AccountId: 011433970860
ContactId: 93ccc5c2-88fa-4db5-9e87-a2e100de822e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 800020 ms
Total Talk Time (AGENT): 318717 ms
Total Talk Time (CUSTOMER): 177504 ms
Interruptions: 3
Overall Sentiment: AGENT=0.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/93ccc5c2-88fa-4db5-9e87-a2e100de822e_20250521T16:53_UTC.wav
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[AGENT][NEUTRAL] This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], it's [PII] with APL care team. I have a [PII] on the line and he is the group admin. He had, he got some checks from us and then he, he thinks they're refunds, um, and he doesn't know what they're for, and I was wondering if I could, if you could help him with that.
[AGENT][NEUTRAL] Hey.
[AGENT][POSITIVE] Yeah absolutely let's see what's that group number?
[CUSTOMER][NEUTRAL] 18808
[AGENT][NEUTRAL] 80818808.
[CUSTOMER][NEUTRAL] And he has been verified [PII].
[AGENT][NEUTRAL] And is the number on the screen the return call number?
[CUSTOMER][NEUTRAL] I have the number as [PII].
[CUSTOMER][NEUTRAL] [PII], so it looks like it's different.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, I'm ready for him whenever you are.
[CUSTOMER][NEUTRAL] And you said your name is [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] [PII], are you still on the line? Yes I am. I have [PII] from our billing department and she should be able to help you with those checks, OK?
[CUSTOMER][POSITIVE] OK, sounds good. Great. Thank you so much. Thank you.
[AGENT][NEUTRAL] Hi Mr. [PII], this is [PII]. Like she said, I understand you have a question about some refunds.
[CUSTOMER][NEUTRAL] Uh, yes, [PII], um, so you've got my account pulled up correct?
[AGENT][POSITIVE] Yes sir, I do.
[CUSTOMER][NEUTRAL] OK, so for this check dated [PII], uh, like for example for, uh, for [PII], I'm aware that you know her she's aged out of our current insurance, so, uh, she's moved over to, uh, to Medicare, um, but can you, are you able to help me with the reasons why.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Where were these uh duplicate policies like for example for [PII] and for [PII], um, was this refund due to them them having been assigned to different policies for some reason?
[AGENT][NEUTRAL] Alright, let me just get all of those different things that's pulled up here.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Give me 1 2nd.
[AGENT][NEUTRAL] OK [PII] here we go.
[AGENT][NEUTRAL] Let me pull up his particular.
[AGENT][NEUTRAL] Mr. [PII].
[AGENT][NEUTRAL] 3024.
[AGENT][NEUTRAL] OK, so it looks like his refund for Mr. [PII] was for premium paid in November.
[AGENT][NEUTRAL] And.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, so it looks like his, um, he changed policies in October, so it was premium that was paid on the old policy in um November so what it was is you guys paid on a month that after it had changed.
[AGENT][NEUTRAL] So he has a new policy that is slightly higher premium.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes sir, so that's what it was, um, his new policy took over in October and the old premium was paid, so that's what that one is for Mr. [PII].
[CUSTOMER][NEUTRAL] OK. How about, uh, [PII]?
[AGENT][NEUTRAL] Alright, let's
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Was he on a different check?
[AGENT][NEUTRAL] Let's see here.
[CUSTOMER][NEUTRAL] Uh, same, same check.
[AGENT][NEUTRAL] Oh, OK, because I was looking at one that doesn't say show a Mr. [PII], so let me.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let's see, Mr. [PII] premium overpayment so let's see [PII].
[AGENT][NEUTRAL] It might be the same thing for him is the group renewal October?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Is that it might be that everybody just got new policies and let's see.
[AGENT][NEUTRAL] No, looks like it's December. Let's see.
[AGENT][NEUTRAL] Mr. [PII].
[AGENT][NEUTRAL] OK, he's only had one policy.
[AGENT][NEUTRAL] I apologize, just taking me a second.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Uh, so,
[AGENT][NEUTRAL] It doesn't tell me which month was overpaid, but it perhaps is he did have a a a rate change back in October where it went from the premium went from $101.87 down to 5094 cents and given that the the refund was 15093 cents, I believe it was probably an overpayment in November of last year.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] When it changed, it's likely that uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's what it looks like. Let's see, September.
[CUSTOMER][NEUTRAL] I think he may have went from family coverage to individual coverage or something like that.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] Removed spouse and yes that's what it was back in November a spouse was removed, so it was an overpayment at that time when you guys paid the full premium with the spouse and then that one month that y'all paid um the full premium for with the spouse, he had changed it so we had to refund that difference. Alright, let's go on to Mr. [PII].
[CUSTOMER][NEUTRAL] There we go.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So let's see [PII], I know that one she aged aged out of the insurance about [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] [PII], here we are.
[AGENT][NEUTRAL] That says premium overpayment. Let's see if we can figure out why.
[AGENT][NEUTRAL] It looks to be the same thing here, uh, 4839.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me do a little math here 4839 plus 15094. Yes, that's what it is. It was a month that we uh the coverage changed. Let's see when that happened.
[AGENT][NEUTRAL] Provider.
[AGENT][NEUTRAL] Well, it doesn't say when that would have been.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] That's what it is.
[AGENT][NEUTRAL] There was a coverage change. I apologize, I can't tell you when I think it would be October let's see.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Coverage change.
[AGENT][NEUTRAL] Uh, oops.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] It looks like it was February of this year.
[AGENT][NEUTRAL] That there was a coverage change.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's just the difference of that higher premium.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] All right, Mr. [PII] or [PII]?
[CUSTOMER][NEUTRAL] And then uh [PII], how about [PII], I think he aged out as well.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 43, 4535.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so on this one it looks like um it's the same as the first with Mr. [PII] like Mr. [PII], where the old policy was 4535 and full premium full premium was paid but you also paid in the same month the new premium of 7641, so we refunded the 4535.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, can you check and see I, I think he has, I think he should no longer be on the account and I don't see him looking at the online.
[AGENT][NEUTRAL] Well, I do see him as still active. However, the um
[AGENT][NEUTRAL] Pay to date is only to April. I don't know if that's the case for the group or not. Let's see.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] No, it looks like everybody else is through June.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well, I thought he was gonna age out, but.
[AGENT][NEUTRAL] If it's an aging out thing, I think that it's uh there's rules about that and I'm trying to think of what it is. um.
[AGENT][NEUTRAL] When do you know what, when, uh, well, I guess I might have the birthday here.
[AGENT][NEUTRAL] I don't see it at the moment.
[AGENT][NEUTRAL] Do you know when he aged out?
[CUSTOMER][NEUTRAL] You know what I think that may be this month actually um kind of looking at.
[AGENT][NEUTRAL] Right, yeah, so that's, that's possibly the case there.
[CUSTOMER][NEUTRAL] Yeah, so actually that that would be fine then.
[CUSTOMER][NEUTRAL] Um, I guess that would just leave us with Mr. [PII] then.
[AGENT][POSITIVE] All right, let's check that one out.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mr. [PII] [PII], premium overpayment.
[AGENT][NEUTRAL] I believe that's gonna be the case where it was.
[AGENT][NEUTRAL] Uh, the difference in two or two premiums, let's see here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do do do
[AGENT][NEUTRAL] OK, so it says here in February of this year changed to single parent.
[AGENT][NEUTRAL] Yeah, so.
[AGENT][NEUTRAL] The difference, yes sir, that's gonna be the difference in um premiums from changing over to single parent.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, very good.
[AGENT][NEUTRAL] 5093, yes sir, that's what it is.
[CUSTOMER][POSITIVE] OK, awesome.
[AGENT][NEUTRAL] Was there anything else I can help you with?
[CUSTOMER][POSITIVE] No, I appreciate you running through that list with me though and uh hope you have a wonderful afternoon.
[AGENT][POSITIVE] Oh, no problem. We're always happy to help.
[AGENT][POSITIVE] Thank you you as well thank you for calling ATL.
[CUSTOMER][POSITIVE] I appreciate it thank you bye bye.
[AGENT][NEUTRAL] Mm bye-bye.