AccountId: 011433970860
ContactId: 05b6067d-5202-4033-9ad3-9877b3eae6d6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 447220 ms
Total Talk Time (AGENT): 191543 ms
Total Talk Time (CUSTOMER): 174663 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/05b6067d-5202-4033-9ad3-9877b3eae6d6_20250326T21:33_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How you doing?
[AGENT][POSITIVE] I'm good. How are you, [PII]?
[CUSTOMER][NEUTRAL] I'm doing good. I need to transfer this call to you. Um, the member, it sounds like, so she said she sent the claim to American Fidelity. She's spoken to American Fidelity and they said they've uploaded everything, but I don't see anything since January.
[AGENT][NEUTRAL] Yeah
[AGENT][NEGATIVE] I mean if she sent it to American Fidelity and they've uploaded it, it's gonna be on their system. It's not gonna be on ours.
[AGENT][NEUTRAL] We don't share a system.
[CUSTOMER][NEUTRAL] But it's an APL policy.
[CUSTOMER][NEGATIVE] She sent it to the wrong, the post office sent it to the wrong place.
[AGENT][NEUTRAL] Weird
[AGENT][NEUTRAL] That is weird.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Very, very weird.
[AGENT][NEUTRAL] OK, hang on.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] What is that policy number?
[CUSTOMER][NEUTRAL] So it's 243-561-5.
[CUSTOMER][NEUTRAL] Yes ma'am, part one.
[AGENT][POSITIVE] Thank
[AGENT][NEUTRAL] She doesn't have any other policies.
[CUSTOMER][NEUTRAL] Mm mm.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh I mean she has a few.
[AGENT][NEUTRAL] They all lapsed.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do we know if the date of service was before her last day or his last day?
[CUSTOMER][NEUTRAL] Um, no, we don't know if the data services before the wait, hold on. I do know that she said that he had this, he had surgery in December. This is them resubmitting because they, the initial claim was denied.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] But she said she spoke with American Fidelity and they said that they uploaded everything and I'm like,
[AGENT][NEGATIVE] See, and that doesn't make any sense because.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEGATIVE] They don't have access to our system.
[AGENT][NEUTRAL] They would have had to have sent it to us through like email or something.
[CUSTOMER][NEUTRAL] So then I don't
[CUSTOMER][NEUTRAL] I'm not sure. That's all she told me.
[AGENT][NEUTRAL] OK, um.
[CUSTOMER][NEGATIVE] But just, I'm, I'm confused.
[AGENT][NEUTRAL] Is there any way that you can let them know that because I mean we don't have anything, you know we don't have anything, is there any way that you can let them know that we need to reach out to American Fidelity and um kind of verify and we can give them a call back.
[CUSTOMER][NEGATIVE] That one threw me for a loop.
[CUSTOMER][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] Um, let me do this because [PII] has instructed me to go ahead and transfer the call. So can you take this call for me, please? But I'll note the policy because I just don't want any issues.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] No yeah I understand OK.
[CUSTOMER][NEUTRAL] Um, but I'll go ahead and note the policy, everything she said, and yeah, I, I don't see anything.
[AGENT][NEUTRAL] OK, is it like uh the spouse or something for part one?
[CUSTOMER][NEUTRAL] Yeah, it's part two calling, um, his wife.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They're together, but we're talking to her.
[AGENT][NEUTRAL] Right, got you, OK.
[CUSTOMER][NEUTRAL] Alright, [PII], um hold on one moment let me get her.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Hello Mrs. [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much for holding. I have [PII] um on claims on the line with us and she'll be assisting you further, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] Hey Mrs. [PII], how are you?
[CUSTOMER][POSITIVE] Good, how are you?
[AGENT][NEUTRAL] I'm doing well. Um, so [PII] was stating that you all had resubmitted for Mr. [PII]'s surgery that occurred in December, um, and you spoke with someone with American.
[CUSTOMER][NEUTRAL] Yes, all the, all the.
[CUSTOMER][NEUTRAL] Uh, they give documentation that was required, it was mailed off in February.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And American Fidelity verified that they had it, and that they uploaded it on their system for that to look at.
[AGENT][NEUTRAL] OK, so the only.
[CUSTOMER][NEUTRAL] They said all they have to do is go in there and pull it out.
[AGENT][NEUTRAL] So the only issue is that American Fidelity and American public life don't share the same system. Um, we work on different systems because we're, while we're under the same.
[AGENT][NEUTRAL] Parent company we are we're different insurance companies, um, so if you're OK with it.
[AGENT][NEUTRAL] Can I try and reach out to American Fidelity and give you guys a call back to see what they have and if it needs to be sent to us like through fax or something.
[CUSTOMER][NEUTRAL] If you could please.
[CUSTOMER][NEUTRAL] Because like I said, well, can you get that information to them? Can you send me back the documents, the forms?
[CUSTOMER][NEUTRAL] And she says, we have already uploaded them in the system and they can just go in there and pull it and it'll be there for them. So if you could contact them and see what's going on.
[AGENT][NEUTRAL] I mean,
[AGENT][NEUTRAL] Yeah I'll I'll definitely contact them and see what's going on because um like I said we don't share the same system so if they've uploaded something um we uh we're not gonna be able to see it so I'll need to reach them and try to figure out um if they've uploaded it for a claim with them and they need to also send us a copy or what's going on that way we can really get to the bottom of what happened.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, yeah, if you can please call and find out because, you know, they did tell me it was there, so.
[AGENT][POSITIVE] OK, yeah, I definitely will.
[CUSTOMER][NEUTRAL] Like I said, I had mailed it to you to America uh public life, but for some reason the post office sent it to American Fidelity.
[AGENT][MIXED] Interesting. I don't know why they would do that.
[CUSTOMER][NEUTRAL] And it was signed for, and I, I don't know, I don't know.
[AGENT][NEUTRAL] OK, uh, when did you speak to American Fidelity?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, they
[CUSTOMER][NEUTRAL] A couple of weeks ago, it's gonna be, I believe.
[AGENT][NEUTRAL] OK, do you remember who you spoke to?
[CUSTOMER][NEUTRAL] And so I gave it a few days and I called last week.
[CUSTOMER][NEUTRAL] Uh, no, I sure don't.
[AGENT][NEUTRAL] That's OK, that's OK. Um.
[CUSTOMER][NEGATIVE] No, I thought I had sent information, but I don't.
[AGENT][NEUTRAL] That's OK. Alright, so, um, I don't know if I'll reach anyone today. I will try. It may be tomorrow before I'm able to contact you back just because, um, it's already 20 minutes till [PII] for our company and so I don't know if I'll be able to reach someone today so it may be tomorrow but I will give you a call back and let you know OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It could have been [PII]. I have her name [PII] here on the side, so it might be [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'll make a note of that for sure and just and just let them know.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All right then. Thank you.
[AGENT][POSITIVE] You're very welcome. Have a great evening.
[CUSTOMER][NEUTRAL] Uh, you too. Goodbye.
[AGENT][NEUTRAL] All right, bye bye.