AccountId: 011433970860
ContactId: 30a5df2c-e7ec-425c-adc4-997968be191e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 880559 ms
Total Talk Time (AGENT): 566515 ms
Total Talk Time (CUSTOMER): 282661 ms
Interruptions: 10
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/30a5df2c-e7ec-425c-adc4-997968be191e_20250507T21:27_UTC.wav
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[AGENT][POSITIVE] Thank you for calling ATL. You're speaking with [PII]. How may I help you today?
[CUSTOMER][POSITIVE] Yes ma'am, how are you doing on this lovely day?
[AGENT][POSITIVE] I'm doing great.
[CUSTOMER][NEUTRAL] Uh, this is [PII].
[CUSTOMER][NEUTRAL] I called you a little while back and I've had a few things since you called me back.
[CUSTOMER][NEUTRAL] Um, I'm, I'm faced with the new dilemma.
[AGENT][NEUTRAL] OK, before you start, let's pull up your information. You're calling in reference to yourself, is that correct?
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, let me have your policy number.
[CUSTOMER][NEUTRAL] Oh, mom.
[CUSTOMER][NEUTRAL] Hold on a second, let me get it for you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] We we wrote it down and I ain't got nothing over here with me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Ozzie.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] I see what good they're done.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'm, I'm trying.
[AGENT][NEUTRAL] OK, we can look it up by your social. Hold on, let me pull it up like that. You don't have to look for it. What is?
[CUSTOMER][NEUTRAL] Alright, here we, here we go.
[AGENT][NEUTRAL] OK, what is it?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, let me look that up. Give me one second.
[AGENT][NEUTRAL] All right, verify your date of birth and your mailing address for verification.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And my mailing address is [PII].
[CUSTOMER][NEUTRAL] My physical address is [PII].
[AGENT][NEUTRAL] All right. What about your email address on file?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you for that information. That's what we got. Tell me, how can I help you?
[CUSTOMER][NEUTRAL] All right, um,
[CUSTOMER][NEUTRAL] The doctor still got me out of work.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And I got a I got a little scared because on that on my paperwork.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Seems like he wrote a go back date.
[AGENT][NEUTRAL] Yes, he did. Mhm.
[CUSTOMER][NEGATIVE] And I'm not going back.
[AGENT][NEUTRAL] OK, so what you're gonna do is you, you're gonna have to get, if he got you out longer than [PII] because to get paid for May, we need your portion of the claim form to pay you up to [PII], but if you're gonna be out longer than he got you returning on [PII], then you're gonna need your doctor portion and your portion.
[CUSTOMER][NEUTRAL] He still got me out there.
[CUSTOMER][NEUTRAL] What do you mean doctor portion and my portion?
[AGENT][NEUTRAL] The mean that claim form that you received in the mail, it's got insurer's statement, which is your portion of the claim form, which is 2 pages and then the physician portion is the attendant physician, which is 2 pages.
[CUSTOMER][NEUTRAL] So in other words, I'm gonna have to give him another one.
[AGENT][NEUTRAL] Yes, to make for us not to pay you to be, to be able to pay, pay you past [PII], yes, I would have to have an updated doctor form, but if you just send your portion in here, I can only pay you up to [PII], but regardless, you're going to have to send something in to get paid for me.
[CUSTOMER][NEUTRAL] To make it right.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, alright, so I need to get.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] His portion he needs to redo it.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And make it make it correct my portion should be fine.
[AGENT][NEUTRAL] If we still have to have, no matter, no matter how many times we pay you every month, you're gonna have to send in something. That's why when you got that explanation of benefit, you got a claim form with it and it told you to fill out your portion. That's all we was asking for because we're gonna pay you up to the [PII]. But since you're gonna be out longer, you're gonna need your portion and the doctor portion completed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you understand that?
[CUSTOMER][NEUTRAL] So you need more you need more phones.
[AGENT][NEGATIVE] Y'all should have got them when you got your explanation of benefit. You didn't get no new forms in the mail cause you should have got them in the mail.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I've got, I
[CUSTOMER][NEUTRAL] I got one set.
[CUSTOMER][NEUTRAL] Uh, and the young lady emailed them to me.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] I mean, I didn't nobody explained this is gonna be an ongoing process. I've never done this before.
[AGENT][NEUTRAL] Uh, it tells you, OK, OK, I'm, well, if you read your explanation of benefit and that's what come in the mail showing you what we put in your bank account, it tells you on the explanation of benefit what is needed for the next time you get paid, it should.
[CUSTOMER][NEGATIVE] Well, that's what I'm, no, no, that's what I'm saying. I've never received anything in the mail.
[AGENT][NEGATIVE] Oh, you, you haven't received any.
[CUSTOMER][NEUTRAL] She faxed me this paperwork. No.
[AGENT][NEUTRAL] OK, let me bring up, OK, let me bring up and the explanation of benefits out here and then you should be getting them in the mail because, uh, whenever we pay and put money in your bank account, if you get that to show what we put in your bank account. Otherwise you wouldn't know what's going in your bank account. So let me pull it up. [PII].
[CUSTOMER][NEUTRAL] Well, we know because it's alerting our.
[CUSTOMER][NEUTRAL] Yeah, it was automatic deposit. My bank told me it was in there, but as far as being mailed anything.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, but you, you need.
[AGENT][NEUTRAL] OK, let me pull up, let me pull up the explanation of benefit. And so you said you ain't never received nothing in the mail from us, ever.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, no, no, ma'am, she say she would, she told me to fill it out on my phone.
[CUSTOMER][NEUTRAL] Well, I'm not really phone savvy.
[CUSTOMER][NEUTRAL] So the young lady.
[CUSTOMER][NEUTRAL] Got a fax number for the truck stop up the street.
[CUSTOMER][NEUTRAL] And she faxed it all to me and I, you know, pay for it that way to fill it out the first time.
[AGENT][NEUTRAL] OK, I'm looking at the explanation of benefit that was mailed out, and here is the address that's on the explanation of benefit that you should have got and it, it, it got it right here and let me pull it up and let me put the address for you that we got on here to make sure one is on here.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Cause every time we pay something or do anything, ask for anything, you're gonna get something in the mail from us. So I'm trying to see.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEGATIVE] And you, what you're saying that you ain't never received nothing from us. I got to see what's going on. OK, and I'm going to the next page.
[CUSTOMER][NEGATIVE] We ain't got
[CUSTOMER][NEUTRAL] Uh, no, no, ma'am.
[CUSTOMER][NEUTRAL] Cause that's why it's all new what you're saying.
[AGENT][NEUTRAL] Uh-huh. OK.
[CUSTOMER][NEUTRAL] Because I wasn't looking for nothing. I mean, I didn't know.
[AGENT][NEGATIVE] Here it is, it is right here. The address is on here. [PII] and these be mailed out automatically, but I'm gonna get with the lady that uh that uh know that these folks go out and let her know that you said you have never received anything from us ever. You never received.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Normally I'm
[CUSTOMER][NEUTRAL] Yeah, because you know I don't check my mailbox much here.
[CUSTOMER][NEGATIVE] But normally all I get in the mail is junk.
[AGENT][NEGATIVE] OK, well, you might have thought our stuff was junk because even when we first got your first claim in here back, uh, I mean, even when we processed your claim back in [PII], you never received any mail from us.
[CUSTOMER][NEUTRAL] You know, new, new flyers and.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] You, OK, OK, I, I don't know what could be going on because we paid you back in [PII]. You had claims with us and we processed and paid you and you said you never received nothing showing what was uh processed on your claim.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I'm trying to figure out what happened in [PII].
[AGENT][NEUTRAL] Oh, in [PII], let me tell you what happened in [PII]. [PII], you was out starting [PII]. Your your diagnosis code was M0579. [PII], we, we paid you $7900 in [PII].
[CUSTOMER][NEUTRAL] Let me have it
[AGENT][NEUTRAL] And I can, I can, I can bring up the claim. Let me bring up the claim because we keep a copy of everything. This claim number 70.
[CUSTOMER][NEUTRAL] Uh, I, I don't remember. I
[AGENT][NEUTRAL] I can tell you who the doctor was and everything. I can tell you who the doctor was and everything.
[CUSTOMER][NEUTRAL] You want to work 7 months.
[CUSTOMER][NEUTRAL] I think that's when I had double pneumonia.
[AGENT][NEUTRAL] Mm, I don't, I don't know. Let me see. It's coming up. But anyway, even then we were sending out explanation of benefits. This is doctor, this is, you have arthritis, rheum rheumatoid arthritis and cervix disc disease. Uh-huh.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yeah, that was my
[CUSTOMER][NEUTRAL] Yeah, that was, that was when I had my double pneumonia.
[AGENT][NEUTRAL] Doctor [PII].
[CUSTOMER][POSITIVE] Yeah, that's what we, yes ma'am.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] He had me on chemo treatments or whatnot.
[AGENT][NEUTRAL] OK, well, yeah, you're gonna have to, you're gonna have to get that claim form completed now I can email it to you or we can put it in the mail to you again because I mean they, the explanation was sent out and I don't know you know what could happen to it or you can go online and get it so how would you like to get uh.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] That uh claim from.
[CUSTOMER][NEGATIVE] I, I'd prefer it being, I would prefer it being mailed to me.
[AGENT][NEUTRAL] OK. Well, I request right now for it to be put in the mail to you.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Post
[CUSTOMER][NEUTRAL] And you
[CUSTOMER][NEUTRAL] Can you send it to my post office box?
[AGENT][NEUTRAL] OK, yeah, I can ask them to send it to the PO box. What is the box you, do you want your address changed to the PO box too, or you wanna leave it like it is?
[CUSTOMER][NEUTRAL] Yeah, do that.
[AGENT][NEUTRAL] You want your address changed too?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, give me your new address that you want it to be.
[CUSTOMER][NEUTRAL] It's it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so [PII], I mean [PII], is that right?
[CUSTOMER][NEUTRAL] Yes, ma'am. Now, when you, when you
[AGENT][NEUTRAL] OK, now, when you fill out your claim form, make, wait a minute, say this. When you fill out your claim form, you make sure you use the PO box because if you have that [PII], we gonna have to, we'll change it back cause you have to use whatever address that you want your mail to go to on your claim form.
[CUSTOMER][NEUTRAL] OK. Oh, all right. But what you just done.
[AGENT][NEUTRAL] OK. OK. Now go.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Might explain what's happened.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because there is a [PII].
[AGENT][NEUTRAL] No, we got [PII]. We got [PII]. Your address has not changed. We wouldn't change it unless you call like now telling us to change it. So we got [PII] and even on the explanation of benefits, they got [PII].
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'll just, I was just thinking well maybe that's what happened.
[AGENT][NEUTRAL] Mm no. Mm mm.
[CUSTOMER][NEGATIVE] Because we ain't, I, I really haven't I ain't received nothing from y'all.
[AGENT][POSITIVE] OK, well, we should definitely been sending stuff out.
[CUSTOMER][POSITIVE] Good
[CUSTOMER][NEUTRAL] Well, that's
[CUSTOMER][NEUTRAL] That would explain, you know, why I don't know what's, what you're talking about.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Because back in [PII] I never got nothing.
[AGENT][NEUTRAL] OK. Well, I would, I would mention that to them, but, uh, I, I mean, we do have the explanation of benefits showing where they was mailed to you, so I can't explain, you know, what, what happened, but we will get your address changed to the [PII].
[CUSTOMER][NEUTRAL] And so.
[CUSTOMER][NEUTRAL] Right, well,
[AGENT][NEUTRAL] And I will get that claim form put in the mail to you, and you need your portion completed by you, which is 2 pages, and the doctor portion completed by you, which is 2 pages. The uh policyholder statement which is the job, we don't need that anymore, so you only got to get your portions and the doctor portion and submit it back to our office.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and I'll get that uh your address updated and I will request a claim form to be put in the mail to you to that PO box.
[CUSTOMER][POSITIVE] All right thanks.
[AGENT][NEUTRAL] All right. Anything else I can help you with today?
[CUSTOMER][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEUTRAL] No, I am.
[AGENT][POSITIVE] All right, well, we'll get this out as soon as possible so you can, you know, get it done and get it back to us and anytime you have any questions about anything, you may I wish you had a call earlier, you know, because you, if you hadn't received anything, you know, we could at least got this out to you so you can go and get your claim form filled out.
[CUSTOMER][NEUTRAL] Well, I didn't
[CUSTOMER][NEUTRAL] What's that?
[CUSTOMER][NEGATIVE] I, if I'd have known I was supposed to be receiving something, I would have called earlier but.
[CUSTOMER][NEGATIVE] I didn't know I was supposed to be receiving anything.
[AGENT][NEUTRAL] Well, well, how you thought you were gonna get paid for the next month?
[CUSTOMER][NEUTRAL] It went into the, my bank.
[AGENT][NEUTRAL] That was just one month. That was just a month, that was just the month of, uh, of, uh, that was just the month of April. So now you got to get paid for May and we was gonna only pay you up to [PII] based on the doctor form.
[CUSTOMER][NEUTRAL] I was surprised when I seen it.
[CUSTOMER][NEUTRAL] Right, that, that, that's.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's what I'm trying to tell you.
[CUSTOMER][NEUTRAL] It went straight to my bank, so I didn't think nothing was wrong.
[CUSTOMER][NEUTRAL] I, I didn't know nothing about all this other.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, well, and for future reference, for future reference for you'll know, no matter how many times we pay you to get paid again, you always gonna have to send in your portion of the claim form or your portion of the claim form in the doctor claim form. If you do not get a claim form, please call our office because you won't get paid unless you should submit additional information each month. You're never just gonna get paid continually without sending anything in the office.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I'm gonna get this updated.
[CUSTOMER][NEUTRAL] Uh, it's my first time so I had no clue.
[AGENT][NEUTRAL] OK, well, I'm gonna get this updated and I'm gonna get your claim forms put in the mail to you, OK?
[CUSTOMER][POSITIVE] Alright yeah thank you ma'am.
[AGENT][NEUTRAL] You're welcome. If you have any other questions, just give us a call back, OK, Mr. [PII]?
[CUSTOMER][NEUTRAL] I will.
[AGENT][POSITIVE] You have a great day and thank you for calling American Public Life. Bye-bye.
[CUSTOMER][POSITIVE] Thank you.