AccountId: 011433970860
ContactId: feb0ab37-1634-4b4e-80b0-4efc3d1f360f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 624280 ms
Total Talk Time (AGENT): 272971 ms
Total Talk Time (CUSTOMER): 272852 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/feb0ab37-1634-4b4e-80b0-4efc3d1f360f_20250313T16:02_UTC.wav
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[AGENT][NEUTRAL] Good morning calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hi [PII], hey, um, I just got a quick question because I'm looking here right on my APO website for like our different plans. I'm looking at our at our um our plan for our PEO um I can give you the group number on that in case you wanna look at this with me.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Are you the insured or you're calling on behalf of the group?
[CUSTOMER][NEUTRAL] Um, I mean, I, I am the group administrator slash broker.
[AGENT][NEUTRAL] OK. And may I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, this is [PII], and a good number to call me back at would be [PII].
[AGENT][NEUTRAL] Thank you. And may I have the, you said you have the group number or a particular policy number?
[CUSTOMER][NEUTRAL] I have, I have the group number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 25054.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so I have you here and I just need you to verify um your email address and the mailing address for the group.
[CUSTOMER][NEUTRAL] Yes ma'am. OK, it's [PII] and then a good mailing address. I mean we switched offices so we haven't switched it so it might be that [PII] or it could be um.
[CUSTOMER][NEUTRAL] What was our previous.
[AGENT][NEUTRAL] No, that's right, it's OK.
[CUSTOMER][POSITIVE] OK, OK, perfect, that's awesome. I'm glad I got it on the first try.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, you did. Uh, if you do want to update that, just send an email to care team or you can make those changes. Well, no, you have to send that to care team and we'll update the address for you. And then, so you're, you're saying that you need help with the coverage?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] First
[CUSTOMER][NEUTRAL] Well, I'm just not understanding what I'm seeing on my portal because I uploaded it because we had open enrollment um effective [PII] was the start date for all their products for our ATI jet client and I uploaded it and just just for one policy per person or or however many they elected but then when I just came in here to term somebody from another one of our groups off of this plan, I noticed I see like.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For Mr. like, for example, [PII], I'm seeing like 4, I mean like each policy so he had one short term, one hospital indemnity and one accident plan.
[CUSTOMER][NEUTRAL] And they're doubled up and I'm seeing two of each, but there's not a different policy number for each. It's just a different date. So there's like a [PII] and then a [PII] and I just, I want, I don't want to term anything before I understand what's going on exactly so that, you know, he's not missing any of his policies that we're deducting for.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK. So just for the call, all the information provided is a verification of benefits, not a guarantee of payment. So I do, so there's a few things. Um, I do see for like for [PII], for example, I see the three policies that he has here, and I am showing them effective. Some are effective [PII], some are [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Well what I'm seeing is is um [PII] and [PII], so that's why I was um confused because we don't wanna obviously be paying for three po double the policies that you know what I mean that we're not deducting for so I just wanted to know is this something like they didn't get the premium for 21 and so they're double collecting or is this just a little bit of an internal error?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Multiple, right.
[AGENT][NEUTRAL] So this is what I'm gonna do. If you don't mind, I'm gonna place you on a brief hold and reach out to group billing. Um, I don't know if this is more of a billing issue or how it was submitted.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] To us, I'm not sure, so I'm gonna reach out to them and see if they can give us some clarity. Um, do you mind if I
[CUSTOMER][NEUTRAL] No worries. I, I, yes, yes, ma'am. I use your spreadsheet. uh, I've done this many of times and it usually doesn't happen this way. I just don't know if did does somebody input these into the system themselves or is it an automatic the system implements and puts that information in there.
[AGENT][NEUTRAL] It could be both. Um, sometimes if it comes in and um like when we get it on the email and we have to send it over, then
[AGENT][NEUTRAL] Um, they'll be manually entering it.
[CUSTOMER][NEUTRAL] I do I did it through the upload. I, I do it through the upload portal.
[AGENT][NEUTRAL] So yeah, then that, well.
[AGENT][NEUTRAL] I would, I would
[CUSTOMER][NEUTRAL] I just, I'm trying to figure it out.
[AGENT][POSITIVE] And I don't know how it works, so I would rather speak with group billing so that we can get correct answers for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][POSITIVE] Yes, ma'am. No, that sounds great. That sounds great.
[AGENT][NEUTRAL] Um, so hold on one moment for me, but just so that I make sure I relay the message correctly on your end, you're seeing February effective dates for [PII] and [PII].
[CUSTOMER][NEUTRAL] No, just for for [PII] and [PII].
[AGENT][NEUTRAL] Oh, [PII] and [PII], OK.
[CUSTOMER][POSITIVE] Yes ma'am, yes ma'am.
[AGENT][NEUTRAL] OK, let me um let them know. Hold on one moment, OK?
[CUSTOMER][POSITIVE] Perfect. Yes, ma'am. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Why is it so hard to find a billing discrepancy card?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEGATIVE] It doesn't help.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. Can I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you?
[CUSTOMER][POSITIVE] I'm good. How are you?
[AGENT][NEUTRAL] I'm good. Um, I may not have to transfer, but can you look at this with me?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, it's, uh, well, policy number 246-4302.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] So now I'm confused because I was trying to decide if this was group billing or customer service because I'm talking to the, you know, the agent broker, but
[AGENT][NEUTRAL] They have a specific member?
[AGENT][NEUTRAL] He's showing up on the billing multiple times. So, so I'm all, I'm thinking group billing, but because it's his specific policy, I didn't know if it was customer service, which one?
[CUSTOMER][NEUTRAL] Uh, looks like according to the notes, um, the policy or the insured added spouse effective to one.
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] Uh, on the March invoice it's billing for.
[CUSTOMER][NEUTRAL] The couple coverage plus the February premium difference.
[AGENT][NEUTRAL] Oh, OK. That makes sense. I understand. I can relay that back. OK, I just get confused with like if I'm sure it's good billing or customer service, so I.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] No, that's fine. Yeah, it's, it had a coverage change, so the March invoice is showing March premium and then February premium difference.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yep, and that's what he was saying, [PII] and [PII]. OK. Thank you, [PII].
[CUSTOMER][POSITIVE] Yes. You're welcome.
[AGENT][NEUTRAL] All right, bye bye.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] All right, thanks so much for holding. I apologize for that wait, but I did get the answer for you. So you're seeing double for, it's not, it's not really double. There was a spouse, he added the spouse to the policy um effective [PII]. So that's why you see the [PII] and then [PII] because we billed for him, but then we had to add the spouse, so we had to bill for her also. So now moving forward, you'll just see that um couple charge instead of two.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and would that, would that be the same for like [PII] too because I, I'd uploaded him with the accident plan and I see two of those and two of the short term disability but he would, he, he, it was all individual there wasn't like any dependents being added or anything.
[AGENT][NEUTRAL] OK, hold on one moment. And what was his name?
[CUSTOMER][NEGATIVE] No, no, I, I don't want you to, I don't want you to keep going back and forth. I just don't understand what, what happened here, you know, I mean, I.
[AGENT][NEUTRAL] Well, that's what I'm here for. It's OK. What's the member's name?
[CUSTOMER][NEUTRAL] Oh man, there's a, there's a, it's like this list that I have, you know, it's, it's all the people that I uploaded for for that [PII]. It seems like a lot of them are doubled up and, and I understand the reason for [PII]'s because he added the spouse, but I, but it's just concerning me that, you know, it seems that all of them were affected, you know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, well, I mean, you have two options. If you want to go through the list over the phone, we can. If you want to email the list to us and have us go through it and let you know what we find, we can do it that way. I mean, it's
[CUSTOMER][POSITIVE] Yeah, that would be awesome. Yeah, I would prefer that way.
[AGENT][NEUTRAL] OK, um, so just send the list to care team, so it's [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And then just list, you know, whatever your concerns are, what you're looking for, you know, put it all in the email and then we'll work it and reply back to you with the findings.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] Perfect that is so awesome thank you so much. I really appreciate all your help.
[AGENT][POSITIVE] Well, you're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, man, that that was, that was it.
[AGENT][POSITIVE] All right, [PII]. Well, thank you for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] Yes, ma'am. You too. Thank you. Bye.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.