AccountId: 011433970860
ContactId: 00b2cff4-0639-46d3-953b-2a0ca3fdb34f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1218400 ms
Total Talk Time (AGENT): 348566 ms
Total Talk Time (CUSTOMER): 331754 ms
Interruptions: 1
Overall Sentiment: AGENT=-0.7, CUSTOMER=-1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/09/00b2cff4-0639-46d3-953b-2a0ca3fdb34f_20250109T19:48_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I was calling uh about my claim. I had sent in the information from my um.
[CUSTOMER][NEUTRAL] My, uh, therapist and I sent it in from, to my, from my doctor saying that I was going back to work and uh I was wanting to know uh when would my payments be extracted to my case.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Extracted to your cake, like when your payments be made to you?
[CUSTOMER][NEUTRAL] Yes, because um
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Because um I'm not going back to work and I sent, I sent a letter from the doctor saying I'm not going back to apply for a disability, and um I sent in uh the doctor's uh the statements from the, the uh therapist where I go see her. I still going to therapy.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, well, I'll be more than happy to help you with your claim and um [PII], may I have a good contact number in case we're disconnected and then your policy number?
[CUSTOMER][NEUTRAL] [PII]. My policy number is 620424.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] My date of birth is [PII] [PII] [PII].
[AGENT][NEUTRAL] Alrighty, and thank you so much for verifying your information and all the information provided is a verification of benefits, not a guarantee of payment. Um, so are you speaking of the, because there's a claim that came in on January or yesterday, [PII] or the previous claim from [PII]?
[CUSTOMER][NEGATIVE] Well, yes, and I was told that I had to send in information to show whether if I'm going back to work or not, and I, I'm not going back to work cause I'm, I'm gonna have to file for disability because of my injuries and um I send in the documentation from my therapist.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just in case if they wanted to know, I'm still in therapy and I have not, it's gonna be over a year or so, but he said before I get right, he said he really can't tell cause I have other underlying illnesses that's preventing me from getting welfare.
[AGENT][NEUTRAL] OK. Um, so hold on one moment. I'm just pulling up the documents that were received on the [PII]. Um, it's in processing now, so it is, it's usually about a 7 to 10 business day turnaround from when we receive it, um, but is this from, I'm trying to see if I can find an ortho Rehab and specialty center physical therapy.
[CUSTOMER][NEGATIVE] Yes, yes, and, and I, and I sent the doctors uh thing saying that I'm not going back to work. I sent that on Tuesday.
[AGENT][NEUTRAL] Would that be it? OK.
[CUSTOMER][NEGATIVE] It's a doctor's note from my doctor. I sent it on Tuesday, then I sent the, the medical records yesterday and I already have a claim, ma'am. The only thing I had to send in to show I was not back at work and I have not going back to work and I'm gonna be out. I'm not going back to work at all.
[AGENT][NEUTRAL] Right, I understand.
[CUSTOMER][NEUTRAL] And if you see what the doctor's statement says, I'm not going back to work, uh, was, I was advised to apply for uh state disability.
[AGENT][NEUTRAL] How was the doctor's note sent?
[CUSTOMER][NEUTRAL] It was sent in by fax, ma'am.
[AGENT][NEUTRAL] On the tip.
[AGENT][NEUTRAL] OK, the only reason I'm asking is because I only see all it's about 17 pages, but it's from the physical therapy. So I can, I'm just asking so I can look.
[CUSTOMER][NEUTRAL] Ma'am, I said the doctor's statement in on Tuesday. I sent it in on on the [PII].
[AGENT][NEUTRAL] I understand.
[AGENT][NEUTRAL] I'm, I'm only asking so I know what to look for, that's it.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, the only thing that I see prior to what came in yesterday was [PII]. Let me see if this is it.
[CUSTOMER][NEUTRAL] I have confirmation to say that y'all got it too cause I went to FedEx and send it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's not no separate claim because I'm not uh I'm not I I sent it in on [PII], which was Tuesday.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And it said that it was confirmed.
[AGENT][NEUTRAL] OK. I'm not looking for another claim. I just, I'm just needing to know what to look for, that's all.
[AGENT][NEUTRAL] Do you mind if I place you on a brief hold while I look through the faxes?
[CUSTOMER][NEUTRAL] Yeah, it, it says.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] I'm so sick and tired of them.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Get cussed out. That's all they're doing.
[AGENT][NEGATIVE] I can't even, there's 3, but I can't access it, so now what? I can't call nobody.
[AGENT][NEGATIVE] Ridiculous.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] I don't even know how to look and, you know what, whatever.
[AGENT][NEUTRAL] To see if anything came in.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Claims.
[AGENT][NEGATIVE] Because now I'm in hot water and I can't reach out to, you know what? I'm calling clients just.
[AGENT][NEUTRAL] Write me up.
[AGENT][POSITIVE] At least I'm helping the patient.
[CUSTOMER][NEGATIVE] This is [PII].
[AGENT][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you?
[CUSTOMER][POSITIVE] Good how are you love?
[AGENT][NEGATIVE] I'm doing OK. Um, I have an insured on the other line. She's extremely frustrated. I need some help with a fax. She said she sent a fax on [PII], this should be like her doctor's note saying that she's gonna be out of work.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] I tried to look in on base and I see 3 things from the [PII], but when I click it, nothing happens.
[CUSTOMER][NEUTRAL] OK, what's the policy number?
[AGENT][NEUTRAL] It is 620424.
[CUSTOMER][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] Is it Cynthia Page?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is she talking about the claim that just was uploaded on the [PII]?
[AGENT][NEUTRAL] Oh, so I saw that those are from her physical therapist, but she's, um, she said it should, should have been on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK, let me look.
[CUSTOMER][NEUTRAL] Hm, let me look in indexing, see if it's been indexed.
[AGENT][NEUTRAL] OK. Let me check that with her, OK?
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello Miss [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] All right, thank you so much for holding. I just wanted to check back with you. I'm on the other line with claims and they're searching on the back end for your uh fax from the [PII].
[CUSTOMER][NEUTRAL] OK, because my confirmation, I, I faxed it to [PII] at [PII] and it was uh uh sent and it the confirmation told me it was sent [PII] and y'all received it.
[AGENT][NEUTRAL] OK, hold on one moment, OK?
[CUSTOMER][NEUTRAL] Ma'am, can I speak with the lady who do my claim cause you don't, you don't do my claim, so can I actually speak with the lady who's doing?
[AGENT][NEUTRAL] You sure can. Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hey [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] She's now asking, can I, can she talk to the person who uh examines her claims because that's not me.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, so I'm gonna see who processed her last claim and try to get her with them.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, sounds good it's [PII].
[AGENT][POSITIVE] All right, thank you so much. It's [PII].
[CUSTOMER][POSITIVE] No problem, uh huh, no problem, mhm, bye.
[AGENT][POSITIVE] Alright, thank you.
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEGATIVE] It's tension all around. This is ridiculous.
[AGENT][NEGATIVE] I hope y'all listening cause it's a hot mess.
[AGENT][NEUTRAL] She's away, of course.
[AGENT][NEUTRAL] How does she spell her name?
[CUSTOMER][NEUTRAL] Transferring.
[AGENT][NEGATIVE] I can't do this every day.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Hey, [PII], this is [PII] on the care team. How are you doing?
[CUSTOMER][POSITIVE] Doing well [PII] thank you how are you?
[AGENT][NEGATIVE] I'm OK. Um, I have a, I don't know, frustrated customer on the line. Um, she faxed in two faxes, one on [PII], 1 on the [PII]. We don't have the one from the [PII], but I do see the one from the [PII], um, but she has a confirmation, so she's bent on that. Misty tried to help, but she didn't see it either. Um, she's now asking to speak to the examiner who processes her claim, but [PII] is away. So is there any other solution?
[AGENT][NEUTRAL] To get her to speak to somebody.
[CUSTOMER][NEUTRAL] Um, go ahead and give me the policy number.
[AGENT][NEUTRAL] OK. It's 620.
[AGENT][NEUTRAL] 424.
[CUSTOMER][NEGATIVE] And so she's just upset that we don't have the facts. I mean if we don't have it, we don't have that, but.
[AGENT][NEGATIVE] I mean, I think she's just upset period at this point because I, I'm just checking faxes and she's mad, so I think she's just upset um and she has that confirmation there that it was sent successfully, but that doesn't mean we received it successfully, but you know, um.
[CUSTOMER][NEUTRAL] So we ask for information?
[AGENT][NEUTRAL] Yeah, um, so she's gonna be, I guess it sounds like the, however long she was supposed to be out is being extended, she's not returning to work and that's what was sent on the [PII], the doctor's note with everything.
[AGENT][NEUTRAL] But we don't see it.
[CUSTOMER][NEUTRAL] OK, let me, and what was that I'm, I'm pulling it up now.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What was sent in.
[CUSTOMER][NEUTRAL] I mean I'm not really sure what I can help her with. I mean, honestly I don't, I'm not trying to be mean. I just, I don't know.
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm gonna look at what was sent in on the [PII].
[CUSTOMER][NEUTRAL] So we just needing it looks like the doctor's form is that what it is?
[AGENT][NEUTRAL] Mhm. And she said it was the um the doctor has filled out and has a note to it too, um, as to why she's not returning to work.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] If anything, you know what, let me see.
[CUSTOMER][NEUTRAL] I was gonna look and I'm looking to see if it's something that maybe wasn't indexed.
[AGENT][NEUTRAL] That's what Misty said.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But I don't think she didn't either. I don't think she saw it, but by the time I got back on the phone, the lady had or the, the insured had asked to speak to her examiner. So it looks like [PII]'s on lunch though. I think I should just have her call her back? Oh Lord, I don't know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, well, I mean, the best case scenario I guess is that we can try to contact the doctor's office and ask him to fax it again. If we don't have it, we don't have it. Um, I'm gonna, um, suggest that to her. I'll get the phone number from her doctor's office and I mean, I, that's the only thing I can think of to try to comfort her or whatever and calm her down, you know.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, that would probably be the best case scenario is that we extend that offer to contact them and see if they'll, uh, resend it to us since we don't have it. Um, I think I have the doctor's information, but I'll just, um, I'll speak to her and, and let her know that that's, um, our only solution at this point. So if you wanna go ahead and she's been verified and all that, correct?
[AGENT][NEUTRAL] 56
[AGENT][POSITIVE] Yes, she's totally verified.
[CUSTOMER][NEUTRAL] And that's her number there, the [PII] number or [PII]. OK, OK, you can go ahead and transfer her and I'll try to, like I said, intervene with the doctor and see if we can get the information resent, OK.
[AGENT][NEUTRAL] 3604. Mhm.
[AGENT][NEUTRAL] Get it.
[AGENT][NEUTRAL] OK. Thank you, [PII]. Hold on one moment, OK?
[CUSTOMER][NEUTRAL] Sure, OK.
[AGENT][NEUTRAL] Hello [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Thank you so much for holding. I have [PII] on the line and she'll be assisting you further, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hi Ms. [PII]