AccountId: 011433970860
ContactId: da077899-c16d-4df1-97ec-3541b7e27a89
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 866059 ms
Total Talk Time (AGENT): 418540 ms
Total Talk Time (CUSTOMER): 324554 ms
Interruptions: 4
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/da077899-c16d-4df1-97ec-3541b7e27a89_20250113T20:28_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. This is Me [PII] in customer service. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] with the care team. How are you doing today?
[AGENT][POSITIVE] Good. How are you?
[CUSTOMER][NEUTRAL] Hey, I've got maybe a couple of questions you can help me with. Um, I'm looking at policy number 7,346,660.
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] All right, [PII].
[CUSTOMER][NEUTRAL] Yeah, so originally why I called over to you is, um, his wife has lapsed and he said that he was under the impression his wife was on the account. It looks like it shows that the policy is for a couple and I see on here that his wife was added in [PII], um, but I don't know why his wife says lapsed. Like it doesn't have a note that anyone termed her for any reason and so I wanted to like know if you could help me look into that.
[CUSTOMER][NEUTRAL] But then I'm also looking into it and it looks like this policy is a self pay and it's supposed to be it since the draft type is electronic, but it looks like we billed him in November but like we never received payment um and he's waiting on eligibility for a claim to go through and he doesn't understand because he thought his stuff was supposed to get drafted so there's those two things I can call group billing if I have to, but.
[CUSTOMER][NEUTRAL] Originally I called about the wife.
[AGENT][NEUTRAL] OK, so the wife is um.
[AGENT][NEUTRAL] Reactivated. I just added her back. Apparently when the policy lapsed before previously, uh, she just wasn't reinstated in that screen, um, but he is, uh, he does have couple coverage, so I have changed that and corrected that. Um, now, as far as the draft.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, he's not set up for a draft, he's set up for a quarterly bill.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEGATIVE] Oh, doesn't it, because I guess how, how does that work? So you can't draft on a quarterly bill. So when it says draft type e electronic, like it's not actually gonna do that.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, because it's not set up to draft the so the mode of payment is how it determines what happens and so mode of payment 2 is a draft and so it will take the information uh at the bottom of the screen and draft that account but if it's not set up for mode of payment to it it won't do that.
[CUSTOMER][NEUTRAL] He thought he was being drafted monthly. OK, so he's being billed out that makes sense, um.
[AGENT][NEUTRAL] Yes, he's being billed out quarterly.
[CUSTOMER][NEUTRAL] And I can't update that for him, right? Like I can't change it to um if he wants to be draft and every month I can't change that.
[AGENT][NEUTRAL] Uh, yeah, we can change that and hold on just a second, let me see.
[AGENT][NEUTRAL] Reactivated spa. I'm having to make a note.
[CUSTOMER][POSITIVE] You're OK.
[AGENT][NEUTRAL] OK. Let me go back and look.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK, so back in October.
[AGENT][NEGATIVE] His account was compromised. He had to freeze the account and close it. He had a draft for September.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] I sent him a new EFT and switched him over to direct bill until he could update his banking information.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] I don't see.
[CUSTOMER][NEUTRAL] Where it was ever updated?
[AGENT][NEUTRAL] Yeah, that's what I'm checking. Give me just another minute. Let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] I'm able to take payment over the phone.
[AGENT][NEUTRAL] You mailed in a check for quarterly payment.
[AGENT][NEUTRAL] Hey, how, like you have to cycle all the way back through to read the.
[CUSTOMER][NEUTRAL] Yeah, to go back to the top, it looks like the one right before, like the one right underneath you from [PII] says received insured's new EFT form and changed his bank draft info online, and it was put in 5 days after they sent him the new form.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I see that now. So yes, if he, if he wants to change it back to monthly we can.
[CUSTOMER][NEGATIVE] OK, I think he thought when that form went in it was gonna get switched back on him because he's like, I pay every month, so I don't.
[AGENT][NEUTRAL] Yeah, I think.
[CUSTOMER][NEUTRAL] I just want to say.
[AGENT][NEUTRAL] Yeah I think [PII] just forgot a step so um I mean we can change that back um he is only paid up to December though so we actually need to draft for.
[CUSTOMER][NEUTRAL] December and then January.
[AGENT][NEUTRAL] December and January. Mhm.
[CUSTOMER][NEUTRAL] OK perfect I will um do, do I, I can let him know that um I don't know how to change I mean I'm assuming it's like CHG and then it's a 2 and a 12 and then yes to save.
[AGENT][NEUTRAL] Uh, yes, that's how you would change it, yes, um, but I can do all that. Do you need me to talk? I can, did you need anything else like or just trying to get this fixed?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, he just wants to take this care of because he is, he got that explanation of benefits saying that he's pending eligibility and he was like, I thought I paid so um I can let him know that when that form came through it didn't update that he was, we haven't had his January or his December payment but we can switch it out and bill him for both and and then do I let him know like that is gonna be billed when would that come out?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Hold on just a second, [PII]. I, I.
[AGENT][NEUTRAL] If you don't mind, just go ahead and transfer the call, um, yeah, so that I can talk to him yeah I can talk to him about when we can draft because um with the billing schedule I could go ahead and draft him tomorrow for December and January and then his regular February payment I can switch it back to the first, um, so I just need to know if he's OK with that so I'll just talk to him about that and I'll let him know that um.
[CUSTOMER][POSITIVE] Transform, yeah, OK, cool. There's a lot of things there.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That I've fixed everything else, so.
[CUSTOMER][POSITIVE] OK, perfect. And then in the future, that's how I would change it and um I appreciate your help, learned a lot today.
[AGENT][POSITIVE] No problem, [PII]. You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Hi [PII], are you still there with us? Mm yes ma'am I'm here. Hey, I really appreciate your patience while I looked into all of that for you. I have Miss [PII] on the line, um, and she's gonna be able to take over the call and help you out as far as making sure everything's set for your billing, but she was able to go ahead and reactivate your wife that was just a a technical error on our part and she got that taken care of so this [PII] is covered, OK?
[CUSTOMER][NEUTRAL] [PII] is covered. Yep, so she'll be all set and then it's [PII] on the line and she's gonna take over the call from here, OK, [PII]?
[CUSTOMER][POSITIVE] OK, thank you very much. It's my pleasure. Thank you.
[CUSTOMER][NEUTRAL] Goodbye.
[AGENT][NEUTRAL] Hi, Mr. [PII]. My name is [PII]. How are you doing today?
[CUSTOMER][POSITIVE] Oh doing pretty good, I think.
[AGENT][NEUTRAL] Good, good, glad to hear it. Uh, so [PII] was just telling me a little bit about what was going on and I was looking through the policy with her, um, like she told you just now. I have, um, fixed the fact that your wife was showing up as lapsed on there. I fixed that for you. I do apologize for that. Um, the other thing is we got your new bank draft information. I just need to talk to you about um.
[AGENT][NEUTRAL] When we're gonna run the the draft, um, because you do still owe for December and January, so in order for us to switch it back to a bank draft, we need to get it caught up to current.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, you haven't mailed in a check or anything recently, have you?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I believe it was supposed to be automatically taken out of my checking account was my understanding.
[CUSTOMER][NEUTRAL] But it seemed like I did, I did mail one check um couple of months ago to catch up everything.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, sir. I spoke with you back, I think it was in October. You were having some issues with your bank account and all of that and, and, but you didn't have your new bank account information.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, we had to send you the paperwork and all that for it so that way you still stayed up to date we switched you over to a direct bill so that you would get the bill in the mail so that's what's happening so now we just need to switch you back to the bank draft and I just wanted to make sure that you had not mailed in a check or anything recently um that we needed to wait to come in before we drafted your account um so I just didn't want you to.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Have already paid, do you see what I'm saying?
[CUSTOMER][NEUTRAL] OK, I think so, but
[CUSTOMER][NEUTRAL] I think when we kind of got my checking account straightened out that
[CUSTOMER][NEUTRAL] My premiums are going to be automatically deducted from my checking account. I wouldn't have to mail you a check.
[AGENT][NEUTRAL] Right, yes sir, that's what I'm doing today. I'm fixing that for you um I just needed to make sure it was OK to go ahead and draft your account for the December and the January payment, and then you'd start at your regular payment on [PII], is that OK?
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, you, you'll take.
[AGENT][NEUTRAL] All right, Mr. [PII].
[CUSTOMER][NEUTRAL] You'll do that today.
[AGENT][NEUTRAL] Um, the draft will go through tomorrow for, um, January and, um.
[CUSTOMER][NEUTRAL] To
[AGENT][NEUTRAL] December and then on [PII], it'll be for just one month and you'll be caught up, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, I don't have to do anything else if you're gonna take care of that for me and everything will be good.
[AGENT][POSITIVE] Yes, sir. I'm gonna take care of that for you right now. Was there anything else I could do for you?
[CUSTOMER][NEUTRAL] OK, and um.
[CUSTOMER][NEUTRAL] I was submitting a bill from a dentist for I believe for $217.
[CUSTOMER][NEUTRAL] That that's gonna be paid accordingly or
[AGENT][NEUTRAL] No, that
[CUSTOMER][NEUTRAL] From Doctor [PII]
[CUSTOMER][NEUTRAL] Yeah, Dr. [PII]
[AGENT][NEUTRAL] I apologize, Mr. Good. That is a, uh, claims question. Is the claim for your wife?
[CUSTOMER][NEUTRAL] No, no, it's, it's for me.
[AGENT][NEUTRAL] It's for you? OK. And you have already submitted it?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, yeah, yeah, I had the work done about 2 weeks ago.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I have, I have a letter back from your company that I got, I received today.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But no check with the letter, just, just a letter.
[CUSTOMER][NEUTRAL] We are waiting information from our, from your employer to confirm eligibility. Upon receipt of this information, we will continue processing your claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's what I received today.
[AGENT][NEUTRAL] All right, Mr. [PII] um.
[AGENT][NEUTRAL] Hm, let me get somebody in claims that way they can explain what that means and what's going on with it, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry for the transfer again, uh, but I'm gonna get somebody on the line just like Ali did and I'm gonna explain everything to them so that they can discuss what that letter means, OK?
[CUSTOMER][POSITIVE] OK, OK, thank you.
[AGENT][POSITIVE] No problem, Mr. [PII]. Thank you so much for calling APL and I hope you have a wonderful rest of your day, OK?
[CUSTOMER][POSITIVE] Yes ma'am, yes ma'am.
[AGENT][POSITIVE] Thank you. Hold on just a moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] This is [PII]. May I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] customer service. How are you today?
[CUSTOMER][NEUTRAL] I'm fine. How are you?
[AGENT][NEUTRAL] I'm good, thank you. Um, I have an insured on the line. He is calling because he received a letter today about a claim he submitted and I was just gonna see if you could tell him what that letter means and talk to him about the
[AGENT][NEUTRAL] What point he's at in the claims process.
[CUSTOMER][NEUTRAL] OK, do you have a callback number for him?
[AGENT][NEGATIVE] Um, oh [PII], he was transferred to me and I did not get that from Ali.
[AGENT][NEUTRAL] Um, let's see. Let me see if it's the same as that's in his policy. Um, his policy number is 734.
[CUSTOMER][NEUTRAL] OK. Do you have the policy number?
[AGENT][NEUTRAL] 660.
[CUSTOMER][NEUTRAL] OK, and you verified everything?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, she did before she transferred.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right, here he comes. Thank you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] This is [PII]. May I help you?