AccountId: 011433970860
ContactId: 26066694-1802-484e-8d98-0ea93ddbd5d4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 568500 ms
Total Talk Time (AGENT): 209302 ms
Total Talk Time (CUSTOMER): 250529 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/26066694-1802-484e-8d98-0ea93ddbd5d4_20250415T16:52_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] in the care team, and I've got a member on the line, um, she's got a short term disability claim and the EOB says that we need the employee statement, but I see the employee statement and on base, so trying to figure out what's going on.
[AGENT][NEUTRAL] OK, just take a look at that for you.
[AGENT][NEUTRAL] Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's 244-620-1.
[AGENT][NEUTRAL] OK, it's under the part one?
[CUSTOMER][NEUTRAL] Uh, yes, [PII].
[AGENT][NEUTRAL] OK, give me just a quick second.
[CUSTOMER][NEUTRAL] See, we initially on the [PII] we received just the attending position, but then it looks like on the [PII] we got all three statements so I didn't know if this just.
[CUSTOMER][NEUTRAL] Um, cross or what, uh, or do we really need anything from her or?
[CUSTOMER][NEUTRAL] Are we good?
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] All three claim claim forms are attached to the 331 correspondence with the that claim number.
[AGENT][NEUTRAL] Um, I think that we processed the benefit.
[AGENT][NEUTRAL] Uh, I guess I'm confused.
[CUSTOMER][NEUTRAL] Yeah, we did.
[CUSTOMER][NEUTRAL] Well, the EOB says that we need the employee statement.
[CUSTOMER][NEUTRAL] That's why I was confused.
[AGENT][NEUTRAL] 00, yes. Uh, we, yes, we normally ask for the updated statements, um, each month from the insured just to be sure if they, anything changes if they return to work early or anything like that, but we have the updated information to prevent any overpayments. Uh, so yes, I, I can let her know that.
[AGENT][NEUTRAL] That we normally do ask for updated claim form each month.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK, all right, I'm gonna transfer on through. Is that OK?
[AGENT][NEUTRAL] Sure, what's the callback number?
[CUSTOMER][NEUTRAL] Uh, callback number is [PII].
[CUSTOMER][NEUTRAL] [PII] and then I verified her other info.
[AGENT][POSITIVE] OK great thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you for holding this is [PII].
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. Uh, I was just being transferred, I guess to talk to you. Um, I found, um, some paperwork for my insurance because I had hand surgery and, uh, like I was telling the lady before I talked to you that, um, I received some paperwork from y'all saying that y'all needed some um paperwork from me, but I sent in everything.
[CUSTOMER][NEUTRAL] And she said that she saw everything that was filed that I had sent in that was faxed, but I received this yesterday, so I'm uh I don't know if you need more information.
[AGENT][NEUTRAL] Uh yes, ma'am.
[CUSTOMER][NEUTRAL] On my, on my case.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that.
[AGENT][NEUTRAL] Um, so yes, I do see that we did process and release your benefits. It looks like it was paid through [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, through the end of this month, um, do you already have your return to work date verified?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, ma'am. I'll go to the doctor on Monday and um he said he was gonna see how my hand has been progressing. Um, he just wanted to wait until uh I go into the office on Monday to, he could examine me again and talk to me.
[AGENT][NEUTRAL] OK, sure, so yes, so we did request um an updated claim form from you um if your disability is to continue beyond the end of this month that we have already paid, um, just so that we have an updated status for you so we we can update that return to work date for you, um, so that's why it asked for an updated claim form, um, for after the end of this month, yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I would have to fill all this out again?
[AGENT][NEUTRAL] Uh, just the employee form, that's correct.
[CUSTOMER][NEUTRAL] Um, employee form, I don't have one. All I have is, uh, the state, uh, statement of insured.
[CUSTOMER][NEUTRAL] And then I have um.
[CUSTOMER][NEGATIVE] Oh, that hurt, that hurts. I have the disability claim form.
[CUSTOMER][NEUTRAL] Uh, attendance physician statement.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, that's page 2 of that, and then the policy holder statement.
[AGENT][NEUTRAL] OK. Yeah.
[CUSTOMER][NEUTRAL] That's all they sent me.
[AGENT][NEUTRAL] Uh, let's see, so you don't have that page 3, the employee, uh, disability claim form?
[CUSTOMER][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] OK, OK, well I'm sorry for that. Um, well, well, we do have an option that it is available online off of our website, um, that you can fill out and download, um, um, and also that is available on the online service center as well, um, that, that employee claim form.
[CUSTOMER][NEUTRAL] Employee claim form, OK, because I, I have one, but it's the one that I got through work. Would that be the same thing?
[AGENT][NEUTRAL] Um, you say you do have an employee claim form?
[CUSTOMER][NEUTRAL] Well, it's uh employee initial disability claim form?
[AGENT][NEUTRAL] Yes, ma'am. Yes, that's the claim form that you can use. Mhm.
[CUSTOMER][NEUTRAL] Is that the, that's it?
[CUSTOMER][NEUTRAL] OK, I, I just, I would have to go back to [PII] to get one of those.
[CUSTOMER][NEUTRAL] Oh, I need to fill out the whole whole information, right? The 2 pages of it?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Um, well, let's see, the first page should be, um, just the information that we need, um, and like I said, it could, it's also available online off of our website, and it's just the, you know, just your general information and yeah, just please make sure to include, you know, your return to work dates um if you already have that verified.
[CUSTOMER][NEUTRAL] OK, so I need the.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, what if I don't have that verified until Monday after I go back to, to the doctor?
[AGENT][NEUTRAL] Uh, well, you can just update the days that you, that you currently have verified with your doctor.
[CUSTOMER][NEUTRAL] OK, OK, so I need the employee initial disability claim form and the employer initial claim form, the one that [PII] fills out and then the one.
[AGENT][NEUTRAL] Uh, no, ma'am.
[AGENT][NEUTRAL] I'm I'm sorry, just the employee form, just your form.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK, just the employee, OK, OK, yeah, I could get that from [PII] because she's the one that had that for me.
[CUSTOMER][NEUTRAL] OK, I'll just go and get that from her then.
[AGENT][NEUTRAL] Oh sure.
[CUSTOMER][POSITIVE] OK. All right. Well, thank you so much and I could.
[AGENT][NEUTRAL] That was not, was there anything else?
[AGENT][POSITIVE] Oh, I'm sorry?
[CUSTOMER][NEUTRAL] Uh, yes, who do I, can I fax?
[CUSTOMER][NEUTRAL] Can I fax it to uh the [PII]?
[AGENT][NEUTRAL] Uh yes ma'am. Is that [PII] and you can attention it to the claims department.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Attention, please.
[CUSTOMER][NEUTRAL] Department
[CUSTOMER][NEUTRAL] OK, OK, anybody in, in particular, uh, your name or anything?
[AGENT][NEUTRAL] Uh, no, the claims department should be sufficient, and then you can also just add, make sure to add your, your policy number on the cover page, and yeah, it will go into your file for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, and then like if he does extend my my um.
[CUSTOMER][NEUTRAL] My uh my leave, do I call y'all also to let y'all know?
[AGENT][NEUTRAL] Um, if you, you can just complete that claim form with that updated information and then we should be able to um go ahead and reprocess your claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Um, should I do it now or should I wait until after I go to the doctor?
[AGENT][NEUTRAL] Uh well we, we won't need it till the end of the month. So because we already paid you through the end of April and so for your next benefits, so if you're out for the entire month of May, then you would send that updated information so that we can reprocess your, the extended benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, I don't think that it'll be like the whole month of May. It'll probably be like another two weeks of May, but I'm not thinking it'll be the.
[CUSTOMER][NEUTRAL] Would that matter?
[AGENT][NEUTRAL] Uh no, ma'am. You, you would just be able to just fill out the information according to your, to your doctor.
[AGENT][NEUTRAL] And then it would just retro pay you for whatever days that you that you're out.
[CUSTOMER][NEUTRAL] OK, alright, I sure will.
[CUSTOMER][POSITIVE] OK. All right, well thank you so much.
[AGENT][POSITIVE] Yeah, sure and thanks for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] You too. You have a blessed day.
[AGENT][POSITIVE] Thanks bye bye.
[CUSTOMER][NEUTRAL] Bye bye.