AccountId: 011433970860
ContactId: 1fc6be80-cf24-41b1-b286-1f7adae72897
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 657219 ms
Total Talk Time (AGENT): 204424 ms
Total Talk Time (CUSTOMER): 280228 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/1fc6be80-cf24-41b1-b286-1f7adae72897_20250414T15:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Can I help you? Hi, [PII], this is [PII] and Lo. Um, I'm calling to see what, OK.
[CUSTOMER][NEUTRAL] I've been on the, I, I'm on the short term disability for foot surgery.
[CUSTOMER][NEUTRAL] And I submitted a claim, you know, the monthly claim form, um, I believe, well, I know y'all got it because y'all sent me an indication, a letter saying y'all got it.
[CUSTOMER][NEUTRAL] And then I received a check yesterday for a day before yesterday for $10. So can you please, uh, um, tell me what's going on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have your policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] I'm sorry, I didn't know how to
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Well, I have the claim number um.
[CUSTOMER][NEUTRAL] Just one sec, I'm so sorry. I was doing my my exercises. Oh, here we go. Policy number 1245023. While I was on hold, I was doing my, my homework exercises for free for PT.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Oh, I get it.
[AGENT][NEUTRAL] Understand.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah.
[AGENT][NEUTRAL] Um, OK, um.
[CUSTOMER][NEUTRAL] Hey, make use of that time, right? Not that I have much to do.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] OK, Ms. [PII], can I get a few pieces of information? What is your birth date?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and do you have a good call back number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then lastly is your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much. OK, let's see what's going on.
[CUSTOMER][NEUTRAL] Um, I
[CUSTOMER][NEUTRAL] I have a suspicion that it has to do with the change in my return to work date.
[CUSTOMER][NEUTRAL] But I was just checking to make sure that's all it is.
[CUSTOMER][NEUTRAL] And how that's handled.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because initially I was hoping to be back at work already.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] I had to start therapy late because.
[CUSTOMER][NEGATIVE] I ended up with a pressure wound on the incision.
[AGENT][NEUTRAL] OK.
[CUSTOMER][MIXED] Still got a little hole, but, but, but it's shallow enough that I can do therapy now.
[AGENT][NEUTRAL] OK, so it looks like we've sent, you've received our previous two payouts, correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see what's going on.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Return to work date was for sure could reassigned on Thursday so.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I handed off the the paperwork the.
[CUSTOMER][NEUTRAL] I can't remember if that was uh JFK.
[CUSTOMER][NEUTRAL] Of the of the paperwork, but the physician's statement.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I handed that office doctor's office to them and they said they would get it back to you guys on Friday. That's why I said I figure I know what's going on, but.
[AGENT][NEUTRAL] Uh, let's see
[AGENT][NEUTRAL] Uh, give me just a moment pulling this up.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] I'm sorry, I bring up complicated questions and I'm so sorry.
[AGENT][NEUTRAL] Oh, no, no, that's what we're here for.
[AGENT][NEUTRAL] OK, so it looks like we paid out 1089 and
[AGENT][NEUTRAL] Let's see, your first date off, that was in January, correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like we, let's see, disability, we paid 7667, there was a premium deduction. It took out your premium.
[AGENT][NEUTRAL] 6578. Um, let's see.
[AGENT][NEUTRAL] Let me, can I place you on a brief hold?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi!
[AGENT][POSITIVE] Not bad.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Quit it.
[AGENT][NEUTRAL] Lay down.
[AGENT][NEUTRAL] OK, so sorry about that. Thanks for holding. Yeah, I'm having trouble figuring out what why the payment is reduced. Um, would it be OK, yeah, I'm trying to figure that out. So what would it be OK if I transfer you to our claims department? I'll explain everything that's going on, um, and then they can look into this further.
[CUSTOMER][POSITIVE] Exactly
[CUSTOMER][NEUTRAL] OK, um, and they could tell me if they got the fax from Doctor [PII]'s office.
[AGENT][NEUTRAL] Um, let's see, I can tell you that. Let's see.
[AGENT][NEUTRAL] Um, let's see, so.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Do you know when he sent it?
[CUSTOMER][NEUTRAL] Uh, even Friday. Friday was the [PII].
[CUSTOMER][NEUTRAL] My appointment was the [PII] and he has extended um.
[CUSTOMER][MIXED] My return to work date until [PII], in my ankle more time, yeah, the therapist said it was, he was kind of frustrated, but I understand that I don't want to redo this. He said there was too much of a chance of me reinjuring it right now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because it's too weak, and I agree it keeps rolling.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] My ankle rolls. I just had ankle surgery and my ankle rolls.
[AGENT][NEGATIVE] Yeah, I, yeah, I broke my ankle in [PII]. It was pretty catastrophic, so.
[AGENT][NEGATIVE] It's awful.
[CUSTOMER][NEGATIVE] Well, I don't want to add that to the collection, but um it was Achilles tendon with a bone spur from heck and then like I said, I ended up, I've already had one significant incident.
[AGENT][NEUTRAL] I know.
[AGENT][NEUTRAL] Yeah, gosh.
[CUSTOMER][NEUTRAL] Where I landed on the incision.
[AGENT][NEUTRAL] Oh gosh.
[CUSTOMER][NEUTRAL] And then, yes, ma'am, 5 days out, had surgery on on Wednesday and landed on it on Sunday night.
[AGENT][NEUTRAL] [PII]y goodness.
[CUSTOMER][NEGATIVE] And unfortunately didn't.
[CUSTOMER][NEGATIVE] I've taken half a pain pill and did not realize the significance.
[CUSTOMER][NEUTRAL] Of lending on it
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] I thought I'd done better.
[CUSTOMER][NEUTRAL] Until the doctor took the dressing off and it was like.
[CUSTOMER][NEGATIVE] Oh snap and not in a good way.
[AGENT][NEUTRAL] Oh gosh.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] Yeah, I've taken the pain medicine so I didn't feel the pain is what I'm saying.
[AGENT][POSITIVE] Right, absolutely, yeah.
[CUSTOMER][NEGATIVE] That was, by the way, last time I took last time I took any of that mess, that's stuff I've just been ibuprofen ever since that crap is in the top of the clock to get from the kids, so the babies can't get a hold of it, you know, not taking no more of that mess.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Oh my goodness.
[AGENT][POSITIVE] Yeah, uh, it's pretty strong.
[CUSTOMER][NEUTRAL] I need to know if I'm hurt.
[AGENT][POSITIVE] Absolutely, yeah, totally understand.
[CUSTOMER][NEUTRAL] And that was half one and that.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I, I don't take, I generally don't take anything but Tylenol or ibuprofen. So you can imagine that it had me a little loopy and that's probably a lot of what happened. But um anyway, that's what delayed therapy starting up. I started therapy almost a month late.
[AGENT][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] Because the wound had to have time to heal, so there we go.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, absolutely.
[CUSTOMER][NEUTRAL] So I'm just hoping I didn't everything up.
[AGENT][NEUTRAL] Yeah, I totally understand. OK, I don't show a fax on file yet, but I believe our claims department can actually check that as well. Um, they have access to the information. I don't. So let me get you over there. I'm gonna give them all the information that we've discussed, and then they can check and see what's going on with this claim and see if the fax was received, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you [PII] I appreciate you.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. Hold on one moment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning. Thanks for calling APO. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII], this is [PII] from the care team. I've got a member on the line that has a question about her short-term disability claim.
[CUSTOMER][NEUTRAL] OK, what's your policy number?
[AGENT][NEUTRAL] Policy number is 1245023.
[CUSTOMER][NEUTRAL] And her name is?
[AGENT][NEUTRAL] [PII], and then I've verified her information and I've got a callback number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What's her callback number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And what was her question?
[AGENT][NEUTRAL] Um, it's on the most recent claim 3585529. I couldn't figure out what the payment amount, why it was um $10.
[AGENT][NEUTRAL] Uh, wasn't sure why it was reduced or what was going on. And then she also, I didn't know if you have access to, she said her healthcare provider sent a fax Friday about the return to work, and um I, I can't see, I know there's a place in Onase where we can see faxes, but I don't have access to that because it's not loaded yet in Onase.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, it looks like looking at the remark code it looks like it was deducted due to her premium but you can send her on over to me.
[AGENT][POSITIVE] OK, I'm gonna transfer on through. Thank you so much.
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] Good morning. Thanks for calling ATL. This is [PII], and how can I help you?
[CUSTOMER][NEUTRAL] Hi Miss speaking. My name is [PII], um.