AccountId: 011433970860
ContactId: f8d5aa91-18b4-4b80-8533-7ef6bd4ecb47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 541510 ms
Total Talk Time (AGENT): 177238 ms
Total Talk Time (CUSTOMER): 190616 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/03/f8d5aa91-18b4-4b80-8533-7ef6bd4ecb47_20250203T14:05_UTC.wav
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[AGENT][NEUTRAL] Hello, thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, ma'am. Um, I wanted to check. Um, my husband was going to get a crown today, and the, the dentist office called us and said that our insurance isn't, is not active. And so I was trying to check in on that.
[AGENT][NEUTRAL] Could I have your policy number?
[CUSTOMER][NEUTRAL] 1080673
[AGENT][NEUTRAL] And what is your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And [PII], what's your date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And can you verify your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and what is your email address that we have on file?
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][NEUTRAL] Thank you and [PII] a callback number just in case the call is disconnected is the [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] You're calling in regards to your eligibility of your policy. It looked like this policy was terminated [PII]. Let me see if the group terminated itself.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] Are you still with their employer?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] What is the name of your employer?
[CUSTOMER][NEUTRAL] Yeah, it's LJP and.
[CUSTOMER][NEUTRAL] LJP Enterprises are either South Side Lighting.
[AGENT][NEUTRAL] Yeah, that's what it is, the lightning.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] So.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] May I place you on a brief hold?
[CUSTOMER][NEUTRAL] Like
[AGENT][NEUTRAL] 01 moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Sing.
[AGENT][NEUTRAL] Hello.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII] in customer service. How may I help you?
[AGENT][POSITIVE] Good morning, [PII]. How are you doing?
[CUSTOMER][POSITIVE] I'm good. I'm sorry about that. I guess my mute was on when I turned on my mic.
[AGENT][NEUTRAL] Mm mm. No worries. It's Monday morning.
[CUSTOMER][NEUTRAL] It is, what can I do for you?
[AGENT][NEUTRAL] [PII], could you look at a policy for me? I have an insured on the phone calling about eligibility, but it says that it's terminated, but then I see a note in here from [PII].
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] OK, what's the policy number?
[AGENT][NEUTRAL] Yeah let me know when you're ready for the policy number 108.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][NEUTRAL] 0673 that's 1080673.
[CUSTOMER][NEUTRAL] OK, yeah, I hadn't gotten started on anything yet so I was ready to go. All right, let me see.
[CUSTOMER][NEUTRAL] 2.
[AGENT][NEUTRAL] Yeah, I try to cause I, I don't like when people call me and just go straight into a policy number like, hold on, I'm working on something, so can you give me a moment, please.
[CUSTOMER][POSITIVE] I appreciate that. I appreciate that because a lot of times we're in the middle of a policy where we're doing changes and you know it makes you put a note and all this other stuff. So let's see, correct PIDFT claims did not know what the term date was the benefits was double benefits were in PIBFT and always said.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Was dropped. What?
[AGENT][NEUTRAL] I don't know what they mean.
[CUSTOMER][NEUTRAL] I don't know last policy from overdue effective [PII].
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] And, but the pay today is only 101. What in the world is going on with this?
[CUSTOMER][NEUTRAL] Yeah, they haven't paid a premium on this since uh da da September.
[AGENT][NEUTRAL] Oh it was terminated. It actually is terminated. I want to verify before I told her because of the notes that [PII] left in.
[CUSTOMER][NEUTRAL] Yeah, let me double check and see if maybe it's a group thing. Hold on just one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What date are they trying to confirm the benefits for?
[AGENT][NEUTRAL] Um, she said that they're trying to go to the provider now to get services and the provider called to verify benefits, but the services that they want is not covered. He want a crown that's not covered under the policy, but.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She wants to know why her policy says it's terminated. And I asked her if she still work for the employees, she says she does.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, it looks like the whole group is turned. Hold on let me look.
[CUSTOMER][NEUTRAL] EMPL.
[AGENT][NEUTRAL] And should
[CUSTOMER][NEUTRAL] Well, I don't see any notes where the group was termed, but there's nobody active on the group right now.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so I'll let her know that it's turned.
[CUSTOMER][NEUTRAL] Yeah, I mean what I'm looking at, they haven't paid a premium since um August and so yeah and so it's only paid to [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] So I'll let her know. Thank you, [PII] for looking into it for me.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] No problem. Thank you. Have a good day. Bye-bye.
[AGENT][POSITIVE] Have a good. Thank you. You should be fine. Bye.
[AGENT][NEUTRAL] Thank you for holding [PII]. I apologize for the inconvenience. So it looks like, did you guys when open enrollment season was going in, was going, did you guys, um, sign fill out benefits for a new company with a new to go with a new company because it looked like the whole group is terminated here.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Not that they told us um I'm good when she gets here, I'm gonna have to ask her but so back in I was looking at my calendar then it said that I went to the dentist in November, but my kids went and me and my husband went so did it not cover any of that?
[AGENT][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] You said you went back in November?
[AGENT][NEUTRAL] Do you have a like a actual date?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, on my calendar, I, it says I went on [PII], my husband went on [PII], and
[AGENT][NEUTRAL] OK, so [PII] date of service was paid.
[AGENT][NEUTRAL] But it's term, the policy is term.
[CUSTOMER][NEUTRAL] OK, so I guess when you, whenever the policy goes out at the end of the year, I guess.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Is that right?
[AGENT][NEUTRAL] Well, it actually says it doesn't give the date that it turned, but it just says this participant was dropped date not on file.
[CUSTOMER][NEUTRAL] [PII]. And everybody has been dropped from our group.
[AGENT][NEUTRAL] The entire group. Mhm.
[CUSTOMER][NEUTRAL] The entire group. OK, let me ask them. Thank you.
[AGENT][POSITIVE] Alright, you're welcome. Is there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's it.
[AGENT][POSITIVE] Thanks for calling APL. Have a good day. Goodbye.
[CUSTOMER][NEUTRAL] Bye bye.