AccountId: 011433970860
ContactId: 386dac20-e64d-4852-8c19-ac657d657124
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 759159 ms
Total Talk Time (AGENT): 340267 ms
Total Talk Time (CUSTOMER): 231543 ms
Interruptions: 2
Overall Sentiment: AGENT=1.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/386dac20-e64d-4852-8c19-ac657d657124_20250414T17:14_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello [PII], my name's [PII].
[CUSTOMER][NEUTRAL] I have a claim.
[CUSTOMER][NEUTRAL] I don't know my uh.
[CUSTOMER][NEUTRAL] I don't know my
[CUSTOMER][NEUTRAL] Claim number.
[CUSTOMER][NEUTRAL] But I have the card here to give you my.
[AGENT][NEUTRAL] Your policy number
[CUSTOMER][NEUTRAL] Whatever it is you need to, yeah.
[AGENT][NEUTRAL] OK, you want to check on your claim status?
[CUSTOMER][NEUTRAL] Well, I need to make sure I got I had to get a.
[CUSTOMER][NEUTRAL] A filled out by my.
[CUSTOMER][NEUTRAL] By my work so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You're wanting to see if that's been received?
[CUSTOMER][NEUTRAL] I'm wanting to make sure that I know where to send it and how long it's gonna take once they get it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So my policy number is 02.
[CUSTOMER][NEUTRAL] 02597992
[AGENT][NEUTRAL] And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And I have you here. I just need you to verify your date of birth and your mailing address.
[CUSTOMER][NEUTRAL] My mailing address is [PII]. My date of birth is [PII].
[AGENT][NEUTRAL] Thank you. Hold on one moment. Oh, and then there's an email. I'm sorry.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. Um, so you can either
[AGENT][NEUTRAL] Um, mail the claim or you can um send it electronically, um, because the claims go to IMA, but we have a claim here. Did you
[AGENT][NEUTRAL] Is that what you're looking for?
[AGENT][NEUTRAL] Is it processing?
[CUSTOMER][NEUTRAL] I'm, well, they told me all the other girls that I've talked to told me to fax it.
[AGENT][NEUTRAL] Wait a minute. You can't.
[CUSTOMER][NEUTRAL] I can send it electronically.
[CUSTOMER][NEGATIVE] They told me what I needed was one more paper I was denied because the employer didn't fill out their paper. I've got that in my hand.
[AGENT][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Right. The thing, the reason I'm hesitant is because of where your claims go, faxing is not an option, so I'm going to the notes.
[AGENT][NEUTRAL] OK, so I'll let, I'll let the representative that you spoke with on the [PII] know how that works, but the options are, um,
[AGENT][NEUTRAL] Really mailing is the only option because electronic I can give you the payer ID, but that's more for like providers. It's not like you can go on our portal and upload it because it doesn't come directly to us.
[AGENT][NEGATIVE] It goes to IMA to be repriced first and then they send it to us. So that's why I was hesitant because you.
[CUSTOMER][NEGATIVE] Right, well I mean it's already been a month and they didn't tell me that I needed the employer form.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] So I'm literally going broke with insurance that I paid for for disability. I mean it's gonna be.
[AGENT][NEUTRAL] So let me do this. Let me reach out to claims just to double check.
[CUSTOMER][NEUTRAL] This is just.
[AGENT][NEUTRAL] And if we can fax it, I'll go ahead and give the fax number because I, I mean, I had to be on disability too. I understand when those bills come. So let me see if I can reach out to claims and maybe get some clarity on that part and then at least we'll know how to move and then
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] There is a claim here, we received it on the [PII], that's in processing now. So I can look at that and see if that's the employer's part or is that yours.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because something came in on the [PII] and the [PII], so I'll check them both for you.
[CUSTOMER][NEUTRAL] Well, I was in the hospital for 2 different times for uh.
[CUSTOMER][NEUTRAL] Toe amputation so.
[CUSTOMER][NEUTRAL] I have 8 weeks worth of picks so.
[AGENT][NEUTRAL] OK, let me start with claims. Do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey, [PII], this is [PII] on the care team. How are you doing?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Fine, how are you?
[AGENT][POSITIVE] I'm doing good. I, I'm trying to avoid an escalation. It's a hospital indemnity policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] If it's in processing and they did not send, wait a minute.
[AGENT][NEUTRAL] And they didn't, I'm trying to correct what a new agent uh told them.
[AGENT][NEUTRAL] If it's hospital indemnity, they have a um
[AGENT][NEUTRAL] They're sending in their claim form, but they've already, like something's in processing. If they have something else that they want to send, but now I'm getting confused because he's talking about disability. I don't think this agent. I'm trying to see if if something has already been sent to IMA. Can we send them more like the claim? Do we send them more stuff if it's additional, or can they then fax it to us because he's been told that he can fax, but it's big IMA, so I'm trying to.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Make sure I give him the right information this go wrong.
[CUSTOMER][NEUTRAL] So they will request additional information on the claim or are you just trying to submit additional documents?
[AGENT][NEUTRAL] What I'm about to do, let me, can I give you the um policy number?
[CUSTOMER][NEUTRAL] Yeah, what's the policy number?
[AGENT][NEUTRAL] It's 259-799-92.
[AGENT][NEUTRAL] But he's wanting disability.
[CUSTOMER][NEUTRAL] So this is on [PII].
[AGENT][NEUTRAL] So that's why she told him, mhm.
[CUSTOMER][NEUTRAL] Tick bone
[AGENT][POSITIVE] You know what, I'm good.
[CUSTOMER][POSITIVE] OK, you got it.
[AGENT][NEUTRAL] I got it because he gave hospital indemnity, but he was talking to the rep about disability, so that's why she said the facts because I got it now. I just wanted to make sure because he's getting upset and I don't want him to, you know.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] Gotcha.
[CUSTOMER][NEUTRAL] That makes sense.
[AGENT][NEUTRAL] I don't, I don't want them to go there. OK, thank you.
[CUSTOMER][NEGATIVE] Gotcha.
[CUSTOMER][POSITIVE] Mm you're welcome.
[AGENT][POSITIVE] Have a good day.
[AGENT][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][NEUTRAL] So that's what happened.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Thank you so much for holding. I apologize for that wait. While I was waiting for claims, I noticed the the difference. So the policy number that you gave me pulled up your medical claim, but you're talking about disability, which is why she gave you the option to fax because that's a different type of product, so that does come straight to us. And I do see where, where the um it was denied for missing the employer. So yes, sir, if you have that, you can go ahead and fax it in, but as of right now, nothing has been received.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] From the employer.
[CUSTOMER][NEUTRAL] Yeah, I've got it in my hand and my employers said they didn't, yeah, the employer said that they had to send it to their corporate first and they had to mail it and I was like what the heck it's already been a month. So the fax number is [PII].
[AGENT][NEUTRAL] Oh, you have it, OK.
[AGENT][POSITIVE] Yes, sir, that's correct.
[CUSTOMER][NEUTRAL] So, OK, I'm, I'm headed to my hometown now to fax it, and I'm assuming that you'll get it then. How long it won't take another 47 to 14 days to process this one.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, as soon as we receive it, we'll continue processing, um, and we say the 7 to 10 business days just as the turnaround, but it most likely will not take all that time because it's already, you know, been the process has been started.
[CUSTOMER][NEUTRAL] And with
[CUSTOMER][NEUTRAL] And since I, since.
[CUSTOMER][NEUTRAL] Since I've already, you've already got my direct deposit papers and everything but this paper whenever they do approve it, since it's got direct you've got my bank account information as soon as it's approved, then they'll drop it into my bank.
[AGENT][POSITIVE] Correct, it'll be direct deposited and yes, I, I do see it here. Yes, sir.
[CUSTOMER][NEUTRAL] Is that how that works?
[CUSTOMER][NEUTRAL] OK, so I, I will be, uh, I'll be faxing it in like the next 30 minutes, so they said something about by the [PII] is whenever they.
[CUSTOMER][POSITIVE] Do something it needed to be in by the [PII]. That's why I drove all the way over here to my work.
[CUSTOMER][NEUTRAL] To get the paper to try to make sure it was in before it waits till the next month but.
[CUSTOMER][NEGATIVE] I'm just stressing out over no money. I went from 70 hours a week watching game shows.
[AGENT][NEUTRAL] I understand it.
[AGENT][NEUTRAL] Look, uh, if, if, if you don't talk to anybody else on this phone from APL, I definitely understand. I was in a car accident and it changed my whole life. The engine dropped down and broke my leg and whole rigmarole, but I definitely understand the bills coming in and you got to get this money, so I definitely.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, as soon as we receive it, I put a note in here for you. So as soon as we receive it, we'll go ahead and continue processing. You can even
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We usually say to give it uh like at least 24 hours because document management has to upload it so that we can see it.
[AGENT][NEUTRAL] Um, if you want, what's today, Monday, if you wanted to give us a call on Wednesday.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And see if we've received it, we can go ahead and try to make it, you know, see if we can expedite or what see what our options are for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, well you you had the best news I've had in a month, so I appreciate it.
[AGENT][POSITIVE] Well, I'm so glad and um if you need anything or think of anything, just give us a call and we'll be more than happy to help you.
[CUSTOMER][POSITIVE] OK well I appreciate it.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][POSITIVE] God bless you. I got you.
[AGENT][POSITIVE] God bless you also, was it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, just try to have a good day.
[AGENT][POSITIVE] Thank you, sir. You too, and don't worry about it, it's gonna work out for you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye-bye.
[CUSTOMER][NEUTRAL] Alright bye bye.