AccountId: 011433970860
ContactId: 2989cd67-b7e8-4e4c-b78d-3b0dfec5f2b1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1341400 ms
Total Talk Time (AGENT): 388857 ms
Total Talk Time (CUSTOMER): 311780 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/2989cd67-b7e8-4e4c-b78d-3b0dfec5f2b1_20250210T18:36_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey Ms. [PII], how are you doing today?
[AGENT][NEUTRAL] I'm doing fine, and yourself?
[CUSTOMER][NEUTRAL] I'm great Miss [PII], I'm, I'm trying to find out about a claim I placed with you guys and I'm trying to verify that there is no other information needed from me.
[AGENT][POSITIVE] Good, that's wonderful.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so you're the insured and you filed a claim with us and you're wanting to check the status on that?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] All right. And Mr. [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And your policy number, please?
[CUSTOMER][NEUTRAL] Um, my policy number is.
[CUSTOMER][POSITIVE] Oh I had it right here.
[CUSTOMER][NEUTRAL] My policy number is 2243.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 426
[AGENT][NEUTRAL] OK, thank you. So give me a moment to get your information pulled up please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, Mr. [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. I will need to verify several things with you first for security. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] And also your home mailing address please.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] The phone number that we have on file for you is the same as the one that you gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Thank you. And lastly, your email address, please.
[CUSTOMER][NEUTRAL] It's uh [PII].
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] OK, thank you so much. So I do see that there was um the most recently reviewed information.
[AGENT][NEUTRAL] Uh, was done last week and the remark on it states that benefits will be paid after [PII].
[AGENT][NEUTRAL] Benefits pending and will be released after the [PII] of the month. So no, sir, there's not any additional information that is needed at this time.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me ask you a question. I noticed when I did this the first time they say every month that uh I would have to do the same thing.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That's correct. Yes, sir.
[CUSTOMER][NEUTRAL] OK, now, uh, I'm getting ready to go in for surgery.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, so regardless, the same paper would still have to be done every month.
[AGENT][NEUTRAL] Yes, or no, if anything changes with your time off that your doctor initially, when the initial claim was filed, if that changes, then the physician will also need to complete their section again.
[CUSTOMER][NEUTRAL] Well I think he put on the unknown date to return to work.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, just a moment.
[AGENT][NEUTRAL] Give me a moment to look at a few things, please.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so we show that the
[AGENT][NEUTRAL] We show that your return to work is [PII].
[AGENT][NEUTRAL] According to the information that was received.
[CUSTOMER][NEUTRAL] That was on the first one, but when I on the specialist, the one I just submitted, he has um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Unknown date to return.
[CUSTOMER][NEUTRAL] On the 2nd 1 I had to submit to you guys?
[AGENT][NEUTRAL] OK, so what I can do is I can connect you over to one of the examiners to look more um at the documents. That's, that's what I'm seeing, but again, they can, if you're saying it doesn't have a date on there?
[AGENT][NEUTRAL] Um, let, let me look at one more thing.
[AGENT][POSITIVE] It just takes a moment for this information and Miss [PII], Mr. [PII] said thank you for your patience.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][POSITIVE] I thank you for your help.
[AGENT][POSITIVE] You're welcome. My pleasure.
[CUSTOMER][NEUTRAL] Just trying to make sure the easiest way to get this done and.
[AGENT][NEUTRAL] OK. So again, what I'm seeing on what the physician completed, it, it does show your return to work.
[CUSTOMER][NEUTRAL] We all
[AGENT][NEUTRAL] As
[AGENT][NEUTRAL] February, the beginning of February.
[AGENT][NEUTRAL] So you submitted additional.
[CUSTOMER][NEUTRAL] OK, that, that's on the [PII], yes.
[AGENT][NEUTRAL] OK, so yes sir let me um get you connected with someone who can look at the additional information because I'm.
[AGENT][NEUTRAL] I'm just not able to see that.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on the information, let me look at one more thing.
[AGENT][NEUTRAL] OK, so yes, when I transfer you there, Mr. [PII], you're not gonna have to re-verify any of your information. I'll give them your policy number and let them know that that has been done.
[AGENT][NEUTRAL] And then they can further assist you. But before I do transfer you, is there anything else that I could help you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No, ma'am, not at this time.
[AGENT][POSITIVE] OK. Well, I hope everything goes very well for you with your surgery.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] And thank you and thank you again for calling APL. So one moment please and I'll connect you over.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Referring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], it's [PII]. How are you today?
[CUSTOMER][NEUTRAL] Fine, how are you?
[AGENT][POSITIVE] I'm doing good. Um, I have an insured on the line and I'm not able to locate something that he says was sent in.
[AGENT][NEUTRAL] It's on policy number 2243426 for Mr. [PII].
[AGENT][NEUTRAL] So, I went over the latest claim process about the benefits being, you know, released after the [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But he is saying that he's, and we show his return to work date according to notes as [PII], but he says he submitted information because he's gonna be having surgery and his doctor had put that there was no return to work date. I don't see any of that.
[CUSTOMER][NEUTRAL] Mm let me see from this, the mail that was that's out here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And let's see here.
[AGENT][NEUTRAL] Because he's saying the 25, the 2 and actually we, anyway, he's saying that was the initial that was submitted, but there has been other submitted that did not have a return to work date.
[AGENT][NEUTRAL] I just don't
[AGENT][NEUTRAL] Cause he's wanting to verify exactly, you know, what he needs to do and he said he had been told that, you know, he would have to do his portion monthly. I explained that that was correct and that's the only time the physician would need to
[AGENT][NEUTRAL] Um, submit as if his return to work status changed. Isn't that correct?
[CUSTOMER][NEUTRAL] Mhm. Yeah. So I'm trying to find the most uh current position form that we have.
[AGENT][NEUTRAL] And, OK.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Yeah, I do see on the most recent mail that we did receive on that claim that's out there that in the physician put anticipated return to work is um [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He, yeah, that information we have, it does put in a.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK. So,
[AGENT][NEUTRAL] Now what?
[CUSTOMER][NEUTRAL] Normally, the, the disability adjuster will probably still verify by calling the physician's office, but let me verify that real quick. Hold on, let me send [PII] a message real quick.
[CUSTOMER][NEUTRAL] This is, it's not a NA there.
[CUSTOMER][NEUTRAL] Uh, let me see.
[CUSTOMER][NEUTRAL] I mean since it's a NA there let's see here.
[CUSTOMER][NEUTRAL] And has he mentioned if he's he hadn't returned to work, right?
[AGENT][NEUTRAL] No, he's not mm mm. So, so yeah, so I mean.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I'm gonna check real quick with one of the disability examiners. Give me a moment.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Hey, does she have a quick question.
[CUSTOMER][NEUTRAL] We have an insured on the line calling just trying to inquire about um their disability. They needed any.
[CUSTOMER][NEUTRAL] Additional information from us regarding um what we're gonna pay them up in. I was, I have pulled up the insurance physician statement and on the most recent physician statement, it has um the physician put on the estimated return work as NA. In that instance, if the physician puts NA, do we normally just call the physician just to verify if they have returned work or the job or is there more information we would need from the insured?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me see on this.
[CUSTOMER][NEUTRAL] See if I can find the second page.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] See if that was page because they all separated here. Let me see what page number that one was.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, so that's page 6, page 7.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And uh let's see. OK, so page 8, it has.
[CUSTOMER][NEUTRAL] No, yeah, I'll share my screen.
[CUSTOMER][NEUTRAL] I will.
[CUSTOMER][NEUTRAL] So this is the page 8, which is the policyholder's statement.
[CUSTOMER][NEUTRAL] And I don't see it
[CUSTOMER][NEUTRAL] Yeah, this is page 8.
[AGENT][NEGATIVE] My own base is stuck to my own base is stuck. I can't, I mean.
[AGENT][NEGATIVE] It has a gray circle in the middle of the screen. It's not even moving.
[CUSTOMER][NEUTRAL] See, and this is the page 7.
[CUSTOMER][NEUTRAL] I'm page 6, no, this is page 6.
[AGENT][NEGATIVE] Oh yeah, my own base is totally frozen.
[CUSTOMER][NEUTRAL] Page 7 is, let me see which one this one is.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] H 56.
[CUSTOMER][NEUTRAL] I think this one was
[CUSTOMER][NEUTRAL] Mm, let me go back to this one.
[CUSTOMER][NEUTRAL] Yeah, this is the 7th, but it doesn't have the next office visit date on this.
[AGENT][NEUTRAL] I'm gonna put you on hold for just a second, [PII], OK? Just to let him know that um.
[CUSTOMER][NEUTRAL] This is page 7.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Speaking with you or if I'm transferring. I thought I was gonna transfer him, but uh just let me let him know that I had forgot about him, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Alright thanks.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi, Mr. [PII]. This is still [PII]. I didn't want you to think that I've forgotten about you, but I'm speaking to one of the examiners now. So, um, just please continue to hold and either I will be back on the line with you or I will connect you with one of the examiners, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] All right. You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Yes. Sorry about that.
[AGENT][NEUTRAL] Hey, OK. That's OK. I didn't know what had happened because I was you I you and I was like, OK.
[CUSTOMER][NEUTRAL] Yeah, I was
[CUSTOMER][NEUTRAL] Yeah, you had, you had, you, oh you IM me, did you? I was having the shade, oh, there you go. I have put you on cause then I was trying to hear her tell me you have, I heard the music in my ear at the same time. Yeah, no.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Well, I just wanna make sure you had done it right. When I put you on hold to tell him that I had, you know, I haven't forgotten about him. When I came back, I heard music and I was like, uh oh, did you, did you put me on hold or?
[CUSTOMER][NEUTRAL] Yeah, what we
[CUSTOMER][NEUTRAL] Yeah, I only put you on hold cause I was trying to hear her over the music.
[AGENT][NEUTRAL] I understand.
[CUSTOMER][NEUTRAL] So yeah, we're, we're gonna have to get his number to have the examiner give her, him a call back because it looks like they only paid him up until the return to work day and the only way that we can extend benefits possibly is if he has been still seeking treatment. So what we'll have to have the disability examiner give him a call.
[AGENT][NEUTRAL] OK, can you just explain him that? Can
[CUSTOMER][NEUTRAL] To get his
[CUSTOMER][NEUTRAL] Yeah, I'm just gonna let him know that we're gonna have it further review and have someone give him a call back and I'll just get his name and I mean get his number and have one of the disability examiners give him a call back.
[AGENT][NEUTRAL] OK. Thank you so much for that. Since he, since he's been on hold and I told him I was gonna connect him with someone and you know, I think it'd just be better if you were to tell him that y'all have looked at it, but you're gonna have to have the other examiner to contact him.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You can send them to me.
[AGENT][POSITIVE] Perfect. Thank you so much. And I don't, hopefully nothing will happen with the call, but the phone number that's in the system for him, [PII] is the one that we would call back on if it dropped or whatever. All right, thank you so much.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Alright, bye bye.