AccountId: 011433970860
ContactId: 9de724a7-58fc-4b6d-8cc1-78d3f15538bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 657820 ms
Total Talk Time (AGENT): 203601 ms
Total Talk Time (CUSTOMER): 205589 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/9de724a7-58fc-4b6d-8cc1-78d3f15538bf_20250303T16:02_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I'm calling from Nicholas Children's Hospital. I needed to verify eligibility for a patient.
[AGENT][NEUTRAL] OK, I can help you. What's your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], what's the policy number and a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Policy number is 243-0725. My phone number is [PII].
[AGENT][NEUTRAL] OK, you cut out when you were giving me the policy number. I have 242,430 and then the last two digits were [PII].
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] Yeah, so yeah, 725.
[AGENT][POSITIVE] OK thanks.
[AGENT][POSITIVE] Got it, thank you.
[AGENT][NEUTRAL] And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. And you're just wanting to verify the eligibility information?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I'm showing a policy. I have that information for you. The policy effective date is [PII]. I show this policy is no longer active as of [PII], and I don't show any active coverage for the, for the patient or family at this time.
[CUSTOMER][NEUTRAL] Oh, so they don't have an active policy.
[AGENT][NEUTRAL] Not with APL.
[CUSTOMER][NEUTRAL] Let me see, because I called last month and they told me it was active.
[AGENT][NEUTRAL] So it could have been termed within the time you called last.
[AGENT][NEUTRAL] When did you call? What date do you remember?
[CUSTOMER][NEUTRAL] But then
[CUSTOMER][NEUTRAL] I called on the [PII].
[AGENT][NEUTRAL] On the [PII].
[CUSTOMER][NEUTRAL] [PII]. Mhm.
[AGENT][NEUTRAL] Let me see, let me see.
[AGENT][NEUTRAL] Advised policy is active at the moment.
[AGENT][NEUTRAL] And then let's see.
[AGENT][NEUTRAL] Yeah we could receive notification from their employer at any time, but I'm just checking the notes.
[AGENT][NEUTRAL] Still looking.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] Bear with me a few more seconds.
[CUSTOMER][POSITIVE] You're good.
[AGENT][NEUTRAL] I'm gonna place you on a brief hold, uh, [PII], I'll be right back with you, OK?
[CUSTOMER][POSITIVE] Sure, not a problem.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. Can I help you?
[AGENT][NEUTRAL] Hey, [PII], this is [PII]. How are you?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] Good. I have a simple question. Um, it's regarding policy 243-0725.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 243-07
[AGENT][NEUTRAL] 25
[CUSTOMER][NEUTRAL] 25
[AGENT][NEUTRAL] And it is for.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, um, in mine I didn't show where the policy or why the policy lapsed, but I'm in the employee file or the employer's file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh la la la la, let me look at something else.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] My first guess would be that they did it and.
[AGENT][NEUTRAL] Renewal
[CUSTOMER][NEUTRAL] OSC or renewal um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me look at the OSC.
[AGENT][NEUTRAL] And I didn't see any documentation in in um on base any correspondence or anything.
[CUSTOMER][NEUTRAL] On base, yeah.
[CUSTOMER][NEUTRAL] What come on online service center, OK, um.
[CUSTOMER][NEUTRAL] Save one digit I have on 24.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It so it couldn't have been done in error just simply by someone doing it through coin uh because there's an actual line that says lapse.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I would have to say it's at the renewal level or something um and with there not being anything if there's not anything in on base I would have to suggest reaching out to cus broker resources or customer service and have them look in the file or whatever they have for renewal.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Broker resources or customer.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] Um, because, yeah, it was something done by the system, um.
[CUSTOMER][NEUTRAL] Because there was a line created um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And so, and then there was another.
[CUSTOMER][NEUTRAL] There was another policy issued effective [PII], but it's lapsed as well.
[AGENT][NEUTRAL] I see that.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And there's no notes on it, so I would, I would reach out in my, in my opinion I would reach out to customer service first and ask them, um, because ultimately they would be the one that worked the quote unquote uh, the exceptions after the the renewal is done so they would have been the ones to lapse it in the system, um, so yeah, I would ask them first.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] After the renewal. OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, good deal. I'll reach out to customer service thank you [PII].
[CUSTOMER][POSITIVE] Uh-huh, you're welcome.
[AGENT][NEUTRAL] All right, bye bye.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] [PII], one quick minute minute, OK? I think I, I know why, OK, right.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Bring
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hi, [PII], hold on one second.
[AGENT][NEUTRAL] Thank you, [PII]. Let me give you the policy number.
[AGENT][NEUTRAL] Um, I have 243-072-5.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it is for the [PII] family. I didn't see any notes in Lion or on the uh the group level stating why the policy was turned.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And um I have a caller holding. I was trying to verify benefits and I wanna make sure that it wasn't termed inadvertently.
[AGENT][NEGATIVE] But I didn't see any notes anywhere or nothing in on base.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] corrected.
[AGENT][NEUTRAL] Billing seems to think it could have been like during the group renewal or something like that.
[CUSTOMER][NEUTRAL] Mhm. Yes, it could have been.
[AGENT][NEUTRAL] Maybe
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, because
[CUSTOMER][NEUTRAL] Um, yes, because it was right at, um, the beginning of the year.
[AGENT][NEUTRAL] OK, so, so that would have been per the employer?
[CUSTOMER][NEUTRAL] Yes, it would be per the employer.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, all right, thank you so much.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] OK, [PII], thank you so much for holding. So yes, we've confirmed uh that the group termed the coverage and so they this this family no longer has coverage with APL um effective [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so their last coverage would have been the end of the year.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, and is there a reference number for the call?
[AGENT][NEUTRAL] You'll use my name in today's date as your reference [PII] and then first initial last name is [PII].
[CUSTOMER][POSITIVE] All right, I appreciate it. Thank you so much.
[AGENT][POSITIVE] All right, [PII], thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.