AccountId: 011433970860
ContactId: 31c49087-fe3e-4d70-84f5-58de3a11ec93
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 707539 ms
Total Talk Time (AGENT): 307627 ms
Total Talk Time (CUSTOMER): 276677 ms
Interruptions: 3
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/14/31c49087-fe3e-4d70-84f5-58de3a11ec93_20250214T18:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], it's [PII]. How are you today, lady?
[AGENT][POSITIVE] I'm good, how are you?
[CUSTOMER][POSITIVE] I'm good. Um, happy Friday, yay.
[AGENT][POSITIVE] Yay.
[CUSTOMER][NEUTRAL] Well, I have an insured on the phone. She's calling about her disability um claim that was processed, and I try to explain to her how the benefits were paid like for a certain date and she wants to know why it was so wasn't.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The full amount, um.
[CUSTOMER][NEUTRAL] And I did tell her that she would need to submit her portion and the physician's portion of the claim form, um, and once you received that to submit it to us, but she has questions on the payment.
[AGENT][NEUTRAL] OK, what's the policy number?
[CUSTOMER][NEUTRAL] 230-1502.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It's cold.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so let's see.
[CUSTOMER][NEUTRAL] Oh, I see right now.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, you can send her on.
[CUSTOMER][POSITIVE] Awesome sauce. Thank you, lady. Have a great day and happy [PII].
[AGENT][POSITIVE] Happy [PII].
[CUSTOMER][NEUTRAL] All right, bye.
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Miss, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] This is [PII] in the disability claims department. [PII], um, said you were checking on your claim.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, yes, ma'am, we paid, um, $662.05 and let me look at this, and we um paid you up to 25, um, so if you were, if you're still disabled, we need an updated um attending physician statement.
[CUSTOMER][NEUTRAL] So how do I get that?
[AGENT][NEUTRAL] Um, you would contact your doctor if he still has you disabled.
[CUSTOMER][NEUTRAL] Yeah, I'm in a rehab facility.
[AGENT][NEUTRAL] OK. Um, yes, ma'am. Your doctor can, um, let me, let me just pull up that claim form and see, um.
[AGENT][NEUTRAL] See why he only had you out to 25, so just one second.
[CUSTOMER][NEUTRAL] Actually.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And did you go back to see Doctor [PII] on [PII]?
[CUSTOMER][NEUTRAL] That's actually the day that I came to this facility. I was still in town uh rehab on [PII]. That's the day I left.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let's.
[CUSTOMER][NEUTRAL] So I'm in a different rehab now.
[AGENT][NEUTRAL] OK, um, you.
[CUSTOMER][NEUTRAL] The skilled nursing.
[AGENT][NEUTRAL] You'll probably need to, um, does, is that, are you still under Doctor [PII]'s care or was he just with that rehab?
[CUSTOMER][NEUTRAL] No, I'm no longer under doctor main care. I'm not even in that facility anymore.
[AGENT][NEUTRAL] OK. Doctor [PII] was with the facility.
[CUSTOMER][NEUTRAL] Yeah, he was with the uh Pam which is post acute medical.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] Let's see. Um, we will just need um the physician who's treating you now.
[AGENT][NEUTRAL] Um, to fill out a claim form stating that you are still in rehab and that um you are still disabled.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm trying to get uh I need to get a uh can y'all fax it?
[AGENT][POSITIVE] Yes ma'am, I'll be more than happy to fax you a claim form.
[CUSTOMER][NEUTRAL] OK, I'm gonna have to go down here and ask.
[CUSTOMER][NEUTRAL] OK, then after y'all get that information, how long will it take for me to get that other check?
[AGENT][NEUTRAL] Um, it takes around 7 to 10 business days for our claims to be processed.
[CUSTOMER][NEUTRAL] have to do this every single time.
[AGENT][NEUTRAL] Um, right, if your doctor does not give, um, we can only pay you up to the date the doctor has you out to. Um, so, um, let's say,
[CUSTOMER][NEUTRAL] Cause Doctor [PII] actually has filled out paperwork for 2 months. I remember seeing it.
[AGENT][NEUTRAL] Um, he, uh, the, the form that we received that Doctor [PII] completed, he did not give an anticipated return to work date.
[CUSTOMER][NEUTRAL] But you just keep doing.
[AGENT][NEUTRAL] And he just states that um he answered the question um if patient is still under your care date of next appointment of [PII], so that's that's why we we're only able to pay you out to 25.
[CUSTOMER][NEUTRAL] Hey, can I get you a fax number? Can I get your fax number? Oh, hold on, hold on. I'm talking to somebody else. I need your fax number. That fax number.
[AGENT][NEUTRAL] Yes ma'am, R X
[AGENT][NEUTRAL] 000, sorry.
[CUSTOMER][NEUTRAL] That hey [PII], not got a fax number. I'm trying to get some paperwork sent over here, um.
[CUSTOMER][NEUTRAL] 512.
[CUSTOMER][NEUTRAL] 840.
[CUSTOMER][NEUTRAL] 7111.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, can you hear me?
[AGENT][NEUTRAL] Yes sir, yes ma'am, I heard it I heard it 512.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yeah. Oh, you got it?
[AGENT][NEUTRAL] 840-7111.
[CUSTOMER][NEUTRAL] Right.
[AGENT][POSITIVE] Yes ma'am. I will get this faxed to you.
[CUSTOMER][NEUTRAL] OK. And then, um, can we just fax it back?
[AGENT][NEUTRAL] Yes, ma'am, you can fax it back.
[CUSTOMER][NEUTRAL] OK, will your fax number be on the paperwork?
[AGENT][POSITIVE] Yes, ma'am, it sure will.
[CUSTOMER][NEUTRAL] OK, alright. What does the doctor need to put on there? Just fill out the form?
[AGENT][NEUTRAL] Yes ma'am, he just needs to fill out the form, um, and, and he'll just need to put the date that he anticipates you being able to go back to work.
[CUSTOMER][NEUTRAL] OK, alright, do you do, do I have to do this every month or what?
[AGENT][NEUTRAL] Um, with, um, the attending physician statement, it's only when we've, we've maxed out your benefits for the time the doctor has you, but you would just need.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] Need to do um uh.
[AGENT][NEUTRAL] Statement of insured every month.
[CUSTOMER][NEUTRAL] OK, how long is a short term disability last?
[AGENT][NEUTRAL] Let me see how much your policy is.
[AGENT][NEUTRAL] Um, yeah, your benefit periods of 3 months.
[CUSTOMER][NEUTRAL] 3 months.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK, so the checks the [PII] of each month if everything, so you said the checks are the [PII] of each month. I'm just trying to figure out how to pay my rent. That's what I'm trying to do.
[AGENT][NEUTRAL] 00 yeah, yeah. Um, yes, ma'am. The, the, the benefits, um, when there's a continuing disability, the benefits are payable on the [PII] of each month. Yes, ma'am.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Because you.
[CUSTOMER][NEUTRAL] OK, cause I was told I was to expect the check by Monday.
[CUSTOMER][NEGATIVE] But see that's not true.
[AGENT][NEUTRAL] Let's see, uh, we did, we did process a claim for $662.05.
[CUSTOMER][NEUTRAL] It's
[AGENT][NEUTRAL] Um, that was processed, uh.
[CUSTOMER][NEUTRAL] Yeah, right.
[AGENT][NEUTRAL] Wednesday.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that should be directed.
[CUSTOMER][NEUTRAL] Yeah, that was for January though.
[AGENT][NEUTRAL] That will be direct deposited in 3 to 5 business days and then when we get the February, we'll pay you for the rest of February.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, and so once you get this paperwork back, then I have to wait another 7 to 10 days to get that check, right?
[AGENT][NEUTRAL] Right. Yes, ma'am. It's usually just 7 days, but we say 7 to 10 business days just to be safe. Um, but yes, ma'am.
[CUSTOMER][NEUTRAL] That one would be for the full month.
[AGENT][NEUTRAL] Um, we've, let me see what we paid you for.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So we paid you $258.33 for February so far, so it would be um.
[AGENT][NEUTRAL] It would be the balance between that and your benefit amount.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] So it'd be like 1300.
[AGENT][NEUTRAL] Let me see if I can get a calculator.
[CUSTOMER][NEUTRAL] 2.
[CUSTOMER][NEUTRAL] So they already pay me for 2 something for February, so it'd be the balance for the whole month and be the next.
[AGENT][NEUTRAL] 58.33.
[AGENT][NEGATIVE] Minus.
[AGENT][NEUTRAL] Um, it will be $1,291.67.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yeah, yeah, alright, well, I guess that's it. Appreciate it, and I'll be looking for that form.
[AGENT][POSITIVE] Oh, you're so very welcome. OK, I'll get this to you just as soon as I can.
[CUSTOMER][NEUTRAL] Can you put my name on it so they'll know it's for me.
[AGENT][POSITIVE] Yes, ma'am, I sure will.
[CUSTOMER][POSITIVE] Well that's one, OK, OK, alright, alright, thank you. You're gonna send that more.
[AGENT][POSITIVE] You're so very welcome.
[AGENT][NEUTRAL] Yeah, I'm gonna send it. um, is, is there anything else I can help you with, Ms. [PII]?
[CUSTOMER][NEUTRAL] No, that'll be out. What's your name again?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Does she?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] It's different. OK. All right, thank you so much. I appreciate you.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] You, you're so very welcome, Ms. [PII]. Thank you for calling APL. You have a wonderful day.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Alright, you too, bye.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I can get it in before the month end.
[CUSTOMER][NEUTRAL] Mhm I'll do today.