AccountId: 011433970860
ContactId: d54495bb-33b8-4aaa-9286-1d5d294eec5c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 538979 ms
Total Talk Time (AGENT): 235055 ms
Total Talk Time (CUSTOMER): 306146 ms
Interruptions: 15
Overall Sentiment: AGENT=0.7, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/d54495bb-33b8-4aaa-9286-1d5d294eec5c_20250113T16:13_UTC.wav
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[AGENT][POSITIVE] Good Morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][POSITIVE] Hey [PII], it's [PII]. Heck of a nice guy, APL agent extraordinaire. How are you this morning?
[AGENT][POSITIVE] Hey, [PII]. I'm, I'm good. How are you today? Happy Monday.
[CUSTOMER][POSITIVE] Yeah, good and happy [PII] to the both of us. Hopefully it'll be a little bit better year now that we know where we need to go. Hey, um, yeah, I, everybody just every broker that I dealt with last year, if they opened up one group that was one group too many, so it was, uh.
[AGENT][NEUTRAL] Right, yes.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh oh.
[CUSTOMER][POSITIVE] Yeah, well, nobody knew which way the world was going, what direction, you know, so everybody sat on their hands, hey, um, uh, hopefully, yeah, we can only hope.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] So hopefully, yes, it'll be different for you this year and us too.
[CUSTOMER][NEUTRAL] Hey, um, so my best callback number is [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] And I need your help with a claimant. He's a really nice super guy that even offered to take me out to lunch, which like I need that like a hole in my head because I get so many of those. Yeah, I know if I, if I got $1 for every free lunch, I'd be 1000 there by now.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So, um, oh, and you're gonna ask me for his date of birth, so hold on, uh, here's the, yeah, it's gonna be, um, yeah, it's gonna be, yeah, yeah, yeah, it's real simple fix, um, it's 0, his policy number is 024.
[AGENT][NEUTRAL] I'm gonna need his policy number first off, [PII]. And why would, so you need help with the claim, is that right? OK. Yeah, I can help you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 831.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 21 and the guy's name is um [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm gonna see [PII] because that's holding, hold on, [PII].
[AGENT][NEUTRAL] All right, give me one.
[CUSTOMER][NEUTRAL] And let me just get you his date of birth from the post.
[AGENT][NEUTRAL] Yeah, while you're pulling that up, let me get into the policy for just a moment.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you do know that I have to verify certain things for security and any, yeah. You know, so you could just come to work for APL and you would already know everything to do. OK.
[CUSTOMER][NEUTRAL] Uh, yeah, go ahead, this call may be monitored for quality control, sir, yeah, I know.
[CUSTOMER][NEUTRAL] Yeah, somebody's got to replace Ms. [PII]. I could do it.
[AGENT][NEUTRAL] Oh, there's no replacing her, but [PII], you would be a good asset.
[CUSTOMER][NEUTRAL] No, there's no, I, I miss her. I know I miss her slowly. Hey, um, his date of birth is [PII].
[AGENT][NEUTRAL] Uh, no, she's a doll.
[AGENT][NEUTRAL] OK, thank you. And then if you'll verify the email address that we have on file for you for this account.
[CUSTOMER][POSITIVE] OK thank you
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] OK, thank you. Alright, just one second.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So, so, so, so.
[CUSTOMER][NEUTRAL] Where else
[CUSTOMER][NEUTRAL] Do
[AGENT][NEUTRAL] And the claim is for him.
[CUSTOMER][NEUTRAL] Um, it's for his wife.
[AGENT][NEUTRAL] Or for someone else. What's her name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, uh, yeah, just give me one second, um, well, OK, hold on.
[AGENT][POSITIVE] OK, absolutely.
[CUSTOMER][NEUTRAL] Her name is gonna be [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] Mm
[AGENT][POSITIVE] Alright thank you one moment.
[CUSTOMER][NEUTRAL] I can give you the claim number and question if you want so because that's really what I'm calling about you, you want the claim number?
[AGENT][NEUTRAL] Yeah, one second.
[AGENT][NEUTRAL] Give me 1 2nd, [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, you can give me the claim number.
[CUSTOMER][NEUTRAL] Yeah, it's gonna be 353-764-7.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And let me look at something I'm trying to help you out instead of going through your 10,000 screens, let me see if I can.
[AGENT][NEUTRAL] That's OK. I can see that we did receive a claim and it was denied, [PII].
[CUSTOMER][NEUTRAL] that we did receive a claim.
[CUSTOMER][NEGATIVE] Yeah, because [PII], they, uh, I got the university to spend $1.17 more. You have no idea how many months that took for for something that the employees are paying to give them a more embellished meddling plan. And what happened is he did have coverage prior to this underneath an old policy, but APO's applying it to the new policy that started [PII], and that's why it says, you know, coverage was not in force.
[CUSTOMER][NEUTRAL] I'm trying to find out his old policy number.
[AGENT][NEUTRAL] OK, so you just need to know the previous policy that he had before this one?
[CUSTOMER][NEUTRAL] Yeah, so yeah, so you guys, well, actually you guys need to know the previous policy so you could re uh file this.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so the the policy number that he had from 325-2024 to
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Was that went until 425, 2024, was 253.
[CUSTOMER][NEUTRAL] 5
[AGENT][NEUTRAL] 8076.
[CUSTOMER][NEUTRAL] 7
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And give me just a second to look at something on that policy, [PII].
[CUSTOMER][NEGATIVE] God I'm losing
[AGENT][NEUTRAL] OK, so hold on one second and let me look. I've, I've got to go pull up another screen to look at.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] Oh believe me I know you know what saves me is just me being.
[CUSTOMER][NEUTRAL] Little bit more special than the rest of the brokers. I have a per occurrence on this, uh, which nobody for the 17 cents extra a month, honest to God I don't know why nobody does it but you know it says right here on this explanation of benefits that was an inpatient expense, so.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, let me look though.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is 13th?
[AGENT][NEUTRAL] OK. So yes, this, that policy number that I just gave you, [PII] was active from 325-2024.
[CUSTOMER][NEUTRAL] yes
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] So 425, 2024.
[CUSTOMER][NEUTRAL] 2.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me verify again what that, if I can get my screen to cooperate. I'm sorry.
[CUSTOMER][POSITIVE] Yeah, take your time.
[AGENT][NEUTRAL] And this was for data service 325-2024, the same day as the policy went into effect.
[CUSTOMER][NEUTRAL] 2.
[CUSTOMER][NEUTRAL] Yeah, that's when she gave birth.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so what I can do, [PII], is I can submit a request to have this reviewed.
[CUSTOMER][NEUTRAL] So what I can do is I can.
[AGENT][NEUTRAL] Under this other policy number that I just gave you.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] For this data service.
[CUSTOMER][NEUTRAL] OK, and can you do me one more favor because I just didn't update my agent's journal, um, uh, like uh [PII] if you know her, she's got this little spiral notebook. I have the same thing. What's the old, what's the old policy number just for my own records again.
[AGENT][NEUTRAL] Uh-huh. OK.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Uh, that is the 253-807-6.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 80767.
[AGENT][NEUTRAL] That was effective from [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the
[CUSTOMER][POSITIVE] OK all right thanks [PII].
[AGENT][POSITIVE] You are certainly so welcome and.
[AGENT][NEUTRAL] And now I'm getting confused, [PII], so hold on just a minute. Let me make sure I just gave you.
[CUSTOMER][NEUTRAL] But I wanna make sure I
[CUSTOMER][NEUTRAL] Yeah, it is the right one because it's not the one that's new.
[AGENT][NEUTRAL] Right, because the one that's 248-3121, that has an effective date of [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] 8, yeah 3121 yeah yeah that's the one.
[AGENT][NEUTRAL] And that one's the one that's active, yeah.
[CUSTOMER][NEUTRAL] Yeah, ask me why. OK, yeah, it's really peculiar, um, it's really peculiar because it really should be for one effective, but I don't understand why it's done that way sometimes. I don't know.
[CUSTOMER][NEUTRAL] Because that you know their open enrollment is actually 41, but as long as the guy gets his $530 paid, you know, I don't care he's only gonna have one kid at one time.
[AGENT][NEUTRAL] Well, what I'll do
[AGENT][NEUTRAL] Oh, yeah. Well, what I can do, like I said, and you know that I can't guarantee payment, I can only verify the benefits, but I will, I will submit the request to have the claim reviewed under this other policy number.
[CUSTOMER][POSITIVE] Yeah I got you.
[CUSTOMER][NEUTRAL] OK, and then it's gonna be the same claim number though, right, that it's being reviewed under my oh, claim number. OK, alright, alright, I'll call back in like 7 days to see if it's processed or not, OK.
[AGENT][NEUTRAL] It will be, well, it will get issued a new claim number once it's processed under the other policy. Mhm. Yes, sir.
[AGENT][NEUTRAL] OK. Well, is there anything else, um, Mr. [PII] that I can help you with this morning?
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Yeah, just have a good day, pretend you're still talking to me and then go home early.
[AGENT][POSITIVE] I will pretend I'm talking to you with every caller today and that is sure to put a smile on my face.
[CUSTOMER][POSITIVE] Thanks. Alright, you take care. I'd be good. You too, thank you, ma'am.
[AGENT][POSITIVE] All right. Have a great day, [PII]. All right. Thank you. Bye-bye.