AccountId: 011433970860
ContactId: 00677264-e034-440a-ae24-8c6bb6093e2b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 437209 ms
Total Talk Time (AGENT): 212161 ms
Total Talk Time (CUSTOMER): 199347 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/00677264-e034-440a-ae24-8c6bb6093e2b_20250411T22:39_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL Cory. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, hi, um, I have received, uh, in the mail the explanation of benefits, um, for my claim, and it says it needs, uh, y'all are needing additional information.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] But it says the enclosed claim form must be completed by you and your physician. There was no claim form attached or enclosed.
[AGENT][NEUTRAL] OK, alright, let me um pull up your policy real quick, can I please get your name and your call back number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, I
[CUSTOMER][NEUTRAL] Yes, um, my name is [PII]. My number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And um can I, and the policy number that's associated with the letter?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it's 02414344.
[AGENT][NEUTRAL] OK, and I'm gonna look this up and see you said that the claim form was not in with the letter, is that correct?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] OK, let me check that out for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Ms. [PII], I do show that on this policy you're not listed on the policy is [PII] there for me to be able to talk to um so that I can discuss the policy with you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, actually, he, he is deceased. So it is a claim for a critical illness, um, plan that he had.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you submitted the claim in his behalf, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] All right, let me look real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like um what you need is a group critical illness claim form.
[AGENT][NEUTRAL] Let me um go to our website.
[AGENT][NEUTRAL] And I can get that claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you ever need claim forms, let me give you the website also just in case you ever need any more of them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, because I thought we had already filled one out. That's the thing. Let's see.
[AGENT][NEUTRAL] It's um
[CUSTOMER][NEUTRAL] APL critical illness claim form. I have it.
[AGENT][NEUTRAL] Oh, OK. Well, that's what needs to be sent in and on the claim form, the instructions that it read were um the remarks on the claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Let me go back to that again. I was in the website trying to get the form. Let me go back.
[AGENT][NEUTRAL] The remarks on the claim was that the enclosed claim form must be completed by you and your physician and the form needs to be returned back to the office and once we get the claim form back um they can finish processing the claim.
[CUSTOMER][NEUTRAL] Hmm.
[CUSTOMER][NEUTRAL] OK, it says they received the attending physician portion, which is the portion that the doctor signed.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And what's her name? [PII], I guess her name is with Crescent City Benefits. She's the one that um submitted all the rest of it. Um, I completed some, um, Sella construction, uh, where the, where he works, they've they completed it too, so I don't know exactly, um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is needed, really.
[AGENT][NEUTRAL] It appears um just from the remarks that's on the claim, they're needing the claim form to be filled out so that it can be used as proof of loss for your critical illness diagnosis.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, OK, I, I can get that for you then.
[AGENT][NEUTRAL] That's what they need it for. OK. Yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah, I have, I have, um, all like 9 pages of it, 9, yeah, 10, 9 page, yeah, um.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yeah, let me get with [PII] and see.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, let me, let me get with her because she had everything, um, the claim form, the physician, the attending physician portion, she had the death certificate, I mean, and the medical records too. So, um, let me get with her on Monday and, um, we'll get, uh, we'll get this to y'all, OK, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, uh, at
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Is there
[CUSTOMER][NEUTRAL] An email address that we can upload everything or all this has to come in the mail?
[AGENT][NEUTRAL] Well, we don't and the only reason why we don't accept it by email because it's just not secure but you can send it by fax um let me give you the fax number.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yes, yes, yes, let me.
[CUSTOMER][NEUTRAL] I'm not the yeah. OK, that number is OK, go ahead.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 3659423.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] and any particular person I need to send this to or attention to claims or?
[AGENT][NEUTRAL] You can just say attention claims and then let me give you the claim number and you could put that on there also um claim number is 358-5605.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And while I've got you on the phone, would you mind just verifying your address for me um so that I can make sure that everything is still up to date?
[CUSTOMER][POSITIVE] OK, we'll get it all back to you.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Y[PII].
[CUSTOMER][NEUTRAL] Yes, it's uh [PII].
[AGENT][POSITIVE] OK, thank you very much. I appreciate you doing that for me, Ms. [PII]. And then I'm gonna put a note in here too that you called and that you will be getting with [PII], um, so that you guys can make sure that that gets completed, OK?
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, sounds great. I sure appreciate your time today.
[AGENT][POSITIVE] Well, it's no problem at all, Ms [PII]. I'm glad I was able to help you. Is there any other questions or anything else that I can go over with you before we leave?
[CUSTOMER][NEUTRAL] Uh, no, nothing at this moment.
[AGENT][NEUTRAL] OK, well you know you can always pick up the phone if you find something later on you need to um call us about, OK?
[CUSTOMER][POSITIVE] OK, OK, thank you.
[AGENT][POSITIVE] All right. You're welcome. You have a good weekend and thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] All right bye bye bye bye.
[CUSTOMER][POSITIVE] You too. Thank you. Bye.