AccountId: 011433970860
ContactId: 9a63159a-d73e-4148-a04f-c071d49c4e4e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2106790 ms
Total Talk Time (AGENT): 654502 ms
Total Talk Time (CUSTOMER): 603415 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/9a63159a-d73e-4148-a04f-c071d49c4e4e_20250210T18:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes ma'am. I was calling because I recently put a claim in and they did pay out on it, but um.
[CUSTOMER][NEUTRAL] They are still going.
[CUSTOMER][NEUTRAL] Off of my
[CUSTOMER][NEGATIVE] The plan that I had last year, which was a $3000 gap plan. And this year, I have a $5000 gap plan. So they told me to call back in because apparently it wasn't processed yet. I've been paying for the new plan since the beginning of January, and I contacted our insurance agent and they said that the information was submitted to you guys.
[CUSTOMER][NEGATIVE] Um, so they told me to call back in and see if that was processed so that they can relook at my claim to finish paying it because they maxed out my $3000 plan, but there's still $1800 and some odd dollars there that I should have been paid.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Because I have a $5000 plan this year. We had to get new insurance, so I had to get a higher deductible and
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Of course, I had surgery, so.
[AGENT][NEUTRAL] And what's your name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] The uh agent said that they also reached out to you guys because they don't know why it wouldn't be.
[CUSTOMER][NEUTRAL] Process
[AGENT][NEUTRAL] And do you have your policy number, [PII]?
[CUSTOMER][NEUTRAL] Um, I have the one that was from last year which is 2461873.
[AGENT][NEUTRAL] And what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Are you still there?
[AGENT][NEUTRAL] Yes, I'm pulling up your information.
[CUSTOMER][NEUTRAL] OK. No, that's fine. I I, I just, there was someone else calling in on my phone and I ignored it and I wanted to make sure that I didn't, uh.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see
[AGENT][NEUTRAL] [PII], verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And your email address on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you for that information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so and is it outpatient services that you said you had or inpatient? OK, so, OK, so.
[CUSTOMER][NEUTRAL] Yes, it was outpatient.
[AGENT][NEUTRAL] The policy number that you gave me was effective [PII] and I'm just talking out loud.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And your.
[AGENT][NEUTRAL] Maximum outpatient benefit under the policy that you gave me was.
[AGENT][NEUTRAL] $3000.
[AGENT][NEUTRAL] Under the policy number that you gave me.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Right, and this year I have a $5000 policy.
[AGENT][NEUTRAL] Mhm mhm I'm just trying to walk through it out loud.
[CUSTOMER][NEUTRAL] And so here's the other thing too, which is what I'm not understanding.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So, um, let me just double check this before I give you incorrect information, but
[CUSTOMER][NEUTRAL] For my [PII] policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I want to give you the exact information, so bear with me one second here.
[AGENT][NEUTRAL] OK. No, you're fine.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Each pay.
[CUSTOMER][NEUTRAL] It was $43.14 for the $3000 policy.
[AGENT][NEUTRAL] Are you talking about your premium?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] Yeah, actually I'm telling you that incorrectly.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm, I'm giving you incorrect information. So for [PII].
[CUSTOMER][NEUTRAL] For I paid $27.14 per pay for my gap of $3000 3000 dollars gap.
[CUSTOMER][NEUTRAL] Now,
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] If I look at my pace of [PII] since the beginning of the year.
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] $43.14 per pay.
[CUSTOMER][NEUTRAL] And it shows right there gap 5000.
[AGENT][NEUTRAL] When was the $5000 policy effective?
[CUSTOMER][NEUTRAL] The begin [PII].
[AGENT][NEUTRAL] Of 25.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I don't show a policy for you with the 5000. I'm just showing the one you gave me, the 246-1873.
[CUSTOMER][NEUTRAL] Right, because that's the only one that.
[CUSTOMER][NEUTRAL] Shows
[CUSTOMER][NEUTRAL] But I called the insurance company or agent and they said that they submitted all of the new policies to you.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] They submitted an enrollment form.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you know when that was submitted over to us?
[CUSTOMER][NEUTRAL] And they said they
[CUSTOMER][NEUTRAL] Say that again.
[AGENT][NEUTRAL] Do you know when they submitted the information or when did you enroll for that product?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] In December? OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] When we had it, when we had open enrollment for our, our health insurance, so my new health insurance plan has a $5000 deductible, so I went with the $5000 gap policy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right, OK. Let me see.
[AGENT][NEUTRAL] Give me 1 2nd.
[AGENT][NEUTRAL] OK, this may, this may be in process.
[AGENT][NEUTRAL] Give me a second, just reading the notes.
[AGENT][NEUTRAL] And you said that was in December?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you for your patience.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you know what the agent broker's name is?
[CUSTOMER][NEUTRAL] Pardon me?
[AGENT][NEUTRAL] Who was the agent that you've been working with or the broker?
[CUSTOMER][NEUTRAL] It's, it's Hackmeyer Insurance Agency.
[AGENT][NEUTRAL] Gonna place you on a brief hold, OK? I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I disconnect
[AGENT][NEUTRAL] OK [PII], I'm gonna request that you send us an email. I'll give you the email address to send it to, but in the email, put your policy number, uh, the one that you gave me, which is the only one that I'm showing for you at this time.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, and indicate that you enrolled in, I think you said a 5000 at least that's your outpatient benefit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, effective [PII].
[AGENT][NEUTRAL] Um, that you enrolled through the agency, state the name of the agency.
[CUSTOMER][NEUTRAL] Well, I mean, it's through my employer, but that's the agency that we use. And I did contact them.
[AGENT][NEUTRAL] I know it.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And they said they were reaching out to you as well.
[AGENT][NEUTRAL] OK, but they did not necessarily send it your employer did.
[CUSTOMER][NEUTRAL] What do you mean?
[AGENT][NEUTRAL] Send, send us the the the new the application, the new enrollment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Who, who I'm asking who, who sent us the enrollment, your employer or the agency?
[CUSTOMER][NEUTRAL] I don't know who does it. I know that we have to fill it out and it goes through them.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just trying to have a trail for the people that's gonna have to review this so you're not sure who sent us the the application?
[CUSTOMER][NEUTRAL] I don't know if the insurance agency sends it to you. I know you guys send us a bill every month because I do the weekly check runs and
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Then you know they take it out of my paycheck and then we pay you guys each month. I do know that.
[AGENT][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] Right, so, OK, so you work for the group?
[CUSTOMER][NEUTRAL] I work for Dream Life Recovery.
[AGENT][NEUTRAL] Right, which is in a group, OK.
[AGENT][NEUTRAL] So I, I've checked all the notes.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Like, is there another department or something that I should speak with?
[AGENT][NEUTRAL] Well that's why I'm asking you to send a note because we can't transfer over to this particular part department um that's what I was checking when I put you on a brief hold earlier which is why I'm requesting you send an email to follow up on the application that was sent and I was just trying to uh you know for you to be as specific as possible like, you know, where did it come from who was sending it to us and how was it sent to us.
[CUSTOMER][POSITIVE] Thank you [PII].
[CUSTOMER][NEUTRAL] where's he going?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I don't know that answer though.
[AGENT][NEUTRAL] OK, so then you would just follow up on your enrollment that was to have been effective [PII].
[AGENT][NEUTRAL] Uh, you'll indicate the group number.
[CUSTOMER][NEUTRAL] What is the group number?
[AGENT][NEUTRAL] It's 262-60.
[AGENT][NEUTRAL] And then your reference, your policy number as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you don't know specifically which entity sent it, but was it you you enrolled in December, so can you confirm that that's when it was sent, or you're not for sure.
[CUSTOMER][NEUTRAL] I, I don't know when it was sent. I know that we had to fill out our enrollment in December. Now, um, I also know that
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I also know that
[CUSTOMER][NEUTRAL] My insurance was done, my new health insurance was done at the same time, and I received my new health insurance cards.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] With, with
[CUSTOMER][NEUTRAL] So I don't see
[AGENT][NEUTRAL] With a different carrier?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Was your primary insurance for the Blue?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, got you, I understand. OK, OK.
[AGENT][NEUTRAL] Yeah and I'm just doing this so that we can when you send it um it's it you know it's not gonna take us long to locate it.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] So you're basically just sending a follow up email. I'm not showing a new one on my end if you're getting a different policy.
[AGENT][NEUTRAL] You know, with a different benefit, it's gonna assign a different policy number than the one that you have and I'm only showing the.
[CUSTOMER][NEGATIVE] Well, that's what I assumed and then when I called in because I needed to file my claim, they said that uh what I don't understand is if you guys don't know that I have a policy for this year, how are they paying me out on my claim, you know what I mean?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, so the claims that we have paid this year.
[AGENT][NEUTRAL] Actually they're being processed under your, the policy number that you gave me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because we're showing that this policy is active as of on, uh, you know, at this time.
[AGENT][NEUTRAL] So, and I'm not.
[CUSTOMER][NEGATIVE] And not the $5000 policy.
[AGENT][NEUTRAL] It's the 3000 for the outpatient, yeah, for the outpatient.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] Well, you guys keep saying outpatient. I'm supposed to just have a $5000 for my deductible.
[AGENT][NEUTRAL] You
[AGENT][NEUTRAL] happen.
[AGENT][NEUTRAL] You have an outpatient benefit under this plan and an inpatient benefit under this plan.
[CUSTOMER][NEUTRAL] Meaning what?
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] If you have any outpatient services, outpatient is emergency room, um.
[AGENT][NEUTRAL] You know, if you have to go to a hospital for surgery, that's considered outpatient inpatient is if you are confined, you have to, you have to be admitted into a hospital. And let me pull up this, let me pull up this policy and see if you have to.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Separate benefits of 3000 or if those two benefits are combined, give me one second.
[CUSTOMER][NEUTRAL] Yeah, I think I just have a, I have, from what I understood, I have a blanket. Well, it's again, it's supposed to be 5000 total.
[AGENT][NEUTRAL] The yeah, the one you enrolled in in [PII].
[AGENT][NEUTRAL] Effective [PII]? OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The [PII] 1 was for 3000.
[AGENT][NEUTRAL] Uh-huh, I see that. Let me see.
[AGENT][NEUTRAL] All right, so,
[AGENT][NEUTRAL] Both your inpatient and outpatient benefit have two separate maximums each have a $3000 per calendar, your maximum per person.
[AGENT][NEUTRAL] Under the policy number that you gave me and I understand that you said that you enrolled in a new one which upped the outpatient benefit to 5000 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So that's the one that we need to check on.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] If you don't mind holding for another brief moment, OK?
[CUSTOMER][NEUTRAL] No I know.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Give me 1 2nd.
[CUSTOMER][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII]. How are you?
[CUSTOMER][NEUTRAL] I'm fine, [PII]. How are you doing?
[AGENT][NEUTRAL] I'm good, um, you may or may not be able to help me, but I'm gonna try here first so I have an employee on the phone with Dream Life Recovery. Uh, that group number is 26,260.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And she said that the broker agency submitted a new enrollment for an effective date of [PII]. She's already, she has a policy, but she's increasing her policy benefits from 3000 to 5.
[AGENT][NEUTRAL] Her outpatient benefit.
[AGENT][NEUTRAL] And um she said that it should have been effective [PII] and she enrolled in December.
[AGENT][NEUTRAL] And I don't see a new policy in my end yet for her, but I am reading the notes um on um the employee notes and it says that the renewal processing is on hold pending new master application from sales showing [PII] as the state issued, and I don't know if it's kind of held up in that. I'm just trying to verify if we have the application.
[CUSTOMER][NEUTRAL] Let me see what we have in the folder for this group.
[CUSTOMER][NEUTRAL] Who is the employee?
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And I think she said she does their billing.
[CUSTOMER][NEUTRAL] Of course, because those are the ones that we always get.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh my.
[CUSTOMER][NEUTRAL] If it's not the HR director, it's the person who does the billing or the owner's wife.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. So [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have something on.
[CUSTOMER][NEUTRAL] Spreadsheet for her but let me.
[CUSTOMER][NEUTRAL] Let me see what it is.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I do see that she increased it to the 5000 effective [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But it has not yet been processed, correct?
[CUSTOMER][NEGATIVE] It hasn't. It makes me wonder how many more have not been processed.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I don't know what to tell her.
[CUSTOMER][NEUTRAL] Um, I don't know either. This is not one of my groups. Let's see.
[AGENT][NEUTRAL] I know.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, there is an email from the [PII]. Let's see what this is.
[AGENT][NEUTRAL] They're reviewing to change the state issued from [PII] to [PII].
[AGENT][NEUTRAL] Just reading the employee notes employer notes.
[CUSTOMER][NEUTRAL] I don't see that a master apples ever since.
[AGENT][NEUTRAL] It says no waiting period per master application.
[AGENT][NEUTRAL] And it also says temporary lapse group so it will not be waiting for new master policy.
[CUSTOMER][NEUTRAL] Uh, Master Policy and Master App are two different things.
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] So the application is what she would have completed, right?
[CUSTOMER][NEUTRAL] But um
[CUSTOMER][NEUTRAL] Well, they did a census enrollment, so she wouldn't have completed anything.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm. OK.
[CUSTOMER][NEGATIVE] But I still show this out of [PII] unless they're doing the billing. Everything is showing out of [PII], so it's like nobody's done anything with this.
[AGENT][NEUTRAL] So it says the renewal processing is on hold pending new master application from sales showing [PII] as the state issue.
[AGENT][NEUTRAL] That was dated on [PII].
[CUSTOMER][NEUTRAL] They just come
[CUSTOMER][NEUTRAL] OK, so [PII], they just did the renewal.
[CUSTOMER][NEUTRAL] No process on the name master application from sales showing [PII] as a state.
[CUSTOMER][NEUTRAL] I wonder if we can.
[CUSTOMER][NEUTRAL] And let me look documents.
[CUSTOMER][NEUTRAL] Look at this group.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] I'm gonna have to get with NAS and see what what the hold up is on this um.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] It's a subdivision of venture. Venture is showing to be a Florida group. It's group number 26201.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But the, the [PII] that you gave me.
[CUSTOMER][NEUTRAL] 2 it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I don't know how all along this got.
[CUSTOMER][NEUTRAL] Sideways.
[AGENT][NEUTRAL] Well, I can at least confirm we do have the application, right?
[CUSTOMER][NEUTRAL] We do have the application and it.
[CUSTOMER][NEUTRAL] I don't even know what to tell her.
[AGENT][NEUTRAL] I'm just gonna say in process or something like that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I, I would leave it at that.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sorry, I wasn't much more help, but I'll try and dig into this a little bit for you and see what I can find out.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you really good help you told me it was here that's what I was needing to know, you know.
[CUSTOMER][NEUTRAL] We, we do have it. I just.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, the hold up.
[CUSTOMER][NEUTRAL] I don't know what the hold up is here, so.
[AGENT][POSITIVE] OK. All righty.
[CUSTOMER][NEUTRAL] Let me get with NAS and see if we can figure it out.
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Uh huh bye bye.
[AGENT][NEUTRAL] Uh bye bye.
[AGENT][NEUTRAL] OK [PII] thank you so much for holding. OK, so I can confirm I can confirm that we've received um your application and it does state 5000 effective on [PII]. Currently this group is in a renewal processing hold, so that's why.
[CUSTOMER][POSITIVE] Yeah, no problem.
[CUSTOMER][NEUTRAL] What does that mean?
[AGENT][NEUTRAL] It it each year a group goes through a renewal process.
[AGENT][NEUTRAL] And it's in that and it's in that process so once that's completed um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Then everything will start rolling again.
[AGENT][NEUTRAL] It'll be processed.
[CUSTOMER][NEUTRAL] So how long, how long does that take? Cause, I mean, that's already been over a month.
[AGENT][NEUTRAL] Yeah, I
[AGENT][NEUTRAL] Yeah, I can't give you a timeline on that, but what I can do um I have your phone number um I can give you a call back.
[AGENT][POSITIVE] Gonna come a tickle.
[AGENT][NEUTRAL] This file here
[AGENT][NEUTRAL] Um, but I can't, but I can't, I, I can't give you a timeline timeline as to when, um, because it's in, it's currently, um, in renewal.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right. OK. I'm just wondering cause like, like I said, I, uh, I
[AGENT][NEUTRAL] But I can
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] I put out like almost $4900.
[AGENT][NEUTRAL] Right, was it outpatient and outpatient service?
[CUSTOMER][NEUTRAL] Um, not
[CUSTOMER][NEGATIVE] Yeah, like they already paid me the $3000 on it, so I still have like almost $1900 so that I put out cause I thought I would get right back. And now that's not happening. So it's kind of put me in a little bit of a bind. That's why I was wondering if you knew, like when it would be.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, um, so we did.
[CUSTOMER][NEUTRAL] Um, done. I figured, uh, like I waited until
[AGENT][NEUTRAL] The the
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] to make sure that it was processed and stuff, but I guess that wasn't long enough.
[AGENT][NEUTRAL] Right, was this for a [PII] data service from Fre Hospital? Have you received that check?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, I, it was direct deposit.
[AGENT][NEUTRAL] OK, OK, you received that and what you're saying is that maxed out your outpatient benefit.
[CUSTOMER][NEUTRAL] The, for the $3000.
[AGENT][NEUTRAL] Yeah, yeah, not technically, but under the old policy.
[CUSTOMER][NEUTRAL] But they
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Got you, I'm with you.
[AGENT][NEUTRAL] OK, what you're saying it should have increased to 5 [PII], OK, so that means you would have like 20 left.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yes, and there's 1800 still on that bill, which they told me they could reprocess that claim.
[AGENT][NEUTRAL] Got it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But I don't know how long that's gonna take for them to finish doing the renewal. I figured by the, you know, by March, by February, it would have, you know,
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Be effective.
[AGENT][NEUTRAL] Right, right. So.
[AGENT][NEUTRAL] Um, I have your phone number and I'm going to, um, share that number if you don't mind with the areas that are handling the, uh, the, the process that it's in now, um, and then, um, you'll receive a call back, um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Once that's complete.
[AGENT][NEUTRAL] If that's OK.
[CUSTOMER][NEUTRAL] Yeah, cause like I said, I just, I wanna get that.
[AGENT][NEUTRAL] And I will
[CUSTOMER][NEGATIVE] that claim redone as soon as possible because like I said, I put that money out thinking I get it right back and now I'm in a little bit of a bind.
[AGENT][NEUTRAL] Mhm, which, which is your primary having to reprocess the one that you're saying that you paid out of pocket?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. OK. OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Yeah, cause she, when I, when they processed that, they paid me the $3000 but they could have paid me like 48, 90 something, um, had my policy been in effect.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I got it. So what we've already received.
[CUSTOMER][NEUTRAL] So they told me just.
[AGENT][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] Yeah, they, they told me just to once the 5000 was showing then to call in and have them relook at the claim because then they could, um, you know, pay out the remainder.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Understood.
[AGENT][NEUTRAL] OK, I understand that. I'm gonna document this call.
[AGENT][NEUTRAL] Um, as we always do.
[AGENT][NEUTRAL] Um, and just, you know, stating, and I see it in here already, uh, you had called on the [PII], I believe.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, February with this so.
[CUSTOMER][NEUTRAL] Because I didn't know if I could submit it because when I logged on, it was still showing the old one. She said, yeah, go ahead and submit it because they can pay you for up to what we have already here.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Right, right. Right. Exactly. OK. I'm with you now.
[AGENT][NEUTRAL] So I will um communicate with the other area, um, provide them with your phone number and kinda let let them know what your situation is.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] Alrighty, did you have any other questions, [PII], that I can answer today?
[CUSTOMER][NEUTRAL] No, ma'am, just hoping they get that processed sooner rather than later.
[AGENT][POSITIVE] I totally understand that.
[AGENT][POSITIVE] I totally understand that, OK.
[AGENT][NEUTRAL] So you should be getting a phone call.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] All right sounds good thank you so much.
[AGENT][POSITIVE] Uh, you're welcome, [PII], and thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Uh, bye-bye.