIVE] I'd like to get reimbursed.
[AGENT][NEUTRAL] Um, the only other, uh, if you didn't wish to contact your HR department, um, I can contact, uh, um, our billing department, and I can find out when, uh, Polylift begins, um, but, uh, usually what we do is we get our information from your HR department and they, uh, will send things via a hub, an electronic hub, and then once they do that, um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, that's when we begin sending out cards and that's why we would be when I'd be able to find you in the system. So what I can do is I can find out when Polift is, uh, is starting, um, and then I can contact your HR department if you didn't wish to, uh, and we can find out what, what is going on. Now if you don't mind giving me your phone number, I can call you back after I've talked to your employer.
[CUSTOMER][POSITIVE] Sure, absolutely.
[AGENT][NEUTRAL] And what is your number, sir?
[CUSTOMER][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, let me find out what has happened with this, and then I can contact you and um find out why and also uh we can, um, once we do that, if, if everything is in order, then we can go ahead and see about getting you cards and how to submit a claim. So let me find out when Polylift begins and and why we're not finding in our system and we can figure out what is happening.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] OK, alright, I appreciate the call back thank you.
[AGENT][POSITIVE] OK, thank you for contacting ATO so you have.
[CUSTOMER][NEUTRAL] All right bye bye