AccountId: 011433970860
ContactId: 0a297040-dfd7-4d74-9fb2-f8d8f6f7d6d7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 512739 ms
Total Talk Time (AGENT): 227216 ms
Total Talk Time (CUSTOMER): 162981 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/0a297040-dfd7-4d74-9fb2-f8d8f6f7d6d7_20250213T18:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] with the care team. How are you doing today?
[AGENT][POSITIVE] Good, how are you?
[CUSTOMER][POSITIVE] Hey, I'm great. I got a quick question for you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I was referred to you, so I am, I have a broker who emailed me asking for every EOB for all of their insured on all three of their policies, and my supervisor, um, just wants me to know, or she said to contact you guys and ask if the brokers can access this via the OSC, um, and if so.
[AGENT][NEUTRAL] Yeah, uh.
[CUSTOMER][NEUTRAL] Can we provide training to them so that way it's something that they can get themselves.
[AGENT][NEUTRAL] I don't think, hang on, I don't think we want them to have access to that because it's personal information, so hold on just a second, let me.
[CUSTOMER][NEUTRAL] It's
[CUSTOMER][NEUTRAL] No worries. It doesn't look like they uploaded it, like, so I don't think it would show up if it didn't come from their OC.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Right, we can't send them anything that they didn't submit, but let me just look at their little help sheet real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But that's a good question. We need to know.
[CUSTOMER][NEUTRAL] It's for one of our broker hot list um brokers under [PII].
[AGENT][POSITIVE] Entertaining room, OK, let's see.
[CUSTOMER][NEUTRAL] Yeah, it's Ms. [PII] and it looks like only 4 EOBs. It wouldn't be difficult, but just seeing.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] I don't think we give that information out to them unless they uploaded it themselves. I believe it from conversations that we've had in the past when I was on the claims team. So let me just look and see.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][POSITIVE] I'm pretty sure you're right. You're right on the money, but I don't wanna disappoint a hot list broker, um, with, you know what I mean, without the touching base with you.
[AGENT][POSITIVE] Oh yeah, for sure.
[AGENT][NEUTRAL] Yeah, let's see. Hang on just a 2nd. 1st file a claim. You upload documents and so file a claim, then selected it. OK. Once you verify the claim and policies, click select files to choose. OK, tells them to do that confirmation.
[AGENT][NEUTRAL] So yeah, so they can only see anything that they submitted and pulled off the portal because they'll have like a it'll show whenever they submit it that it was submitted by the broker.
[AGENT][NEUTRAL] And then they can, they can only view what they uploaded um all other claims information is accessible only on the employee side online so the employee would have to log in on their side to be able to do that um they wouldn't be able to see anything that they didn't submit.
[CUSTOMER][NEUTRAL] OK, so they can only see UOBs from claims they submit.
[AGENT][NEUTRAL] Yeah, it says on the document, your your dashboard will only display details for claims you have submitted on behalf of the employee. All other claim information is accessible only to the employee.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, would you recommend that I maybe email them a copy of the third party authorization form and have them get that filled out from both insured so we can submit you know be to them?
[AGENT][NEUTRAL] I'd, yeah, yes, absolutely, because we don't wanna really, cause we don't know if the employee wants them to have that or not, you know what I mean? That's what I would do.
[CUSTOMER][NEUTRAL] OK, so for each insured, um.
[CUSTOMER][POSITIVE] OK perfect I will go ahead and do that. I definitely just wanna make sure I really just don't wanna like peeve off a a broker that we, you know what I mean, really try to take care of so.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm, right.
[AGENT][NEUTRAL] Yes, yeah, yeah, I mean if they, if he, you know, if they get, are you on the phone with him or is it just an email?
[CUSTOMER][NEUTRAL] It's just an email.
[AGENT][NEUTRAL] OK, let me, is it [PII], is that your last name?
[CUSTOMER][NEUTRAL] You want me to speak to somebody.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, yeah, so I pulled, I just sent you an IM, so this kind of just tells them what they have access to, but for HIPAA, I don't think we would give them the insured's personal explanation of benefits unless the unless they, I mean, I know I would have to have authorization from the customer to release that.
[CUSTOMER][NEUTRAL] No, I was
[CUSTOMER][NEUTRAL] OK perfect so I will send them the third party authorization form, um, alternatively, the insured can call us and give us verbal authorization and we can email it.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] OK, I'll go ahead and I'll give them a list of things that we can do and how we can do it um and just let them know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, is there anyone in your department you want me to CC on that email, or do you want me to just send it as is?
[AGENT][NEUTRAL] Um, you can send it as, I mean you can CC me on it if you want, or, or APL sales, and then we can, um, you know, if we have any pushback on it, then that should be fine but we wouldn't let me hang on just a second, let me check it some one other thing. Hang on a second.
[AGENT][NEUTRAL] Give me just a second. Let me ask [PII] cause she's familiar with [PII]. Hang on.
[CUSTOMER][POSITIVE] You're OK.
[AGENT][NEUTRAL] Which agent which which agent is that? Is it [PII]?
[CUSTOMER][NEUTRAL] Yes, it's [PII] with Crescent City Benefits.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry.
[AGENT][POSITIVE] Good grief.
[AGENT][NEGATIVE] My typing skills are terrible today.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just a second.
[CUSTOMER][POSITIVE] You're totally fine.
[AGENT][NEUTRAL] Is this from an email or a phone call? You said it was an email, right?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, an email.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you said you're also reaching out to your supervisor, is that correct?
[AGENT][NEUTRAL] I'm asking [PII]. She's one of our senior broker partners over here and a broker, a broker resource, and she, um, she's familiar with him. Can you please place it in the [PII] folder? No, it's.
[AGENT][NEUTRAL] It's not in our department.
[AGENT][NEUTRAL] The care team is trying to respond to an email.
[AGENT][NEUTRAL] I mean just, she may have you forward it to us hang on just second.
[AGENT][NEUTRAL] That's fine. Please just direct the email just send it to me and I'll put it in the, um, I'll put it in the put send it to me. I'll send it. Oh, we will put it in the um APL sales folder. Just send it to [PII].
[CUSTOMER][NEUTRAL] OK, so to forward the email directly to you and then you guys from there perfect. Will you, um, if there's different direction you guys want us to do in the future, would you, um, mind messaging out to [PII]? She's the supervisor for the email department.
[AGENT][POSITIVE] Yes, yeah, we'll take care of it. We'll take care of it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, yeah.
[AGENT][POSITIVE] Yeah, we probably should get with them to figure out how to handle that so you guys are running into that in the future and we all are clear on what we can and can't do so yes definitely we'll get with you on that.
[CUSTOMER][POSITIVE] OK perfect thank you so much I will go ahead and forward that to you now OK?
[AGENT][POSITIVE] Mhm. Thank you, thank you.
[CUSTOMER][POSITIVE] Yeah my pleasure bye bye.
[AGENT][POSITIVE] Have a good day. Uh bye-bye.