AccountId: 011433970860
ContactId: 410e39c9-ec82-469b-87fc-f41e86beb815
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 696840 ms
Total Talk Time (AGENT): 230383 ms
Total Talk Time (CUSTOMER): 236752 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/410e39c9-ec82-469b-87fc-f41e86beb815_20250414T15:53_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from the care team. I've got a member on the line that has a question about her short-term disability claim.
[AGENT][NEUTRAL] OK, what's your policy number?
[CUSTOMER][NEUTRAL] Policy number is 1245023.
[AGENT][NEUTRAL] And her name is?
[CUSTOMER][NEUTRAL] [PII] and then I've verified her information and I've got a callback number.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's her callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what was her question?
[CUSTOMER][NEUTRAL] Um, it's on the most recent claim 3585529. I couldn't figure out what the payment amount, why it was, um, $10.
[CUSTOMER][NEUTRAL] Uh, wasn't sure why it was reduced or what was going on and then she also, I didn't know if you have access to, she said her health care provider sent a fax Friday about the return to work and um I, I can't see. I know there's a place in Onase where we can see faxes but I don't have access to that because it's not loaded yet in Onase.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, it looks like looking at the remark code it looks like it was deducted due to her premium but you can send her on over to me.
[CUSTOMER][POSITIVE] OK, I'm gonna transfer on through thank you so much.
[AGENT][POSITIVE] Alright thank you.
[AGENT][POSITIVE] Good morning. Thanks for calling ATL. This is [PII], and how can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hi, Miss. My name is [PII]. Um, it's policy number 1245023.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I'm calling to find out.
[CUSTOMER][NEUTRAL] Two things. One, why was my payment reduced $10.89 and two, did you get the fax from Doctor [PII]'s office?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] On it should have been sent on Friday was supposed to be sent on Friday, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Unfortunately, I'm running behind on starting therapy and so my return to work date got bumped backwards.
[AGENT][NEUTRAL] OK, that's fine. Alright, uh let's see, I'll have to check to see if we have the facts because as of today I do not see that we have anything in.
[AGENT][NEUTRAL] Um, and the payment that was processed on [PII] for $10.89 that payment was reduced.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, due to the premium being deducted from your benefit.
[CUSTOMER][MIXED] OK, but it was still a $76 benefit, um.
[CUSTOMER][NEUTRAL] If they've been sending me a month at a time, so what did I do wrong?
[AGENT][NEUTRAL] Uh, so it looks like the benefit was $76.67.
[AGENT][NEUTRAL] And the premium amount that was deducted was 6578.
[CUSTOMER][NEUTRAL] Yes, yes, ma'am. I, I see that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But why was the benefit only $76? That's what I'm trying to ask.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Let me pull up this claim information one moment.
[CUSTOMER][NEUTRAL] No, I
[CUSTOMER][POSITIVE] Sure, I'm sorry.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] I was looking to make sure she didn't accidentally um.
[CUSTOMER][NEUTRAL] Email me, you know.
[CUSTOMER][NEUTRAL] If she has to me if I need it emailed or or sent, you know, emailed to me or sent to y'all, so I was making sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] OK, because it looks like the claim was, oh, I'm sorry, I'm sorry, uh, the latest claim she paid you for the return to work date that was on the claim, which was [PII], so that was just for maybe one day because she was only paid, she only paid you from [PII] for the [PII] day of service.
[CUSTOMER][NEUTRAL] I didn't actually
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] I'm sorry the [PII] day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so
[AGENT][NEUTRAL] Let me see, let me check the facts to see if I can see if something came through.
[AGENT][NEUTRAL] And if we do have something, then uh excuse me, she should be able to go back to review to see if we can make an additional payment. Give me one second to see if I can check our fax queue.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And you said it would sit on Friday?
[CUSTOMER][NEUTRAL] That's when she said she was gonna send it. I tried getting a hold of their office, but you have to go through the, the, the phone system, and I never got to her. I never got to Miss [PII]. I tried.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So she said she was gonna send it Friday.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, we went from the [PII] to the [PII] to next month on the [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I'm telling you what, after mailing the check to the hospital, oh Lord.
[CUSTOMER][NEUTRAL] I'll take a bit out of your savings account.
[AGENT][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I had actually um.
[CUSTOMER][POSITIVE] I had a little bit of time to prepare, thank [PII].
[AGENT][POSITIVE] Yeah, that's good.
[CUSTOMER][NEUTRAL] But really wish I would have prepared a little bit more physically for the surgery because, because it has been more of a challenge physically than I thought it was.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm looking at what came in on the [PII] and I don't see anything at this time for you.
[CUSTOMER][NEUTRAL] OK, I'll call [PII], see if she can get that sent to you guys.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alrighty and this
[CUSTOMER][NEUTRAL] OK, so I didn't screw up anything. It was just that the date hadn't been changed, right?
[AGENT][NEUTRAL] That's correct. As of today, it has not been.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I thought we had changed it to the [PII], so I was expecting like half a month, you know.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You get what I'm saying? So I didn't know if I had done something wrong.
[AGENT][NEUTRAL] OK, give me, wait a minute, I do see something on this form that says the [PII]. Can I put you on hold just one second?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, one second.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh, that's probably insured.
[AGENT][POSITIVE] Such a going here.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Hey, busy.
[AGENT][NEUTRAL] Alright, I have a question. I just wanna make sure that I'm telling her correctly on this, this disability.
[AGENT][NEUTRAL] Policy 1245023.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 124124.
[AGENT][NEUTRAL] 5023.
[AGENT][NEUTRAL] You know what I think I just answered my own question. Yes, [PII] and Low, OK, and so, uh, on her claim form I see that she's paid through April, well, [PII], but she's.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right. So, uh, on her thing it says [PII], so we just need the doctor's portion stating that she's out to [PII].
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK, but I'm seeing on, on her stuff, her stuff it says [PII], but I don't see that.
[AGENT][NEUTRAL] Yeah, that's what I was asking. That's what I'm saying.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, yeah, I saw that but uh so what does she what does she have? so we need to send her another form or did you send her one?
[AGENT][NEUTRAL] OK. And uh and so then she had to take that to the doctor and then she, OK. All right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, alright, got you.
[AGENT][POSITIVE] Alright, thank you, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, Miss In-law, thank you for holding.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, uh, so did you get the um.
[AGENT][NEUTRAL] The claim form that came with your payment.
[CUSTOMER][NEUTRAL] Uh yes ma'am.
[AGENT][NEUTRAL] OK, and so she said that we would also need the statement from you also included with the doctors. So there was a form for you uh that you would have to sign and date also.
[AGENT][NEUTRAL] And then also the information from the doctor.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So we'll need both of those.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, unfortunately it ended up with that doctor's appointment just being immediately after the processing it looks like, and I'm so sorry for that.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh, no problem. You're good.
[CUSTOMER][NEUTRAL] Um, I, I thought y'all.
[CUSTOMER][NEUTRAL] I thought y'all had y'all processed on the [PII], so when I left the office, I had called to let you guys know that she was supposed to send that the next day, but I'll call [PII] and see if.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We can get the paperwork from her, OK?
[AGENT][NEUTRAL] OK, alrighty, alright, if you have any other questions.
[CUSTOMER][POSITIVE] I appreciate him and you.
[AGENT][POSITIVE] Alright, if you have any other questions just give us a call back, have a great one bye bye.
[CUSTOMER][POSITIVE] Uh thank you, Ms. [PII]. I appreciate you.
[CUSTOMER][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] Yeah.