AccountId: 011433970860
ContactId: 4191878d-6287-441b-8273-d5a6165740cd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1143010 ms
Total Talk Time (AGENT): 501348 ms
Total Talk Time (CUSTOMER): 527182 ms
Interruptions: 25
Overall Sentiment: AGENT=1.8, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/4191878d-6287-441b-8273-d5a6165740cd_20250612T18:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I am trying to set up a new account since y'all changed your system and the information I'm putting in um it's saying that uh the insured doesn't exist.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so yes, I do apologize for all of that um so you are trying to create an account the information you're entering it's just not letting you, you're getting that error?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, so the information you enter does have to match what we have in.
[AGENT][NEUTRAL] So I can go ahead and get that pulled up and verify that all of that is correct. um, what was your name please?
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[CUSTOMER][NEUTRAL] I'm the HR manager, but this is for one of my employees who is sitting here with me.
[AGENT][POSITIVE] OK, perfect. All right.
[CUSTOMER][NEUTRAL] And his name is [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, and then before we go any further, uh, [PII], can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you and then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh, no, I don't have the policy num. Well, hang on, I can get it.
[AGENT][NEUTRAL] That's OK. Uh, if it's easier, um, I can also search with uh his social.
[CUSTOMER][NEUTRAL] OK, his social is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] You get the claim number and policy number?
[CUSTOMER][NEUTRAL] Um, if she can't find it this way, we will. Oh wait, I.
[AGENT][POSITIVE] OK, I do believe I found him out. I'm sorry.
[CUSTOMER][NEUTRAL] Uh, I'm sorry, I'm talking to [PII] as well.
[AGENT][NEUTRAL] No, no, that's fine. um, can [PII] hear me?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hi [PII] I'm just gonna verify some of your information really quick. Uh, can I get your date of birth please?
[CUSTOMER][NEUTRAL] Uh, it's [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and I see the hiccup right here uh we do not have an email on file for you uh so what would you like that email address to be?
[CUSTOMER][NEUTRAL] Uh, it's my name [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] the end [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK awesome give me just a moment let me go ahead and get that added.
[CUSTOMER][NEUTRAL] I don't have your short term or long term information so you'll have to look that up than what they emailed you.
[CUSTOMER][NEUTRAL] Or in your paperwork.
[AGENT][NEUTRAL] OK, now if y'all would um go ahead and refresh that screen whatever screen you're on and um go back to of course selecting the insured and then reenter that information using that email address.
[CUSTOMER][NEUTRAL] I can find it but you'll.
[CUSTOMER][NEUTRAL] OK, hang on one second.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Nope, still says no user was found with the information that was entered.
[AGENT][NEUTRAL] OK, give me just a minute. I'm gonna go ahead and try it on my end as this of course the system got updated uh last week, so there are quite a bit of um little kinks in there uh let's see, give me just a moment.
[CUSTOMER][NEUTRAL] Well, are you able to just give us an update on one of the open claims he has?
[AGENT][POSITIVE] Oh sure, yeah I can definitely check on a claim for you.
[CUSTOMER][POSITIVE] And that's all we're looking for at this point, you know, and we can worry about this once y'all get the get the kinks out.
[AGENT][POSITIVE] OK. Well, sure, no worries.
[AGENT][NEUTRAL] No, no, no, OK, so I will say um I can check on that claim for you, but I will say I was able to get to the next step um this is gonna sound funny um but if you would only fill out the fields that have an asterisk and leave the other ones blank and then also, uh, especially whenever you're putting in his date of birth, which is probably last, make sure that that's unselected so click off of that before you hit next.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] I know it's all these I'm so glad somebody was able to figure these things out because they're the weirdest little hiccup.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Yeah, I was still in the field, so maybe that's OK, hang on.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Because I'd like to have it to where I can keep up with this for him.
[AGENT][POSITIVE] Of course, absolutely.
[CUSTOMER][NEUTRAL] Nope, didn't go through for me that way, so let's empty the fields without asterisk.
[AGENT][NEUTRAL] Right, yes.
[CUSTOMER][NEUTRAL] Let's try it.
[AGENT][NEUTRAL] And then again make sure especially the date of birth as that's probably the last thing you'd enter make sure that that's not selected um like click off of it so it's not selected at all before you hit next.
[CUSTOMER][NEGATIVE] Nope, still not going through for me.
[AGENT][NEUTRAL] Well I mean I can I can get it set up if you'd like um because I I'm able to get to the next steps did you want me to go ahead and get that set up for you?
[CUSTOMER][NEUTRAL] Huh, OK.
[CUSTOMER][POSITIVE] Yeah, sure, let's go ahead and do it just so we can get in.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely. Give me just a minute.
[CUSTOMER][NEUTRAL] Oh that's the indemnity.
[CUSTOMER][POSITIVE] This is the one we wanna look at.
[AGENT][NEUTRAL] OK, so let's see.
[AGENT][NEUTRAL] [PII], do you have access to this email, uh, at the moment?
[CUSTOMER][NEUTRAL] Yes
[AGENT][POSITIVE] Oh goodness. Hang on just a minute. I think I found the problem. Oh my gosh. Hang on just a minute.
[CUSTOMER][POSITIVE] Oh [PII], we are gonna be.
[AGENT][POSITIVE] All righty.
[AGENT][POSITIVE] We're gonna get it. I promise, we're gonna get it. All right.
[AGENT][NEUTRAL] OK, go ahead, refresh and try it one more time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just the ones with asterisks or all of them?
[AGENT][NEUTRAL] Correct, just his last name, email, and then date of birth.
[CUSTOMER][NEUTRAL] Shoot, I forgot [PII] OK I forgot that quick.
[CUSTOMER][POSITIVE] Oh my goodness, we made it we got to go.
[AGENT][NEUTRAL] I swear this is something I'm telling y'all. I am so sorry but at least we're there, OK.
[AGENT][NEUTRAL] Did you still want me to go ahead and check on that claim for y'all?
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Yeah, you might as well because maybe you can give us more than it's gonna tell us anyway.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure, OK, um, which policy was this for?
[CUSTOMER][NEUTRAL] Um, it's for his critical illness policy.
[AGENT][NEUTRAL] Critical illness. OK, let me go ahead and get that one pulled up.
[CUSTOMER][NEUTRAL] American Public Life. Yes, what's the code?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Of course it is.
[CUSTOMER][NEUTRAL] Hang on one second, we're, we're trying to finish this code real quick.
[AGENT][NEUTRAL] Oh sure.
[AGENT][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] If if it if his email will come up.
[AGENT][NEUTRAL] Oh gosh.
[AGENT][NEUTRAL] When it rains it pours.
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] It really does. I don't know what the.
[CUSTOMER][NEGATIVE] Because it says no, why would I make it easy now.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] I mean at least we're going forward, you know, a little slow, but.
[CUSTOMER][NEUTRAL] One step every 20 minutes.
[CUSTOMER][NEUTRAL] OK here we go. Oh wait, [PII].
[CUSTOMER][NEUTRAL] All right, verify code.
[CUSTOMER][POSITIVE] Huh, OK, we're done. I'm, I'm making it the same password I gave you though, OK, and I'll give it to you.
[CUSTOMER][NEUTRAL] I'll give it to you again just to make sure.
[CUSTOMER][NEUTRAL] OK, go ahead. Tell me what you see.
[AGENT][NEUTRAL] No worries. OK, uh, it's a good thing that y'all hung on the line because I imagine if whatever y'all see probably won't provide a lot of information. I am having to look at the notes. So in short, we did have to request uh medical records. um I'm sure you were aware of that.
[CUSTOMER][NEUTRAL] Yes, and there was a problem getting medical records back and forth we know that.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Right, OK, so as of as of yesterday, so this was just yesterday, um, I do see a note in our system that we did receive some medical records from, let's see, Lane Regional Medical Center, but there was no mention of any type of transplant status so we called the Cardiovascular Institute of the South and spoke with.
[AGENT][NEUTRAL] A member there and she stated that the medical record request had been received and had been sent to the correct department for processing so that place the Cardiovascular Institute of the South, I guess again as of yesterday um they have it and it's in process so we should be getting that shortly.
[CUSTOMER][NEUTRAL] OK, so you still do not have the records from CIS.
[AGENT][NEUTRAL] That's correct, um, and again I guess, um, a representative of ours called them yesterday to get the status. They did say it's been received in the correct department and is currently being processed, so I imagine if that was just yesterday we should be getting that very shortly.
[CUSTOMER][NEUTRAL] OK, so let me ask you this. You said that the lane records do not show anything about uh about a transplant.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEGATIVE] But he is in heart failure.
[CUSTOMER][NEUTRAL] So I mean, does it only pay out if he gets a transplant?
[AGENT][NEUTRAL] No, not necessarily, it just looks like from what I see here.
[CUSTOMER][NEUTRAL] Because he's not on the transplant list yet.
[AGENT][NEUTRAL] Sure, I think that what they mean is just that the full records that we're missing from that so we're just waiting for that information from um the cardiovascular institute and once we have that then we can continue getting it processed.
[CUSTOMER][NEUTRAL] OK, because I mean the records that we have.
[AGENT][NEUTRAL] And then we're just needing all pieces of the puzzle.
[CUSTOMER][NEUTRAL] The records that we have and that I have submitted, hang on a moment, and that's why we're we're really getting kind of confused on this and which I realized you need all the records from the cardiologist and everything, but the.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[AGENT][NEGATIVE] Yeah and this is where it gets incredibly frustrating as it's back and forth between you know us and then the uh providers and all the different facilities just trying to gather all these pieces um but again it does look like we're gonna have this seems like it's the last thing that we're needing um and it should you know if they're saying it was just processing y[PII] I don't imagine it would take long it just depends on how soon they can give it to us.
[CUSTOMER][NEUTRAL] Yeah, but it's like I mean from the records that were submitted from Lane, the form that they filled out and all on y'all's form, I mean the diagnosis on it is the primary diagnosis code is I-50.20 heart failure with reduced ejection fraction.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So I mean it's right there saying that he's in heart failure so I mean what else do they possibly need if the hospital says he's in heart failure? I mean that's, that's one of the things so.
[AGENT][NEGATIVE] Right, whatever it is that this.
[AGENT][NEUTRAL] Right, absolutely. What is needed from uh CIS is apparently all that we're missing.
[CUSTOMER][NEGATIVE] But uh but what I'm, I'm just not understanding why if one facility says he's in heart failure why you even need records from a second facility saying it as well if uh if uh uh original medical center says one that says that he's in heart failure.
[AGENT][NEUTRAL] They just need all of that again it's all the.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] You know, why, why do you need to wait for another one to say the same thing?
[AGENT][NEUTRAL] Apparently this is just one of those things they need all of this information.
[CUSTOMER][NEGATIVE] I don't understand the reasoning.
[AGENT][NEGATIVE] That's just how the process is unfortunately.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] They have to be thorough and make sure they get all of the everything that they need to be able to get it processed.
[CUSTOMER][NEUTRAL] Because I mean, by the time this thing.
[CUSTOMER][NEGATIVE] I mean because he's racking up medical bills. I mean he's he's like up to what would you say like 160, 175,000 I mean he's got racked up to like 175,000 at this point and I mean he doesn't need the stress of these people calling him, you know, he needs some money to be able to pay out and get these people off his back.
[AGENT][POSITIVE] Goodness. Yeah.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] No, I completely understand. Yes.
[AGENT][NEUTRAL] No, I completely understand and I, I.
[AGENT][POSITIVE] Right, yeah, no, I completely understand. I can't apologize enough that it's taken so long, but with this just being from yesterday, like I said, you should have it really soon.
[CUSTOMER][NEUTRAL] And the funny thing is is that this form that was submitted to y'all was signed by his lead cardiologist who is with Cardiovascular Institute of the South, so it's gonna be the same identical records because it's the same identical doctor that treated him at the hospital and that treats him at cardiovascular institute, so it's the same doctor, so the records are gonna say the same thing.
[AGENT][NEUTRAL] They're at the Lane Medical Center?
[AGENT][NEUTRAL] OK, yeah, so, uh, just the way that our pro
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Doctor [PII] is his cardiologist.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, yeah, um, and I completely understand where you're coming from and again I do apologize this is just they have to get all of these pieces to be thorough.
[CUSTOMER][NEGATIVE] I mean, but, but y'all's sorrow is gonna, God forbid, see him in a position where he can't get the help he needs, you know, because it's taken, it's been 3 months.
[AGENT][NEUTRAL] No, I know. Well, and again, I'm, I'm, yes, I.
[AGENT][NEUTRAL] I cannot apologize enough that it's taken so long.
[CUSTOMER][POSITIVE] Oh, and I, and I understand where you're coming from and I promise I don't, you know, we don't need your apology. You, you, you just follow.
[AGENT][NEGATIVE] No, I get it. No, but I am. I hate that y'all have to go through this because I do, yeah.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEGATIVE] In the meantime I've got one of my people sitting here just like has no clue what he can do to try and expedite this, you know, because nobody even ever contacted him to say hey we're having problems getting these medical records they just sent their request back in April and never followed up, you know, so he didn't even know until.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You know, just recently that y'all didn't have these medical records, so it just kind of somebody sent the request and then it sat there for two months and he had no idea that y'all didn't have these records, so I mean what what do we need to do to make sure someone on your end is following up to get these records because it just kind of got sent and then got.
[AGENT][NEUTRAL] Gosh.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] That is incredibly frustrating.
[AGENT][NEUTRAL] Sure, OK, so
[AGENT][NEUTRAL] Yeah, um, and again I think you know I'm, I'm not sure I I'm kind of surface level I'm not one of the ones that actually does any of the uh processing for the claims or anything like that. I see what they say and what they're doing um.
[AGENT][NEUTRAL] But I will say with this uh access to the portal you'll be able to view the statuses there and then of course once they're I think what they're doing really is you know if there's something an actual uh conclusion or solution I guess I should say uh that's when they would reach out otherwise you know of course if you call like you did I could tell you and.
[AGENT][NEUTRAL] Give you those updates and such, um, but I just fingers crossed that the last thing I saw was just yesterday.
[CUSTOMER][NEGATIVE] Right, but it was the gap between early April and yesterday that concerns me. And if I hadn't been out with surgery myself, I promise you it wouldn't have been two months because y'all would have got tired of me calling because I'd be calling every other day, hey, have you heard anything? You know.
[AGENT][NEUTRAL] Yes, yeah.
[AGENT][POSITIVE] Yes, and I completely understand that.
[AGENT][POSITIVE] No, no, that's completely understandable. Yes, absolutely.
[CUSTOMER][POSITIVE] I'm, I'm a very hands on manager here, you know, I take care of my people, so.
[AGENT][POSITIVE] I get that, yeah, that's good. Yes.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, all right, well, we're gonna, we're gonna give them a few days and then we'll be calling back to find out if they've got those records because if they don't, you know, my, my orthopedics, I mean my, uh, cardiologist is also one of [PII]'s cardiologists, and I'll be up in there talking to my cardiologist asking him what the hell is going on, you know, so that [PII] can get the help he needs, you know, um.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, yeah.
[AGENT][POSITIVE] Definitely.
[CUSTOMER][NEUTRAL] Not so much so that we get him back to work, but just so that he can get healthy, you know, and if he does need to wind up on the transplant list, we need him there sooner rather than later, you know, so, um.
[AGENT][POSITIVE] Yeah, rest easy. Definitely.
[AGENT][POSITIVE] Mhm. Yeah, absolutely.
[CUSTOMER][POSITIVE] OK, all right, well, I appreciate all of your help and we'll, we'll keep an eye on it and if.
[AGENT][POSITIVE] Yeah, you're welcome. I'm sorry there's not more I could do for y'all.
[CUSTOMER][POSITIVE] Well, if we don't see some movement here in the next week or so, I'm sure y'all will be hearing from me. So thank you so much for your help.
[AGENT][POSITIVE] Fell free, yes, feel free, give us a call.
[AGENT][POSITIVE] You are very welcome y'all have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Mm bye.
[AGENT][POSITIVE] Thank you. Bye-bye.