AccountId: 011433970860
ContactId: c266d199-00cc-4d0e-a478-1b9ba6444ecb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 863940 ms
Total Talk Time (AGENT): 343204 ms
Total Talk Time (CUSTOMER): 341825 ms
Interruptions: 4
Overall Sentiment: AGENT=0.8, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/c266d199-00cc-4d0e-a478-1b9ba6444ecb_20250203T18:13_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes whatever he said.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][POSITIVE] Can you hold on for one quick second? I'm so sorry.
[AGENT][POSITIVE] Yeah, sure. Yes, no problem.
[CUSTOMER][NEUTRAL] [PII], I'll call you back in just a minute.
[CUSTOMER][NEUTRAL] OK bye.
[CUSTOMER][POSITIVE] Sorry about that ma'am.
[AGENT][POSITIVE] OK, no problem. How may I assist you today?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Um, I am calling because I needed to file a claim, and when I log into my account, it is not showing my new, um, for [PII] it's only showing my [PII] policy it says active, but if I click on my policy documents, it's only showing the ones for [PII].
[AGENT][NEUTRAL] OK, I can check and see if there's been any changes, um, may I.
[AGENT][NEUTRAL] have um your name and a callback number.
[CUSTOMER][NEUTRAL] [PII], my callback number would be [PII].
[AGENT][NEUTRAL] OK, and may I have the policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, I only have the one from [PII]. like I never got anything for my new one for [PII] yet. Um, it's 246-1873.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] So my new one should be for $5000.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I had a surgery and I'm gonna need close to that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Medical is so expensive.
[AGENT][NEUTRAL] It is nowadays it is mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, and may I have your date of birth, mailing address and email address for verification?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh my mailing address is [PII] and my email address is [PII].
[AGENT][NEUTRAL] It looks like we have your work email.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Perfect, thank you.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] But you said it was changed from 3000 to 5000 for this year?
[CUSTOMER][NEUTRAL] Yes ma'am, yeah, because we, I had to pick a new insurance plan.
[AGENT][NEUTRAL] Um let me check.
[CUSTOMER][NEUTRAL] So it did just change?
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] What was that?
[AGENT][NEUTRAL] Ms. [PII], go ahead, what you were saying.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, yeah, I had to, we had to get new policies.
[AGENT][NEUTRAL] OK, and that was new policies with us, with your secondary.
[CUSTOMER][NEUTRAL] No, I mean our health insurance switched.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We had to get new health insurance like we I couldn't get the same policy that I got last year so I had to get a new policy this year, but they said the gap was staying with you guys.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Did they say the gap was gonna change as well?
[CUSTOMER][NEUTRAL] Just which one that I had or um let me look at the email to double check it but.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm also trying to pull the group and see if there's been any changes through the group.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] So I don't see any so far, but let me see.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me look in my [PII] and see if it shows in there.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm, OK.
[AGENT][NEUTRAL] There
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yeah, I don't see any changes here in my end.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, let's see what.
[CUSTOMER][NEUTRAL] Yeah it's APL.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. You might wanna call the HR department and check and see if your change went through. Um, I don't see anything in my end just yet. It looks like it's still the same, uh, information. I don't see any changes.
[CUSTOMER][NEUTRAL] So you, well, there would, is there a policy for me for [PII] that's restarted?
[AGENT][NEUTRAL] I don't see a new one with a different amount. No, I, I see the same one that is continuing.
[AGENT][NEUTRAL] Based on the information I have in front of me.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So what you're seeing shows I have gap coverage for this year in the amount of 3500.
[AGENT][NEUTRAL] 3000.
[CUSTOMER][NEUTRAL] Or 3000
[AGENT][NEUTRAL] 3000. Mhm.
[CUSTOMER][NEUTRAL] Yeah, it says gap 5000 G525 right on my [PII].
[AGENT][NEUTRAL] OK. When did, uh, I'm sorry.
[CUSTOMER][NEUTRAL] OK, so what
[CUSTOMER][NEUTRAL] So go ahead and ask your question.
[AGENT][NEUTRAL] Yeah, go ahead.
[CUSTOMER][NEUTRAL] We had that like I submitted this on [PII].
[AGENT][NEUTRAL] OK, [PII], and that was your open enrollment period?
[CUSTOMER][NEUTRAL] Yes,
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Let me check with customer service and see if they have anything there. If they don't have anything in their end, then um HR probably need to just send us something indicating that that needed to change. But let me go ahead and get with them and see if they have anything in their records, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] Deferring.
[CUSTOMER][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII] in the customer service department. How may I help you?
[AGENT][NEUTRAL] Hi [PII], how are you? This is [PII].
[CUSTOMER][POSITIVE] I'm doing good. How about yourself?
[AGENT][NEUTRAL] I'm good, I'm good. Um, I have a member on the line that she's calling me because she said that her policy should have been changed this year to a higher amount than what we're showing. Um, I pulled a group, I don't see any other policies or any changes, um, but she said that, yeah.
[CUSTOMER][NEUTRAL] What's your policy number?
[AGENT][NEUTRAL] Um, it's 246-1873.
[AGENT][NEUTRAL] And she said she received an email confirming that change.
[CUSTOMER][NEUTRAL] I do have several options.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] Uh, the system's a slow. Hang on.
[AGENT][POSITIVE] Yes, it's OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] And of course there's no detailed description of anything.
[CUSTOMER][NEUTRAL] Hang on let me look at one more thing.
[CUSTOMER][NEUTRAL] She said she got an email from us.
[AGENT][NEUTRAL] No, not from us, for her employer saying that the change went through that it's supposed to be 5000 instead of 3000 for this year.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] And that's why she's like, well, I got this email saying that it went through.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm be.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] I was thinking maybe it was on renewal hold.
[AGENT][NEUTRAL] Oh it's not. I check on that. I check everything that's why I'm like, hm, let me check with customer service.
[AGENT][NEUTRAL] Yeah, if it was in renewal, I know they just need to wait for that to drop.
[CUSTOMER][NEGATIVE] Well, it should be on renewal hold but it's not. I don't know why.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Yeah, let me shoot.
[CUSTOMER][NEUTRAL] She may just have to get the employer to contact us because it doesn't look like we got anything.
[AGENT][NEUTRAL] OK, that's what I was telling her that if we don't have anything more than likely she will have to get um with HR and have them to either send something in writing or contact us.
[CUSTOMER][NEUTRAL] Let me see if they're sending the group the renewal though. I don't know why I don't renew a hold, but it should be because it was done last year.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh. [PII]'s working on the group.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If they're making a plan change. They're removing the 1000 plan and going to the 3000 plan.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Only.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] Oh, only?
[CUSTOMER][NEUTRAL] Hang on.
[CUSTOMER][NEUTRAL] Oh my [PII].
[AGENT][NEUTRAL] Because you said you're supposed to be in the 5000.
[CUSTOMER][NEUTRAL] Yeah, they're, they got 3 options. They're dropping the, the uh-huh and then.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Oh, the one that, yeah, because it's too low and then they're keeping the 3 and the 5, yeah. She was telling me that. She's like, we had a change of the other insurance and now it's really high, so.
[CUSTOMER][NEUTRAL] Yeah, we're still working on it. It's just
[AGENT][POSITIVE] You're working on it.
[CUSTOMER][NEGATIVE] Yes, I don't know why it's not on renewal hold. She must have not.
[CUSTOMER][NEGATIVE] She must have started working on it and never came back to it. Um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So what's the best thing to tell the customer, the insured?
[CUSTOMER][POSITIVE] That the group is still being processed through renewal and as soon as the renewal is completed we'll have everything updated she'll receive new cards um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You can tell her that we're still working on it and that she should have something by the end of the week as far as updated, but of course, it won't go out in the mail probably until next week. I can ask [PII] to see if she can get the group done.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Well, she's waiting for the one that uh on the online service center. She's looking there. She said she don't see it there.
[CUSTOMER][NEUTRAL] Yeah, it'll probably be at towards the end of the week or next week as far as the update um before it's visible but yeah um I'll have to share her message and let her know that people are calling, but it is on renewal hold. It's just not.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Got you. OK.
[CUSTOMER][NEUTRAL] Somebody didn't set up the screen right?
[AGENT][NEUTRAL] OK. OK. Got you. OK dokey. Well, that's all I needed to know. I just needed to know what to tell them.
[AGENT][POSITIVE] OK. Thank you. Have a good day. OK, bye-bye.
[CUSTOMER][POSITIVE] All right. No problem. You're welcome. Thanks. Bye-bye.
[AGENT][POSITIVE] Thank you for holding and being patient for me Miss [PII].
[CUSTOMER][NEUTRAL] I'm like first of all
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so the group is still under review for the renewal. So once that is completed, you will see the card. So more than likely it's going to be either the end of this week or the beginning of next week when you're going to see the new card. Uh, you can continue using the old one until we get the new one. If we receive any claims, it's going to be processed based on the date of service, so it will go to the correct one.
[CUSTOMER][NEUTRAL] OK, so if I am to submit a claim, do I have to still do I have to wait for it to be processed or will they still process it?
[AGENT][NEUTRAL] Um, is it, um, something for this year that just happened this year?
[CUSTOMER][NEUTRAL] Yeah, for this year.
[CUSTOMER][NEUTRAL] Yes,
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] And yeah, it should be set up already, even if you send in an old one because since it's gonna be set up at the end of this week or the beginning of next and the processing time is 7 to 10 business days, we'll go ahead and pick up the card that corresponds to that date of service.
[AGENT][NEUTRAL] So yeah, I don't think there should be any problems if you upload it. Mhm.
[CUSTOMER][NEUTRAL] OK, I, yeah, I just didn't wanna have to wait for like ever for the claim to get paid out because I like to get them paid or they start sending me bills right away and then they start like.
[CUSTOMER][NEGATIVE] Sending me late bills and all that, it's not, I hate, I hate medical bills.
[AGENT][NEUTRAL] and there's that
[AGENT][NEUTRAL] Yeah, I understand. But yeah, um, you can go ahead and do that, and again, we probably need to just put it on the right policy or you can wait for next week and put it on the right policy, um, because if not, we will have to change it to the, you know, we will have to do a change.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. So yeah, you can do either or.
[CUSTOMER][NEUTRAL] OK, well I was gonna just pay them but I don't have the money to pay them without getting money back, you see what I'm saying? So I just wanna make sure that before I pay them that it's gonna that I'm gonna get it back.
[AGENT][NEUTRAL] Uh, yeah, I understand.
[AGENT][NEUTRAL] I understand. OK. Yes, but yeah, you can just go ahead and submit the claim.
[CUSTOMER][POSITIVE] OK great thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today, Miss [PII]?
[CUSTOMER][POSITIVE] No, that's all have a great day.
[AGENT][POSITIVE] You as well thank you for calling ATL. Bye-bye, Mr. [PII]. You're welcome. Bye.
[CUSTOMER][POSITIVE] Thank you bye bye.