AccountId: 011433970860
ContactId: da6f1a03-cd4a-433c-a2f4-f743c510fdb5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 756130 ms
Total Talk Time (AGENT): 434076 ms
Total Talk Time (CUSTOMER): 368726 ms
Interruptions: 10
Overall Sentiment: AGENT=0.5, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/da6f1a03-cd4a-433c-a2f4-f743c510fdb5_20250304T17:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you doing?
[AGENT][POSITIVE] Hey, [PII], I'm good. How are you?
[CUSTOMER][NEUTRAL] I'm doing good. Um, I have a broker on the other line. She needs some help, but I think they may have been speaking with you. Um, it's for group number 25315.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, the broker is [PII]. She said the owner, [PII] Dear keeps getting checks from us for $600 and she, she lost the last check. So she doesn't have the, does that sound familiar? Because they mentioned [PII]. OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I remember that. Yeah, I, I responded to a hub request and I asked her to provide us with the check number because I can't see where we've refunded anything. So I don't even know if that's a billing check, um, but you can send her over to me and I can see if I can get the check numbers from her, um.
[CUSTOMER][NEUTRAL] OK. Well, let me tell you now, she said she doesn't have the check number because she lost the check.
[AGENT][NEUTRAL] [PII]. Well I'm supposed to help her. Goodness. OK. I don't know.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because I mean, I can't see anything that we refunded, um, Lord.
[CUSTOMER][POSITIVE] Well, that makes me feel a little better because I was like looking through the notes and stuff. I was looking to see if there was a claim paid out. I'm like, I don't see anything.
[AGENT][NEUTRAL] Exactly. That's.
[AGENT][NEUTRAL] So did you see any claim information?
[CUSTOMER][NEGATIVE] Well, not for this, right, mhm.
[AGENT][NEGATIVE] Nothing that would have been refunded?
[AGENT][NEUTRAL] See, I can't find any billing, so I don't know what, and I'm, I looked at OnBase, I couldn't find any checks. Um, I, I just have to let her know she gonna have to try to get them check numbers. I don't know what to.
[CUSTOMER][NEUTRAL] Lord. Or maybe if she has the
[AGENT][NEUTRAL] I don't know what else to do.
[CUSTOMER][NEUTRAL] Well, I don't know if she lost the whole check. You know how you can rip the check off and then the top part still has the, that's the part you keep? Maybe, does that have a check number on it?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, right. I'll ask her if she has that then. It might have some information, some more information on it. Um, I'll just see if she's got anything. I mean, cause if she don't have anything, I, I, I don't know what to do cause I don't see anything. Yeah.
[CUSTOMER][NEUTRAL] That we can use
[CUSTOMER][NEUTRAL] We can't pull it, right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] But yeah, to me and I'll see what we can, I'll see what I can help her with.
[CUSTOMER][NEUTRAL] All right, thank you. Hold on one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello [PII].
[CUSTOMER][POSITIVE] Yes, I'm here. Thank you so much for holding. I apologize for the for that wait. Um, I have [PII] on the line and she's um going to be helping you further. She, this is the same [PII] you were um asking for. I didn't know she was gonna answer yes.
[AGENT][NEUTRAL] Hi, [PII].
[CUSTOMER][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] Hi [PII], thank you for jumping on the call. I had a call with [PII] and just a few minutes ago, and she didn't respond back to the email. She said, oh, I couldn't figure out how to open that encrypted email so.
[AGENT][NEUTRAL] Hi [PII].
[AGENT][POSITIVE] Yeah, absolutely.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEGATIVE] I'm like, OK, I'm like, OK, she goes, and I, I don't remember the check number because I lost the check. I'm like, well, of course you don't. If you lost the check that makes sense, but she did say this. I've been getting a check. It feels like every month for about 6 months. The first one she said it's like it was a double payment. I'm wondering, at first I thought maybe it was for someone that we have on Cobra.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then I went back and looked at the girl that's on Cobra only took medical. She did not take gap, so that can't be for [PII]. What I'm thinking is she and her partner um [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] We are on an employee spouse plan and I know that [PII] was in the hospital. I'm wondering if it's from her first dollar benefit from meeting her deductible. It may be for claim reimbursement.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] That's what I'm wondering because I on the billing side, I can't see where we've refunded the group anything you know I've looked at the group history and there's no refunds that have been sent out like let me see, I mean the last refund I can see that we sent to the group was back in [PII] and with it being a just an even $600 amount I was really thinking that it was claim related, um, but I didn't know who to start with with like who.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's what I think.
[AGENT][NEUTRAL] It could have been for um so if you have a name then we can definitely get our claims department to look into um you know a specific person and see if they sent a refund for that amount.
[CUSTOMER][NEUTRAL] Let's look at [PII], and she's gonna be on her policy, which is 0216.
[CUSTOMER][NEUTRAL] 1391.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the group number, of course, is 25315.
[AGENT][NEUTRAL] OK, yes ma'am.
[CUSTOMER][NEUTRAL] 25315
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] OK, yes, I see [PII] on here. I don't know if I can see I'm gonna look at the notes. I don't know if it'll show in the notes since it's claim related. Let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It will either be on [PII] herself or [PII]. I know they're on the same plan.
[AGENT][NEUTRAL] They are on the same plan, um.
[AGENT][NEUTRAL] I can't see um the notes don't show me like claim checks that were sent out um but let me get them on the line um and see if they can look into that with us and see if it was sent um for [PII] um hang on I'm just gonna add them um but I'll stay on the call too um so that we can still kind of work through this, uh, just give me one moment and let me get them added, OK? No problem.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Alright thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] in group billing. How are you doing?
[CUSTOMER][POSITIVE] I'm good, [PII] how are you?
[AGENT][NEUTRAL] Good, I'm doing good, thank you. So I have kind of a um a complicated situation here. Um, so I have a broker on the line and she's calling for the group. She says that the group has been receiving, well, so the group contact is the same person, um, let me give you her policy number. She has a policy also, um, and I think it might be related to her policy, not the group. Um, so the group, the policy number is 216.
[AGENT][NEGATIVE] 1391 it's for [PII] dear, so she says that she's been getting a refund check every month um for $600 even she doesn't have any check information she lost the checks, so I can't look any checks up um but at the group level, you know, we haven't refunded anything.
[AGENT][NEUTRAL] Um, and so the lady that I have on the line, the agent, um, is [PII], she says that she thinks it may be for the, um, dependent listed on this policy for [PII], and I didn't know if you guys could check and see if you had sent any refunds out for them in in that amount.
[CUSTOMER][NEUTRAL] Does she have a
[CUSTOMER][NEUTRAL] Add service, is it coming from American Public Life?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] That's what she says. I mean, I try to get some more information from the group, you know, can they give us the check number, any information? She don't even have the checks anymore, so I can't look it up, you know.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I don't even see anything that's being sent out to her like to the because we have a P1, P2 is for the provider, P1 is for the insured.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because she says she's getting it in her name. [PII] is getting it in her name, but I don't know what to do if she doesn't have the check information. I can't look anything up, you know, and I, I don't see there's nothing at the group level.
[CUSTOMER][NEGATIVE] Right, a claim number or something. There's not even a refund claim in process.
[AGENT][NEUTRAL] OK. OK. Well, I'm gonna let her know that and I'm gonna tell her, you know, if she can locate any information then we can look it up or if she gets another one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, like a claim number or date of service like is there a letter being um sent out to us to her in regards to APL explaining, well, um, does she have an online account? Can she access that to verify which claim it is because every claim that I'm looking at under part one and two.
[AGENT][NEUTRAL] Claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I just see.
[CUSTOMER][NEUTRAL] We just been paying a provider.
[AGENT][NEUTRAL] Paying the provider, OK.
[CUSTOMER][NEUTRAL] Unless the providers are sending her a check because
[AGENT][NEUTRAL] I wonder
[AGENT][NEUTRAL] Does it tell you the amount?
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Because she says they're all for $600 like even.
[CUSTOMER][NEUTRAL] Let me go, hold on, let me see.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] No, OK.
[CUSTOMER][NEUTRAL] I don't see anything for $600 for [PII].
[AGENT][NEUTRAL] I'll let her know that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't even see anything being sent to the insured. Let me check and see if she has another policy.
[AGENT][NEUTRAL] Yeah, that's so crazy.
[AGENT][NEUTRAL] I wonder if she's mistaken it for some another carrier or something.
[CUSTOMER][NEUTRAL] Probably for her primary insurance company or the provider itself that may be sending it to her because it's.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But I'm gonna look and see if she has another policy with us. No, this is the only policy. I don't see anything.
[AGENT][NEUTRAL] I'm gonna ask her to check on that.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, well I really appreciate you looking into that with me and I will let her know that we just really kind of need more information, uh, to be able to look it up.
[CUSTOMER][NEUTRAL] Yeah, we definitely gonna need more information.
[AGENT][POSITIVE] OK, thank you so much, [PII].
[CUSTOMER][POSITIVE] You're welcome. Thanks, have a good day.
[AGENT][POSITIVE] OK, thanks you too bye.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Hi, [PII].
[CUSTOMER][NEUTRAL] Yes, I'm here.
[AGENT][NEUTRAL] Hi, um, it's [PII] again. So I just talked to claims and um she was looking through the um claims that they've processed so far and she doesn't show any refund being sent to um [PII]. She says that there's possibly refunds being sent to the provider. She's not sure if maybe the provider is sending that to [PII], um, but we don't have any record of us sending anything.
[AGENT][NEUTRAL] To her, um, and really we need a little bit more information to to be able to research that if she can provide us with a possible claim number or date of service or even you know I know you said that she doesn't have the checks but in order to look up the the checks that she's receiving if they're from us we would need that information um because I just don't see it here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] to see
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That is so much a mystery. I wonder if she can go into her banking account and look at the last several ones that she deposited.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That that would be helpful too if.
[CUSTOMER][POSITIVE] And we can start working backwards.
[AGENT][NEUTRAL] Yeah, if she could even provide us with that information, that might help. um, and then I'm trying to think.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, if she gets any more, definitely.
[CUSTOMER][NEUTRAL] Because she said she's getting them consistently, which for 6 months, which that is like, really?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm wondering, is it, I wonder it couldn't be from another um carrier or does it, it's is she's sure that it says it's from APL?
[CUSTOMER][NEUTRAL] She
[CUSTOMER][POSITIVE] Cheapest positive is the APL, which is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Where
[CUSTOMER][NEUTRAL] Alright, so I said, well, OK, I'm gonna have her go into her online banking account and go pull. Sometimes if you do like a picture deposit, I don't know if she's physically depositing those or if she's using her phone app, you know, where you take a picture and sometimes if you log in you can see a picture at least who it's from so.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, and that'll help if she can get that. Yeah.
[AGENT][NEUTRAL] Um, but I will make note of this on the group account and if you're able to find any more information, um, if you wanna email me back or if you wanna call and ask for me then I'd be happy to look into it some more with you.
[CUSTOMER][NEUTRAL] OK, all right.
[CUSTOMER][POSITIVE] OK, perfect, and I apologize. I am getting emails and I will respond to [PII] on the renewal for commercial mechanical. I'll work on that and get that over today, so.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, ma'am. Yes ma'am.
[CUSTOMER][POSITIVE] OK, I'm gonna call her and put her on, on a on a on a task and we'll go from there. OK, thank you, have a great day then.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes, ma'am, and like I said, just let us know and I'll look into it, OK?
[AGENT][POSITIVE] Yes ma'am, thank you for calling APL bye bye.
[CUSTOMER][POSITIVE] Thank you, I appreciate it. Thank you. Uh bye bye.