AccountId: 011433970860
ContactId: 3be3f1d1-aec5-461f-a5e7-448395e36369
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 828539 ms
Total Talk Time (AGENT): 194638 ms
Total Talk Time (CUSTOMER): 303144 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/3be3f1d1-aec5-461f-a5e7-448395e36369_20250527T17:28_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] and I'm calling to see like what's going on with my client.
[AGENT][NEUTRAL] OK, uh, Ms [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] Um, I don't have the policy number, but I can give you my social.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Mhm. OK.
[AGENT][NEUTRAL] OK, and what's your social?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK. And what policy was it for?
[CUSTOMER][NEUTRAL] Um, let me try to go online. Hold on for one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I'm online, um, it's for the policy hold on let me.
[CUSTOMER][NEUTRAL] It was 3600377 and 1 is 3599954.
[CUSTOMER][NEUTRAL] So I don't know why all these on there cause I think I already got.
[AGENT][NEUTRAL] It's not a policy number. It sounds more like a claim number. What type of policy was it for?
[CUSTOMER][NEUTRAL] I'm all right. Let me, let me, let me give us the policy number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so the policy number for that one, well the two that's pending is 259-4580, and then I have another one. That's 259-4578.
[AGENT][NEUTRAL] 154.
[CUSTOMER][NEUTRAL] I don't know what, I just see those two online.
[CUSTOMER][NEUTRAL] That's pending.
[AGENT][NEUTRAL] OK. As far as your
[AGENT][NEUTRAL] Disability policy, the 2,594,580. It looks like, let me see.
[CUSTOMER][NEUTRAL] I don't see that one. let's see 25.
[AGENT][NEUTRAL] That's the one you gave me initially, the 2,594,580. It looks like they're waiting for medical records from Doctor [PII].
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Well, I thought they, they faxed them in because I got the paperwork and then I uploaded it last week. And then I showed her that and I uploaded 3 documents to show that they did fax it when they say they faxed it. And so I uploaded on the same myself. But the paperwork shows she's saying that they didn't get it when I called in, but the back paper that I uploaded to the computer, I mean to the website.
[CUSTOMER][NEUTRAL] It shows that they faxed it. They had been faxed the medical papers.
[CUSTOMER][NEUTRAL] And it shows the number that they faxed it to and everything. So I don't, that's why I don't see what what's the problem because I uploaded it to the thing myself when they said they didn't get it, but I made sure I uploaded that that paper where they had been faxed the paper.
[AGENT][NEUTRAL] Uh, don't show anything been sent. Uh, the last claim that was sent was on [PII].
[CUSTOMER][NEUTRAL] Yes, are they, are they not looking at what what I'm uploading on the website even?
[AGENT][NEUTRAL] And you place it under the disability policy?
[CUSTOMER][NEUTRAL] Um, yes, where it says you upload and I did both of them. I put them under the um policy number.
[CUSTOMER][NEUTRAL] 259 4580 and then I put it under 2594578.
[AGENT][NEUTRAL] Uh, let me one moment.
[CUSTOMER][NEUTRAL] And like I said, they faxed the paperwork, and I faxed, I uploaded that paper too to show them that they had already faxed it. They faxed it on like the the [PII].
[CUSTOMER][NEUTRAL] May the [PII], that's when they finish.
[CUSTOMER][NEUTRAL] Cause I, I picked up the paperwork from the doctor. They called me as soon as they faxed me.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment, I apologize. Our system is going really slow.
[CUSTOMER][NEUTRAL] OK, that's fine.
[AGENT][NEUTRAL] Well, what I'm showing we received on the [PII] with this physician's portion of the claim form, but what they are needing is the medical records.
[CUSTOMER][NEGATIVE] I mean, what medical, that's what I say. Nobody telling me, sending me no email. They're just not saying nothing. I have to call and see what it is that I need. And I've never dealt with that with any place that ever didn't, you know, tell me what it was that I needed. Like I got the paperwork, I filled it out and nobody isn't telling me anything except for when she sent the medical paper, I told her that the doctor faxed it, but she didn't tell me nothing different.
[CUSTOMER][NEUTRAL] And I don't know what medical, what else like medical paper that they did because I filled out everything that was needed for the paperwork that they told me that I needed to fill out. So I don't know what medical records they need.
[AGENT][NEUTRAL] Uh, the medical records they need is to see if you receive any treatment or diagnosed prior to your effective date of coverage.
[CUSTOMER][NEUTRAL] Um, I had surgery.
[CUSTOMER][NEUTRAL] So I don't know what they're talking about. And I've been out of work ever since the um I had my surgery on the [PII] and I haven't been back since. So I'm confused that what what I mean, what are they talking about?
[AGENT][NEUTRAL] For your policy
[AGENT][NEUTRAL] Your policy wasn't effective till [PII] of this year, so.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] They need to verify if you received any treatment were diagnosed prior to the effective data coverage.
[AGENT][NEUTRAL] I know you say that you had a surgery, but still, if you were diagnosed or seen by a doctor regarding to uh that condition, they have to check for pre-existing. So that's the reason why they are needing medical records.
[CUSTOMER][NEGATIVE] I mean I sign the paper to the stuff so I don't like I said, nobody's telling me what it is specifically that I need to go get, so I'm just lost. cause like I said, I don't went all month without any disability which I pay for.
[AGENT][NEUTRAL] Well, it's not uh something that we're needing from you. We're waiting for that information from the provider, that medical records from the provider. And it looks like they requested it on.
[CUSTOMER][NEUTRAL] Who did I request this from?
[AGENT][NEUTRAL] Uh, Dr. [PII] office. It looks like they requested on [PII] and we still have not received it.
[CUSTOMER][NEUTRAL] So, OK, so, um, I mean like.
[CUSTOMER][NEUTRAL] Specifically, I know you're saying the medical records like prior to like have I seen him prior to that? That's what I'm confused about.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Have you seen any provider prior to the 12 months prior to your effective date of coverage, that's the uh what the examiners are needing to verify.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Oh well, um because like I said, I don't been to the doctor and then they ain't said nothing about the doctor. I mean about them needing any other paperwork other than um what I, what they fax and what I sign in. So like I said, they're not.
[CUSTOMER][NEGATIVE] They're not telling me, I don't see any mail or anything that they're telling me like what what else is needed.
[CUSTOMER][NEGATIVE] Because if they would have told me I could have went up there and see or called up there to see, but nobody's telling me nothing.
[AGENT][NEUTRAL] OK. It looks like they also, the examiner sent a letter on the [PII], a delay letter explaining um the policy. There's a delay in processing the claim since we're waiting for medical records from the provider.
[AGENT][NEUTRAL] Uh, Ms. [PII], verify your mailing address.
[AGENT][NEUTRAL] Make sure we have it correct in the system.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEGATIVE] It's [PII], because I told the lady that when I did the claim they have 604, but I told her that's not my mailing address. I told her my mailing address is [PII]. Because I'm not receiving any mail. She had to resend the paperwork through my email.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, give that address to me one more time. You said [PII].
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Yes, it's it's in [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what's that zip code again, please?
[CUSTOMER][NEUTRAL] Um, it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I will update your address. Give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] change the mailing address. Um, so hopefully you should receive those notifications, um.
[AGENT][NEUTRAL] But um
[AGENT][NEUTRAL] Once they receive that medical records from the provider, then they can continue to process another claim.
[CUSTOMER][NEUTRAL] OK, and you said they sign it on [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so, um,
[CUSTOMER][NEUTRAL] OK, so I'll give them a call and see.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Well, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, no.
[AGENT][POSITIVE] OK, uh thank you for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You you too bye.
[AGENT][NEUTRAL] Bye.