AccountId: 011433970860
ContactId: 36d60b76-6cb3-47fe-bfd2-cd736a275068
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 861250 ms
Total Talk Time (AGENT): 287860 ms
Total Talk Time (CUSTOMER): 462390 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/36d60b76-6cb3-47fe-bfd2-cd736a275068_20241230T16:12_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, this is [PII] calling and I finally received the paperwork, uh, for the disability claims. And on this thing, it tells me everything that I have to um
[CUSTOMER][POSITIVE] You know, complete and uh forward to you people.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Now, it says attending physician.
[CUSTOMER][NEUTRAL] I don't, if the physician I go to, I see him once a month, and I get these papers after.
[CUSTOMER][NEUTRAL] And I called thinking that it was his office. No.
[CUSTOMER][NEUTRAL] He goes different spots. He's not the same place. I don't see him until I mean until [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So do I, because this happened.
[CUSTOMER][NEGATIVE] I got hurt on [PII].
[CUSTOMER][NEUTRAL] I've been going through this physical therapy and everything since [PII], I think I started. That's where, yeah.
[CUSTOMER][NEUTRAL] Anyway, I've had so many doctors and the main doctor that I go to now, is this who I give this paperwork to? Doctor [PII]?
[AGENT][NEUTRAL] Yes, whoever the doctor is that's ordering you to be out of work.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then um
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So do I send my portion in and then have him? Because like I said, you know, he's working in comp doctors. They're not like a regular.
[CUSTOMER][NEUTRAL] It's, uh, you know, um.
[AGENT][NEUTRAL] Typically, the doctor will have a team. He'll have like an MA, he'll have a nurse, like he has a team that does his clerical work.
[CUSTOMER][NEUTRAL] like
[AGENT][NEUTRAL] Um, if you can get the form, I would, you'll have to reach out to.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Someone from your doctor's team, I don't know how they told you to reach out to the the doctor, but they will be able to get the paperwork completed for you.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Because she, well, when I called, I said, I need to drop off some papers so the doctor can fill out the paperwork. Um, and I said, and I just, you know, got this and so she asked me my date of birth and my name and stuff. She looked it up. She said, well, you don't have um
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] An appointment here until the [PII] um.
[CUSTOMER][NEUTRAL] [PII]. I said, I know, but, you know, I said, I can't come into the office and she said it's not like a regular doctor's office. He's at several different sites.
[CUSTOMER][NEUTRAL] And she said, I can take the paperwork, but he's not gonna get it because he's not gonna be here until that particular date. I said, oh boy. It's not like my regular doctor that I can just go and drop it off and, you know, pick it up. So I just want to make sure that um
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If they're gonna pay some of this uh claims because
[CUSTOMER][NEUTRAL] No one told me when I had this accident. No one reached out to me about, you know, what I should do, and I didn't even find out until, I can't even remember. The year was almost over. It was like September, October.
[CUSTOMER][NEUTRAL] And so when I called, I said, do I?
[CUSTOMER][NEUTRAL] Uh, and I forgot how I, I got it. Maybe it was a, a friend who had
[CUSTOMER][NEGATIVE] Us, you know, this before. And she said, the union, I said, no one called me. My supervisors, the union, no one from this insurance company that I've been using, I've been paying several years now.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And nothing.
[CUSTOMER][NEGATIVE] So I just didn't want to, you know, send my portion in and then have him send his portion in whenever he gets it. So they, you know, wouldn't say, well, wait a minute, well, how come we didn't get this? How come we didn't do that? Because they should know that it's [PII]'s fault, and it's not like a regular doc.
[AGENT][NEUTRAL] OK, so first, let me pull up your policy so that I can note it. Um, Ms. [PII], what's a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then the policy number?
[CUSTOMER][NEUTRAL] Oh, they didn't put it on here.
[AGENT][NEUTRAL] Um, I can look the policy up with your social as well if you'd like.
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][NEGATIVE] I can't even find the paper of all the different people that I've talked to.
[CUSTOMER][NEGATIVE] I hope I didn't want it.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Yeah I'm trying to get papers.
[CUSTOMER][NEUTRAL] Throw it away for the ending of the year and I think I did a little bit too thorough of a job.
[AGENT][NEUTRAL] Well, at least you said you didn't do too you didn't do it too thorough, you did do it thorough.
[CUSTOMER][NEUTRAL] I, I did do tooth of a job because I don't see the paperwork of, you know, um.
[AGENT][NEUTRAL] Like with your number, your policy numbers and things, I can give it to you.
[CUSTOMER][NEUTRAL] Oh brother.
[CUSTOMER][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] But I have a question, so is this for the accident policy or the dis the short-term disability or both?
[CUSTOMER][NEGATIVE] I don't know what this is considered. I was hurt on the plane. So it was a disability because I'm not able to work.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I, at first I thought it was an accident. I mean because the man didn't purposely pass out on me.
[AGENT][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] So, so I didn't know which ones to fill out, but there's all under the same, and they sent me both forms.
[AGENT][NEUTRAL] OK, they did, OK. I would just feel it, I would just claim it under both because I mean if, if you can't use one versus the other, at least, or you may be able to use both once they examine it.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Um, but I can, I'm pulling up the policies now. Um, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm in the accident policy here. I just need you to verify your um date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mailing address [PII].
[CUSTOMER][NEUTRAL] And then it's [PII].
[AGENT][NEUTRAL] Alrighty, and all the information provided is a verification of benefits, not a guarantee of payment. So you do have the
[AGENT][NEUTRAL] Accident and the disability for both.
[AGENT][NEUTRAL] Since you can't get to the doctor, I mean, they, they, since you can't get to the doctor right now, the easiest thing to do, um,
[AGENT][NEUTRAL] I, I would send them the paperwork.
[AGENT][NEUTRAL] And then the reason I'm hesitant is because if you send yours in and everything's not in, it'll be denied. So I'm trying to, I would still give them the paperwork so they have it and he can they really can scan it to him and email and he can have it wherever he is, but if they don't want to do that, then I would just wait until the [PII] appointment and then have him sign it and then do your paperwork and the employer has to fill it out as well and then um.
[AGENT][NEUTRAL] Once we get all
[CUSTOMER][NEUTRAL] Wait a minute, the employer?
[AGENT][NEUTRAL] Mhm. There's an employer part.
[CUSTOMER][NEUTRAL] Oh, I see that.
[CUSTOMER][NEGATIVE] Well, I'm gonna have to cancel this next one because that's too much stuff. They don't tell you that when you're paying all this money, that if you have a problem.
[CUSTOMER][NEUTRAL] That you have to get all these people to sign because I live in [PII]. I'm based out of [PII].
[CUSTOMER][NEUTRAL] My employer is in [PII]. So I don't know who to send this to.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] So this will go to your benefits um department, whoever your HR is, it can be emailed to them um and they can, they can, you know, you can do it electronically, but the, the doctor has to sign it because he's taking you out of work and then work has to verify that you're not working so we can pay, because if you're still receiving income, then that's fraud, so we have to make sure that you're covered.
[CUSTOMER][NEUTRAL] OK, well, none of this paperwork. I was gonna fax this stuff today, my portion, or wait until I saw him, but
[CUSTOMER][POSITIVE] Oh boy, this is.
[AGENT][NEUTRAL] Yeah, I don't want you, I don't, I, I don't want to say don't send it in. I just know that if you send yours in and they can deny it saying we haven't received the physician or the employer, so it's easier to just
[AGENT][POSITIVE] Send it all in at once, so you don't have to.
[AGENT][NEUTRAL] Have the denials and then send the other paper, you know, just have it all at once.
[AGENT][NEUTRAL] And it still goes back to whatever the original date you were, you know, first taken out, so it's not like it will affect the payout.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, OK. Yeah, that, that was the next question was how long? Because like I even called my supervisor and I said, what's going on? And he said, well, I've never really dealt with this, you know, he said, you go out and then you use your different, you know, insurances. And I said, yeah, I said, I got all these insurances, and I said,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] No one told me. I said, you know, when you're insane, you don't think about, oh, is insurance gonna take care of it because
[AGENT][POSITIVE] All the things you got it right.
[CUSTOMER][NEUTRAL] My workman's comp took over immediately. So I thought that was all I had to do.
[CUSTOMER][POSITIVE] And all the paperwork that they had me fill, they had me fill out right away.
[CUSTOMER][NEUTRAL] And then, like I said, I can't even remember how I even
[CUSTOMER][NEUTRAL] And it was like late September, early October when I finally called.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, the APL, and they, you know, told me to, they gave, I had the poli, they gave me the policy numbers and the woman said, I'll send both the accident and the disability.
[CUSTOMER][NEUTRAL] Um, and she said it'll tell you everything that you have to do.
[AGENT][NEUTRAL] Right, mhm.
[CUSTOMER][NEUTRAL] What are the main things that she told me.
[CUSTOMER][NEUTRAL] I had to get a copy of my HI 10.
[CUSTOMER][NEUTRAL] But she didn't say nothing about uh physicians.
[CUSTOMER][NEUTRAL] You know, so, like I said, I'll
[CUSTOMER][NEUTRAL] Oh boy.
[CUSTOMER][NEUTRAL] I'll just take it to her. I'll call the nurse again today. Hopefully, they're working today. And um
[CUSTOMER][NEUTRAL] Just drop it off at the office that I normally go to because she said, you know, how many patients that he has just here alone, let alone all the different offices. And I, you know, I never even thought about it because I only come to him once a month.
[AGENT][NEUTRAL] On
[CUSTOMER][NEUTRAL] Um, so.
[AGENT][NEUTRAL] Well, now, if you wanted to, um, I mean, if, if you wanted to refer back to um Fidelity to see if there
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] is an easier way to file a claim, you definitely can, um, because, you know, APFA as of [PII] of this year is no longer with APL, so you can still file the claim, but I mean if there's an easier way to file it or if they have different paperwork, um, I can definitely give you the number to Fidelity and see if if they file it a different way now.
[AGENT][NEUTRAL] So, you want to try that, so it might not be so much.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, can I have that?
[CUSTOMER][NEUTRAL] Right, can I have the, uh, those policy numbers? I know they're probably gonna ask me, OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Let me know when you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, so your policy number is 223.
[AGENT][NEUTRAL] 73
[AGENT][NEUTRAL] 54.
[AGENT][POSITIVE] And then the number, oh, I'm sorry.
[CUSTOMER][NEUTRAL] Is it
[CUSTOMER][NEUTRAL] Is this accident or disability?
[AGENT][NEUTRAL] This one is for accident. Let me give you, I forgot there were two, let me give you the um disability.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] As well.
[AGENT][NEUTRAL] Disability is 224-076-2.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And Fidelity.
[AGENT][NEUTRAL] It's 833.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 228
[AGENT][NEUTRAL] 5034.
[CUSTOMER][NEUTRAL] 5034
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK dokey.
[AGENT][NEUTRAL] All right, Ms. [PII], was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, that was it. And thank you so much.
[AGENT][POSITIVE] Well, you're very welcome. I'm glad I can help you.
[CUSTOMER][POSITIVE] Well, you have a nice new [PII].
[AGENT][POSITIVE] Thank you, you also, and thanks for calling APL. Happy New [PII].
[CUSTOMER][NEUTRAL] OK bye now.
[AGENT][NEUTRAL] Bye bye.