AccountId: 011433970860
ContactId: 12fd8e46-a8e4-48ee-b9c1-58f0e2b38b8d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 848020 ms
Total Talk Time (AGENT): 371872 ms
Total Talk Time (CUSTOMER): 256143 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/12fd8e46-a8e4-48ee-b9c1-58f0e2b38b8d_20250128T20:57_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I just wanted to check on a claim please.
[AGENT][NEUTRAL] I can help you with the claim. Can I please get your name and your call back number?
[CUSTOMER][NEUTRAL] Yes ma'am, I'm [PII]. It's [PII], and I'm calling on behalf of my husband [PII], and he has sent in a form to speak with me.
[AGENT][NEUTRAL] OK. Can you please give me the policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I I had it written down somewhere.
[CUSTOMER][NEUTRAL] I can give you, I don't have it with me. I thought I had it. I'm at work and I don't have it with me.
[AGENT][NEUTRAL] OK, do you have [PII]'s uh social security number?
[CUSTOMER][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me see if I can find the policy that way. When did he send in the um authorization, the third party authorization, do you know?
[CUSTOMER][NEUTRAL] It's been about
[CUSTOMER][NEUTRAL] About 2 weeks or so.
[AGENT][NEUTRAL] OK I just wanna make sure if had time to.
[AGENT][NEUTRAL] Be updated for you.
[CUSTOMER][NEUTRAL] Yeah, I called and she told me to wait till Monday.
[AGENT][NEUTRAL] OK, and um which policy are you calling about for the claim?
[CUSTOMER][NEUTRAL] It's a disability.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think I saved it up in the email. I, I do have the policy. I'm sorry, I have it. I just looked on the email. OK.
[AGENT][NEUTRAL] I've got it pulled up.
[AGENT][NEUTRAL] Got it pulled up right here. I just need to verify.
[AGENT][NEUTRAL] The HIPA form.
[AGENT][NEUTRAL] OK, I'm not showing that the third party release has been updated to the policy yet.
[CUSTOMER][NEUTRAL] You're saying daily? I'm not sure which.
[CUSTOMER][NEUTRAL] Cause
[AGENT][NEUTRAL] The third party release is not on the policy. Is [PII] there?
[CUSTOMER][NEUTRAL] You saying you don't have my name cause I've been.
[AGENT][NEUTRAL] No, ma'am, it's not on the policy at this time. Let me check the other policies and see if it got loaded on one of those.
[CUSTOMER][NEUTRAL] Yeah, you send it
[CUSTOMER][NEUTRAL] It's got loaded on the very first one. I didn't think he had to do one for every, every time he's right here. I'm on there, but.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If you don't see me, that's fine, but I, I, I know I'm there.
[AGENT][NEUTRAL] OK, I'm checking.
[CUSTOMER][NEUTRAL] That's why he did it.
[CUSTOMER][NEUTRAL] If I have to wake him up, I will.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I'm looking to see on the other policies if it got loaded. Usually when they load them though they load them on all of them so.
[AGENT][NEUTRAL] I just wanna just double check just to make sure before you have to wake him up.
[AGENT][NEUTRAL] Yeah, I'm not showing that you're on the policy for third party at this time.
[AGENT][NEUTRAL] That's not to say that it's not in progress.
[CUSTOMER][NEUTRAL] That, that
[AGENT][NEUTRAL] Because usually it takes 7 to 10 business days to be able to completely finish it.
[CUSTOMER][NEUTRAL] OK. So
[CUSTOMER][NEUTRAL] It's been, it's been uh.
[CUSTOMER][NEUTRAL] I just talked to somebody Friday.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And they told me to call back Monday.
[AGENT][NEUTRAL] That's OK if you can get [PII] and just let me get the verbal consent to be able to talk to the policy about the policy we can look up the claim together.
[CUSTOMER][NEUTRAL] OK, she
[CUSTOMER][NEUTRAL] She said I'm not on there, but every time I talk to other people, they say I'm on there. I what the disability speak.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hi, [PII], this is [PII]. Hello, [PII], this is [PII].
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] is so low.
[AGENT][NEUTRAL] Can you please uh verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Why is it so low?
[AGENT][POSITIVE] Thank you, sir. And then can you
[AGENT][NEUTRAL] And can you also verify your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then also your email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] No, you didn't. Uh, it should be [PII], the one you said it's under yours. [PII] [PII].
[AGENT][NEUTRAL] No, you're you're giving me the correct one. No, you're giving me the correct one, [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] OK, well that's my email address, yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, can you
[CUSTOMER][NEUTRAL] OK, it's [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you, sir. And I have your verbal consent to discuss the policy today with Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you [PII] I appreciate it.
[CUSTOMER][POSITIVE] Alright, no problem. It went on speakerphone.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] You take care, sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I hope you, I hope you get to feeling better.
[CUSTOMER][NEUTRAL] Yeah, me too.
[CUSTOMER][NEGATIVE] I'm getting sick and tired of this day.
[AGENT][NEGATIVE] You're getting sick and tired of being sick and tired.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Yeah, I'm sitting around, ain't got no money. Everybody dragging me through the dirt.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Oh, well, hopefully you'll be better soon.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Get back in that saddle again.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right. Thank you, sir.
[CUSTOMER][NEUTRAL] You told me I didn't tell them nothing we had to do. I was just trying to get information on what they scheduled it.
[CUSTOMER][NEUTRAL] I don't think she know she don't need to know all your doctors are going. OK.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so you want, you're wanting claim information for him. I'm showing that the last claim reported was on [PII].
[AGENT][NEUTRAL] And I'm showing that it's been processed and paid.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me tell you $500.
[AGENT][NEUTRAL] And if it process it's gonna have to process overnight tonight did you guys set up for direct deposit?
[CUSTOMER][NEGATIVE] No, nobody's ever told me that. No.
[AGENT][NEUTRAL] OK. So it's, it's going to need to process overnight, um, and the check should go out.
[AGENT][NEUTRAL] In the next 3 days.
[CUSTOMER][NEGATIVE] OK, but now, um, we just, I went to a doctor with him, um, because he's not getting any better.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the doctor will not release him, so I guess we, so we gotta do another paperwork claim.
[AGENT][NEUTRAL] Yes, ma'am. You have to do them every month until he's released.
[AGENT][NEUTRAL] You have to go through the same thing every single month until he's released.
[CUSTOMER][NEUTRAL] OK, but she just wrote up a doctor's excuse. Would that not work since I just filled, he just had them to fill that out?
[AGENT][NEUTRAL] No, ma'am. You'll have to fill it out again. The doctor will have to fill out his portion stating that he still needs to be on disability.
[CUSTOMER][NEUTRAL] For this month
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEGATIVE] Can you email me because she said that I didn't have the right paperwork last time, that's what they told me and I don't understand how everybody else talks to me then.
[CUSTOMER][NEUTRAL] You tell me I'm not on there.
[AGENT][NEUTRAL] No, ma'am, you're not, you're not on there as far as um having the third party HIPAA.
[AGENT][NEUTRAL] Now, you said you just sent it in about 10 days ago, right?
[CUSTOMER][NEUTRAL] I'm not talking.
[CUSTOMER][NEUTRAL] No, I'm, I'm talking about asking information about the claim. I'm not talking about it.
[AGENT][NEUTRAL] Well, in order for us to.
[AGENT][NEUTRAL] Be able to give you information about a claim we have to have the third party HIPAA form filled out, which you said that you guys have already done, but I'm not showing that they have added you onto the policy to discuss anything about the policy without that form being being uploaded.
[CUSTOMER][NEUTRAL] OK, let me ask you one last question. Do I have to do that form for every claim?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] No ma'am, once that form is uploaded, there's a place that I can go into or anybody else can go into and look to see if you're on the policy as as being able to speak to you.
[AGENT][NEUTRAL] Your name would be there's a certain area that we go and look to see if if your name's on there so we can talk to you if your name's not on there then we have to verify with the insured and that verification lasts for a day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, the first time I did it, I did it in [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you filled out the form and sent it in?
[CUSTOMER][NEUTRAL] Mhm mhm.
[AGENT][NEUTRAL] Well I'm not showing that we have it.
[AGENT][NEUTRAL] Let me
[AGENT][NEUTRAL] Yeah, because it's not been uploaded as far as I can tell to put your name in there so that we can go and look to make sure that you he's released the information to you.
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] Yeah, I'm looking. It was done on [PII]. I have a copy of it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, can you uh email that in again, the copy that you have just email it in?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me give you the email address, that way the email goes quicker let me give you the email address.
[CUSTOMER][NEUTRAL] Are we talking about the same claim that says authorization to request information included protected health information.
[AGENT][NEUTRAL] Right. Does it say third party?
[AGENT][NEUTRAL] Release form.
[AGENT][NEUTRAL] For HIPAA third party release form?
[CUSTOMER][NEUTRAL] I don't know if it doesn't say third party. It just says disability claim form.
[AGENT][NEUTRAL] Mm, let me look and see if we're talking about the same thing because we actually have a third party release form that he could fill out and then we put your name on the policy to where every time you called you wouldn't have to go through.
[AGENT][NEUTRAL] The verification and his um getting his consent to talk.
[CUSTOMER][NEGATIVE] Well, this is, this is the first time I had to get consent form. I don't understand why everybody else is giving me information until today.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEGATIVE] Well, honestly it's a HIPAA violation. If I were to give you information without his consent, that's against the law.
[AGENT][NEUTRAL] So let me look at this form and make sure you've got the same one.
[AGENT][NEUTRAL] It says authorization for disclosure of protected health information from APL.
[CUSTOMER][NEUTRAL] Yes, that's what I have.
[AGENT][NEUTRAL] OK, let me have you email that back in again just to make sure.
[AGENT][NEUTRAL] Let me give you the email address.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK, it's [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] The sign
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and just go ahead and send that back in, give it 7 to 10 business days, and they should have it uploaded into his policies that so that you don't have to have him verify every time.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][POSITIVE] Uh, you're very welcome. I hope you guys have a wonderful day and thank you for calling APL.