AccountId: 011433970860
ContactId: 961584fc-463e-487c-a2e8-b2ffa1403b93
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 259709 ms
Total Talk Time (AGENT): 116416 ms
Total Talk Time (CUSTOMER): 119256 ms
Interruptions: 1
Overall Sentiment: AGENT=2.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/961584fc-463e-487c-a2e8-b2ffa1403b93_20250502T15:29_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Good morning [PII] how are you today?
[AGENT][NEUTRAL] I'm well. How are you?
[CUSTOMER][NEUTRAL] Good, thank you. Um, and I was calling you in regards to a claim. I had a question.
[AGENT][NEUTRAL] OK, and are you calling with the.
[CUSTOMER][NEUTRAL] I have a number.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Are you calling the provider's office or you're the insured?
[CUSTOMER][NEUTRAL] No, the insured.
[AGENT][POSITIVE] OK, and I'll be more than happy to help you with your claim. May I have your name and a good contact number?
[CUSTOMER][NEUTRAL] Sure. My name is [PII], last name [PII] And best contact number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] Sure. Um, 1482644 M as in Mary, L as in Larry, and the number 8.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I just need you to verify your date of birth and the mailing address on file.
[CUSTOMER][NEUTRAL] Sure. [PII], and it's [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. And how may I assist you with your claim today?
[CUSTOMER][NEUTRAL] OK, I received an explanation of benefits from American Public Life. Um, it's for claim number 3592733.
[CUSTOMER][NEUTRAL] And then on the remarks it says that the services were rendered after coverage was terminated.
[AGENT][NEUTRAL] OK, let me take a look at it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so the um data service is [PII], but this policy um is no longer active as of [PII], um, so it wasn't active on the data service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, that's weird. So this insurance is through my husband's employer, and they had open enrollment in November, and as far as I know, we have, we signed up for it. They're deducting his paycheck for for insurance for the secondary insurance.
[AGENT][NEUTRAL] OK, let me check the notes. Um, since it's, yeah, there it is. So on [PII], we received notification from the group to um cancel the policy. So since the policies are through the employer, we can't make any changes, add anything unless they
[AGENT][NEUTRAL] Notify us in writing. So if this is an error, they should not have sent this to us, then um, he would just need to reach out to his HR department who who's over his benefits and see what's going on with that and and they can send, they usually like send us an email, we can get it corrected if this is an error.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so you received notice on [PII] from his employer that this was canceled?
[AGENT][POSITIVE] Yes, from the from the bookkeeper. Correct.
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] From the OK, yeah, I'll have my husband reach out because that should not be and as far as I know, like I said, he's still being deducted every payroll for this insurance. OK, let me do that and then so they'll just contact you directly and will then this automatically be reprocessed or do I have to then do something after that?
[AGENT][NEUTRAL] So, once they, OK, so let's say that this is an error then and we push it back to, you know, some date that makes this date active, um then yes, we can go ahead and reprocess the claim for you, um, but you, I would say to just give a call, um, like once they notify you that everything is OK, because there won't be anything to like prompt it to to do it. I don't want it to slip through the cracks.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Mm, that's what I wanted to know, right, right, if it automatically happens, OK, so once it's all reinstated, which I am hoping it's an error should be an error. I don't see why it wouldn't be. I will call again and let you guys know that perfect. Thank you so much for your help.
[AGENT][POSITIVE] You're welcome, Ms. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that was it.
[AGENT][POSITIVE] Alright, well, thanks for calling APL. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too. Bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.