AccountId: 011433970860
ContactId: 1c274288-b83d-440b-b2fc-73bbdd01ac16
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1886050 ms
Total Talk Time (AGENT): 805619 ms
Total Talk Time (CUSTOMER): 1043631 ms
Interruptions: 15
Overall Sentiment: AGENT=1.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/1c274288-b83d-440b-b2fc-73bbdd01ac16_20250421T14:32_UTC.wav
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[CUSTOMER][NEUTRAL] The disability
[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Is it [PII]?
[AGENT][NEUTRAL] Uh, [PII]
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, thank you, [PII]. I wanted to make sure I wasn't calling you by by another name. I'm calling for my, I know I've been called a lot of things too, but anyhow, I'm calling, uh, uh, for my husband who is sitting here, [PII], date of birth [PII].
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] There's a lot of names that sound similar. I appreciate it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, what was your name please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And I just
[CUSTOMER][NEUTRAL] Oh, I'm sorry, my name is [PII], but here we go, everybody calls me [PII]. See, they call me lots of things.
[AGENT][NEUTRAL] [PII], OK, got it. Um, really quick, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Got it, thank you. OK, and what can we help you with today?
[CUSTOMER][NEUTRAL] OK, I just called [PII], the HR person for Apple Green.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. And she told me to call you because [PII] fell, [PII], broke his arm, and he thought he had disability insurance. So we had all the paperwork filled out and I called her back this morning to say, did you get him and what's going on? And she informed us that we don't have disability has something called group accident.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] And so I was supposed to call you to find out if he had any benefits for that through the group accident.
[AGENT][NEUTRAL] I see. OK, yes, that can be a bit confusing. So I'll get that policy pulled up and we'll take a look at those benefits. Do you have that policy number by chance?
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 245
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 263 7
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEGATIVE] Yeah, they don't send you any paperwork when you sign up for this stuff or any information you just left out in the dark.
[AGENT][NEUTRAL] Oh my goodness, I know it really does depend on the groups and how they operate unfortunately um but I can definitely take a look at all of that, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] And there's a group number here too if you need it.
[AGENT][NEUTRAL] Oh no, that's OK. I was able to get it pulled up. Thank you though. Um, alrighty, so you are listed under this policy, so I can go ahead and just uh verify your information. Um, can I get your date of birth, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] OK, uh, what was your date of birth, please?
[CUSTOMER][NEUTRAL] Oh, I'm sorry. [PII].
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then uh can I get the mailing address please?
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] Your mailing address please?
[CUSTOMER][NEUTRAL] The mail, yes, yes, [PII].
[AGENT][POSITIVE] Perfect and last thing I need is the email address we've got on file and it looks like it might be [PII]'s uh [PII].
[CUSTOMER][NEUTRAL] OK, uh, your [PII], what's your Gmail account on Gmail.
[CUSTOMER][NEGATIVE] No, [PII]. Yeah, he thinks that's what hate passwords.
[AGENT][NEUTRAL] That's it.
[AGENT][NEUTRAL] I understand. Alrighty well I appreciate y'all verifying all of that information. OK, so tell me again, I'm sorry, uh, what exactly happened?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] He fell in the hospital parking lot and fractured his left humerus in three places.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Fracture, all right.
[AGENT][NEUTRAL] All righty. Bear with me just a moment. Let me take a look here.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes, just a minute, you wanna go outside.
[CUSTOMER][NEUTRAL] Like a little, our, our, our dog, a little 5 pound Yorkie, and I think she wants, she picked now to go outside. It's like, just a minute.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] That's so cute.
[AGENT][POSITIVE] My mom has 2 Yorkies. Oh my goodness.
[CUSTOMER][NEUTRAL] Yeah, she, she keeps
[CUSTOMER][POSITIVE] Oh, they're wonderful. They're so loyal.
[CUSTOMER][POSITIVE] And they sure are entertaining.
[AGENT][POSITIVE] Oh, they're funny. They are so funny, yes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Bear with me just a moment. I'm sorry. I'm trying to look, it can be pretty um particular about these so bear with me.
[CUSTOMER][NEUTRAL] That's a that's.
[CUSTOMER][NEUTRAL] Well, that's OK because I don't know why they sent us disability papers if we didn't have disability and the family leave.
[AGENT][NEUTRAL] I don't know either, um.
[CUSTOMER][NEUTRAL] Yeah, I know. It's, it's like they get, we get all these papers and it's like, leave of absence, FMLA and then the doctor had to sign, you know, his medical things as to what was happening.
[AGENT][POSITIVE] Oh, you had everything ready.
[CUSTOMER][NEGATIVE] Yeah, and then, and then I called back today, and I, and then she says, well, you don't have this ability. Well, why the heck did you send this form?
[AGENT][POSITIVE] Oh my goodness.
[AGENT][NEGATIVE] Oh my gosh, that is so frustrating.
[AGENT][NEUTRAL] OK, here we are all right, so fracture.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Of the humerus. So that is a covered benefit. Let's take a look.
[CUSTOMER][NEGATIVE] I just think, cause I sent, sent in a check for 5 weeks for his eye, dental and group accident, you know, cause you have to pay for that while you're off. And I'm like, well, if it's not gonna be something that's not covered, we might as well not have it.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Sure, yeah, OK, so the benefit amount for a fracture of the humerus is $1600. So if you were needing, did you get the correct claim form?
[AGENT][NEUTRAL] For accident?
[CUSTOMER][NEUTRAL] Heavens, no, I think.
[CUSTOMER][NEUTRAL] No, I got, I got FMLA LOA and the medical form for the doctor.
[AGENT][NEUTRAL] Everything for disability, I got you. OK, so.
[CUSTOMER][NEUTRAL] Whatever
[CUSTOMER][NEUTRAL] Yeah, and, and [PII]'s and [PII]'s already got all that. She got it.
[CUSTOMER][NEUTRAL] Th[PII] emailed and faxed it on this past Friday so she already has that she can send that part to you if you need that.
[AGENT][NEUTRAL] Um, let's take a look. So what we really need, of course I can go ahead and send you this correct claim form, uh, if it's easier I can send it to an email so you get it quicker, um, and then with that.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Unfort
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] I don't, if you, yeah, that's OK. We're old people and I'm, I'm not sure we'd be able to figure out the email. I, we do the paper kind of stuff easier, you know.
[AGENT][POSITIVE] No worries.
[AGENT][NEUTRAL] Sure, that's perfectly fine um so let's see, do you have access to a fax machine?
[CUSTOMER][NEUTRAL] Uh no, nope, unless we go to the doctor's office.
[AGENT][NEUTRAL] OK, OK, so I can just.
[AGENT][NEUTRAL] That's OK, um, so I can just fax you or sorry, I can just uh have a paper copy mailed to you then that is perfectly fine. Um, let me see.
[AGENT][NEUTRAL] And that was [PII], correct?
[CUSTOMER][POSITIVE] Correct, correct.
[AGENT][NEUTRAL] Alrighty, OK, I'll go ahead and have this claim form uh sent to you um on the form itself it will have a list of instructions and information that we need. Um, biggest thing is going to be of course the itemized statement uh for any treatment that he received regarding this, um, including, of course, the initial diagnosis, um, so wherever he went for treatment, they'll have that information.
[CUSTOMER][NEUTRAL] OK. So then, let me be sure I have this correct. You're gonna need an itemized statement. So he was seen in the emergency room at the hospital.
[AGENT][NEUTRAL] Uh-huh. Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Then he was sent home that day, and then that evening, his blood pressure dropped.
[CUSTOMER][NEUTRAL] And his heart rate went up, and I called EMS that same evening, he was transported back to that ER and admitted.
[CUSTOMER][NEUTRAL] And spent
[CUSTOMER][NEUTRAL] Uh, 4 nights, Wednesday night, Thursday night, 44 nights in the hospital, and then the follow up, then the follow-ups that we've had, I think 3 or 4 doctor's appointments.
[AGENT][POSITIVE] Goodness.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I need to go, cause we haven't received any billing, of course, from the hospital yet.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] So I need to call them and.
[AGENT][NEUTRAL] Yeah, that's
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And get, OK, for both the ER visit.
[CUSTOMER][NEUTRAL] And the hospital stay, and then I need to get up till now because he has
[CUSTOMER][NEUTRAL] An appointment
[CUSTOMER][NEUTRAL] In May, let me check for his follow-up. I can't remember. I told, I told [PII] all this, uh, his next ortho appointment is [PII].
[AGENT][NEUTRAL] OK. Um, honestly, I
[CUSTOMER][NEUTRAL] So I need, I need.
[AGENT][NEUTRAL] If you really, I'm so sorry to interrupt you, [PII]. Um, I'm going to put you on a brief hold if you don't mind because frankly, I'm not quite sure that we need all of that information, um, as it's just a one-time benefit. Well, that's just what I would think, you know, like I think, you know, of course, the initial um hospitalization and really where they determined that it was indeed uh fractured.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Oh good.
[AGENT][NEUTRAL] So if you'll give me one moment I'm gonna put you on a brief hold uh because I don't wanna give you any incorrect information. I'm gonna make sure and then I'll get right back with you.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I, I appreciate that. Thank you.
[AGENT][POSITIVE] Yes, ma'am. Thank you. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Ferring
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] over on the care team. How's it going today?
[CUSTOMER][POSITIVE] Yes, going pretty good, [PII]. How are you?
[AGENT][NEUTRAL] Doing all right, thanks. So I've got kind of a, a silly question. Um, I have someone on the line who uh accident policy, um, uh, it was a fracture of their arm. I see the benefit, um, in terms of the information they need to send us, apparently he's still receiving like going to the doctor, uh, for it. Would we just need that initial, um, statement showing that, you know, it was indeed a fracture?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, what's the policy so I can kind of see what the benefits look like?
[AGENT][NEUTRAL] Oh, sure.
[AGENT][NEUTRAL] Yeah, it's 2452637.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I guess he went to the ER, um, and then he had to go back and was hospitalized for about 4 days, and, you know, he's got continuous follow-ups and for me, I wouldn't think we would need all of that.
[AGENT][NEUTRAL] Is it just a one time payment?
[CUSTOMER][NEUTRAL] So for the fracture sales because this is a 21, so OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the ER.
[CUSTOMER][NEUTRAL] The initial that initial would be covered. Here's the thing, because of how this policy has everything laid out, there is a possibility that everything would be needed because he went to the ER for initial treatment and if he was not there for any length of time and they sent him home, whether they casted it or whatever then that let me see what the how the fracture pays like does it have to be.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Fixed or does it have to be just diagnosed? Let me see that.
[CUSTOMER][NEUTRAL] Because I think it has to be OK, we pay for an open reduction which is a surgical repair and but then it's like a usually a lesser amount if it's not a surgical repair.
[AGENT][NEUTRAL] Oh, I didn't know what that meant.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] Yes, so open reduction means surgical intervention was needed. They needed to go in and fix it surgically. Close reduction means yes, you do have a fracture, but we are able to um fix this without the need of surgical intervention. So dislocations can be done, yeah, so.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, I see.
[CUSTOMER][NEUTRAL] Every all the charges you see on the policy are gonna be for open reduction and then when you get to the bottom like specifically for um his policy it says close reduction is 50% of whatever the open reduction benefit is.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I see. OK, that's really good to know.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I had no idea that's what that meant.
[CUSTOMER][NEUTRAL] Yes, so that is.
[CUSTOMER][NEUTRAL] Yes, that is what that means. So if he had initial treatment in the ER he does have an ER benefit, um, so that would be able to be considered, um, and then if he was diagnosed there but no repair was done, like did he did I guess I'm trying to figure out because I don't want us to pay for a closed reduction and then he got.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Hospitalized and had to have an open reduction like do we know what the hospitalization was for?
[AGENT][NEUTRAL] It seems like that.
[AGENT][NEUTRAL] I'm not 100%. So I know that he initially went to the ER after he fell, um, and then he went home and then he had to go back and he said that he stayed there for 4 days. So I would imagine, you know, yeah. So that's what it sounds like to me.
[CUSTOMER][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, so I would say at least the initial ER and his hospital stay information will need because he also has admission and confinement when due to an accident. So for sure those two as far as follow up visits, let me see.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Does he have anything for that? Sometimes they do and sometimes they don't. I don't, I mean, he has X-ray major diagnostic exam like I'm sure all of that was done either in the ER while he was there. Mhm. So I don't see what is extended treatment? Let me double check that because I don't know if that's gonna be considered like.
[AGENT][NEUTRAL] Initially, yeah.
[CUSTOMER][NEUTRAL] Follow up visits after an accident or if that's just let me double check our definition for that because if that is inclusive of follow up visits then I would say yes and then everything you know like get as much as you can OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I would think so too, OK.
[CUSTOMER][NEUTRAL] So it says extended treatment um is for each day a covered person receives chiropractic, acupuncture, or mental health services for treatment as the result of an accident. So I don't think it would cover.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] His fracture follow up and him making sure he's healing correctly so I don't, I don't think so.
[AGENT][NEUTRAL] OK, I might just err on the safe side though and go ahead and tell them to send it.
[CUSTOMER][NEUTRAL] But if he's getting physical therapy, he has that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] So I mean there's a whole number of things that we can consider we just don't know what those follow ups are inclusive of and physician's office visit even though it's not the initial it says that we will pay.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] For each day a cover person receives treatment from a physician or medical professional in their office due to the result of an accident. Treatment must occur within 30 days. So if, if he's following up regularly and it's payable up to 10 days per plane year per person.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so let me ask you this.
[CUSTOMER][NEUTRAL] So it doesn't have to be initial for physician's office. So I would say yes, submit everything.
[AGENT][NEUTRAL] OK, let me ask you this then, um, because she said I guess he has another appointment, a follow up, uh, coming up in May. Should they wait and submit all of that at once or is it OK to submit that after?
[CUSTOMER][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] Yeah, go ahead and submit all the things.
[AGENT][NEUTRAL] OK, so they can go ahead and submit what they have now and then the follow up they can do separately.
[CUSTOMER][NEUTRAL] Now.
[CUSTOMER][POSITIVE] Yes, they can submit as they have them.
[AGENT][NEUTRAL] I got it. OK.
[AGENT][POSITIVE] Got it. OK. I really appreciate your help. I always like getting you. You are just always so informative and but really I, I can't tell you how much I appreciate it. Thank you.
[CUSTOMER][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] No problem at all anytime anytime if you have any more questions, OK.
[AGENT][POSITIVE] Alright, I will let her know. Yes, ma'am. Thank you. All right, bye.
[CUSTOMER][NEUTRAL] OK. All right. Bye.
[AGENT][POSITIVE] Alrighty Miss [PII] I'm so sorry about that wait are you still with me?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] OK, so that was a very informative and um I learned quite a bit myself so that's that's good so in short um we kind of dissected the policy a bit more and um just to put it simply submit everything the reason is there are and could be additional benefits outside of just this.
[CUSTOMER][NEUTRAL] I'm here.
[CUSTOMER][NEUTRAL] Well, yeah.
[AGENT][NEUTRAL] One benefit for the um fracture itself, such as uh emergency room visits, uh, hospitalization, even physician's office visits. So submit everything because you could absolutely get um even for like X-rays, um, which I'm sure they did initially, um, but there's all kinds of benefits just, so I would absolutely submit everything. Um, I know you said even the follow-up visits, they can be, uh, filed separately.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So if you would like, as soon as you get the claim form and these other uh documents from, you know, the emergency room and hospitalization, uh, you can send all of that all together and then if he requires more visits, even, you know, I know you said there's one in next month um and you know if he has more after that, you can still submit those uh separately.
[CUSTOMER][NEUTRAL] I'm writing this down.
[AGENT][NEUTRAL] Oh, no, you're fine, you're fine. That is quite a bit.
[CUSTOMER][NEUTRAL] Yeah, cause I know they had mentioned something about um
[CUSTOMER][NEUTRAL] Checking out for physical therapy, um, but kind of
[AGENT][POSITIVE] Yes, in which case that is absolutely going to be covered as well.
[CUSTOMER][NEUTRAL] OK, cause it, it was confusing because
[CUSTOMER][NEGATIVE] I guess this really takes me by surprise. He fractured it in 3 places and no surgery.
[CUSTOMER][NEUTRAL] And it's like, what?
[AGENT][NEUTRAL] Oh, that's what I was gonna ask you that as well. Um, especially with him being in the hospital for 4 days, so he didn't have a surgery?
[CUSTOMER][NEUTRAL] And they said they
[CUSTOMER][NEUTRAL] Yeah, they
[CUSTOMER][NEUTRAL] No, because they, they state that if you have surgery,
[CUSTOMER][NEUTRAL] And if you do not have surgery, your recovery time, if you follow directions, is, is approximately the same amount of time.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But if you have surgery, then you have the risk of, are you gonna make it through surgery? Are you gonna get an infection, you know, and then you got all this extra hardware. That's how they explained it to me. So, it is.
[AGENT][NEUTRAL] I see.
[AGENT][POSITIVE] Right. Interesting. OK.
[CUSTOMER][MIXED] Yeah, it is starting to heal some, anyhow, but the question on the physical therapy was, you don't want to start moving it around because it's fractured in, it looks like a tripod. You got one bone, but it's split in three places. And it looks like tripod legs. And I'm like, how the heck is that gonna heal if you don't put 90 mile an hour tape on it real tight? What?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm trying to picture this, you know. So they, they're, they're good, you know, I, you gotta ask simple questions, right? What?
[AGENT][NEUTRAL] I know.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Absolutely, absolutely, yes, so that being said.
[CUSTOMER][NEUTRAL] Yeah and then and then and then he.
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][POSITIVE] And he ended up also, because of the fracture, he had to have 3 units of iron IV and a unit of blood while he was in the hospital during those 4 days. So it, it's, it's been a, a fun trip.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] It sure sounds like it, my gosh. So that being said, just to set this expectation, um, that $1600 benefit for the fracture was if it required a surgery. So there is still going to be a benefit. I believe it was about, um, if it did not require surgery, I think it was, um, let's see, I can go back and find it.
[AGENT][NEUTRAL] Uh, I wanna say it was 50% or 60% of that if it was um not a surgery. But again, you still, there are still several other benefits as well, including benefits for staying in the hospital, being admitted to the emergency room, um, all these diagnostic tests. So it will still be, um, significant, um, to submit everything.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now I have one really big question. If I have questions about all this, is there a way I can call back and talk to you since you already know all this, or do I just get a random person?
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] You most of the time if you call this number you would I don't have my own direct line you can ask for me if you'd like but I will say I will be making um a note on [PII]'s account uh regarding all of this information um including that I will be sending you this claim form um and so realistically anybody you get would be able to help you they're all pretty great um honestly, but if you prefer you can ask for me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, sometimes it's easier because, you know, I, I dealing with things where you talk to, that's just like talking to [PII], talking to the medical records person, and then it's like, well, can you give me a brief history of what's going on? I'm like, can you not just read the chart that I, and it gets frustrating after a while. And then when [PII], when [PII] said that this morning, I'm like, well why'd you send me all those papers if it doesn't even
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I understand.
[AGENT][NEGATIVE] Yeah, that is really frustrating.
[CUSTOMER][NEUTRAL] I, you know, it.
[CUSTOMER][NEUTRAL] This happened [PII]. It's like, Lord have [PII].
[AGENT][POSITIVE] Oh my goodness. No kidding.
[CUSTOMER][NEUTRAL] But anyways, OK.
[CUSTOMER][NEUTRAL] So I will go ahead and, and get started before I get the papers, go to the hospital and see about getting an ER and an inpatient.
[CUSTOMER][NEUTRAL] Print out and then also from the ortho doctor.
[AGENT][POSITIVE] Absolutely and I will say of course it yes and I will say you know of course the mail can be a little bit hard to um track how long it might take for you to get it. I would say at the most to allow a couple of weeks just in case because you know you never know um but if if after a couple of weeks you've not received it uh give us a call back and we can absolutely send that again um.
[CUSTOMER][POSITIVE] So I'm ready.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me just a moment, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see, I'm trying to find.
[CUSTOMER][NEGATIVE] And then I can always ask at the doctor's office if they can fax everything all at the same time. But nowadays, they charge and we had to pay, see, that's another thing, had to pay $35 to have all those forms we already had that we didn't need filled out.
[AGENT][POSITIVE] Absolutely.
[AGENT][POSITIVE] Right. Oh my gosh, yes.
[AGENT][NEUTRAL] Well it's whatever is easier for y'all whatever is easier for y'all is perfectly fine um and I will say this as well and it's completely up to you but we also have an option to set up direct deposit for this, uh, for the benefit amounts so in that case, once this has completed processing, it can, you know, of course depending on your bank you would get it within about 2 to 3 business days I would assume no longer than that, um, if otherwise we would send a paper check in the mail.
[CUSTOMER][NEUTRAL] It's like, oh my.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So, you know, that, that's completely up to you what you would prefer.
[CUSTOMER][POSITIVE] Yes, and good, good luck with that.
[AGENT][POSITIVE] I, that's exactly my thoughts. I know some people, um, you know, they, they're like, no, but I'm like, I feel like it's safer and quicker, so.
[CUSTOMER][POSITIVE] Yeah, it a direct direct.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, so if you'd like I can send you that form as well, uh, with this, OK, absolutely I will get that sent as well. OK, I'm trying to, I think we, uh, I think that about covers it unless you had any other questions for me.
[CUSTOMER][NEUTRAL] Yes, I know.
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEGATIVE] Uh, no, unless you have, you're on that end of the, this mess. I'm on the end of taking care of him. It's like, can we just get an easier plan, a smoother, quicker,
[CUSTOMER][NEUTRAL] I mean, this was crazy to me. It's like, why did we go through all this?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, I will say just to hopefully if it alleviates any confusion this is the only policy that y'all have with us and so that you're aware you are also covered under this policy. So if anything were to happen to you as well, you can still file claims.
[CUSTOMER][NEUTRAL] It it it so I.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] 00, well he did, like I said, I kept on him when he wanted to sign up for this, and he talked to the tax lady about the 401 and all that. And, you know, we researched things, but then I'm like, well, where's the policy?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] And then you call and there there was no HR person available to talk.
[CUSTOMER][NEGATIVE] And it's like, how are you supposed to figure this stuff out? I mean, you know, I can make my own benefits up, but it, it's just
[AGENT][NEUTRAL] Right, yes.
[AGENT][POSITIVE] Well, and I can absolutely send you a copy of this policy as well if you'd like. Um, it's very easy to read, it's not a bunch of jargon, it's very um clear cut and dry, you know, what is and is not covered. Now granted it's, it's a bit long because it quite a bit of things are covered, um, but that way you've kind of got that for your records.
[CUSTOMER][NEUTRAL] Well, that
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, cause we, like I said, with the eye and the dental, we had no, no idea. Well, what does it cover? Well, I don't know. What, what do you mean you don't know?
[AGENT][POSITIVE] Oh my goodness.
[CUSTOMER][NEUTRAL] Yeah, it's
[CUSTOMER][NEUTRAL] And I I said that bless his heart, 75 years old, and he, he can't sit still, so he wants to work and he shows up every day, goes in early, and it's like, what is the matter with you people? We're old folks and we know it should be easier than this.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] You're absolutely right, that is a lot.
[CUSTOMER][NEUTRAL] So, but you know, it's.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][POSITIVE] Yes, well, it's been a pleasure talking to you, [PII], and I'll keep an eye out.
[AGENT][NEUTRAL] Oh, you too, Corin.
[CUSTOMER][POSITIVE] Um, for these forms and, and see if I can find, see if I can sweet talk somebody in the faxing them so it makes it quicker to get it back to you than the mail.
[AGENT][NEUTRAL] Absolutely and all of our information um our fax number and such I can give that to you it's also going to be on the claim form as well along with our uh mailing address but I can go ahead and give you that now if you'd like.
[CUSTOMER][NEUTRAL] Oh, I need
[CUSTOMER][POSITIVE] Sure, go ahead. I'm ready. I got pen and paper ready.
[AGENT][NEUTRAL] OK, yes ma'am. All right, so our fax number is [PII].
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty and then our mailing address.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] OK. No, that's fine. Go ahead.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, mailing address is [PII].
[AGENT][NEUTRAL] 248.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that is in [PII], [PII].
[AGENT][NEUTRAL] Zip code is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. [PII], [PII].
[AGENT][POSITIVE] Correct, yes ma'am.
[CUSTOMER][NEUTRAL] Well, see, I'm old but I can follow directions.
[CUSTOMER][NEGATIVE] But unless you give me these crazy ones and then you tell me you didn't need all 26 of those papers filled out.
[AGENT][NEUTRAL] Jump through hoops. On the left hoop. Do the, yeah, I know what you mean.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] It's like, are you serious? It's, come on people. Well, anyhow, it has been a pleasure, pleasure talking to you, [PII], and I thank you very much and hopefully by the end of the year, we'll have something figured out.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Oh, you too.
[AGENT][POSITIVE] Uh, it'll be sooner than that, I promise, um, if you have any other questions at all, definitely give us a call back we're gonna do what we can to help you all out through this.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, and when I mail it back, you gave me the mailing address do I send it to group accident?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Um, you could either put, sure, um, APL or, uh, claims department. I would put APL. That's, that's perfectly fine.
[CUSTOMER][NEUTRAL] Or APL or what.
[CUSTOMER][NEUTRAL] OK, APL is.
[CUSTOMER][NEUTRAL] On the address.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][POSITIVE] Well, thank you so much and you have a blessed day.
[AGENT][POSITIVE] Well, I hope you have a great rest of your day and you too, and I sure hope [PII] gets to feeling better soon.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, he's, he's got his good days and bad days, but he's got me, I'm a retired nurse and I'm like nurse ratchet.
[AGENT][NEUTRAL] Oh, lucky.
[CUSTOMER][NEUTRAL] You know, it's like, no, no, no, no. There ain't nothing wrong with your legs, get up.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] That's good, that's good.
[CUSTOMER][POSITIVE] Yeah, so we keep each other going, so.
[AGENT][POSITIVE] Yes, ma'am. That's good to hear. All right. You have a great rest of your day. Yes, ma'am. Thank you.
[CUSTOMER][POSITIVE] Anyhow, thanks again. Thanks again.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Alright, bye bye.