AccountId: 011433970860
ContactId: 4674b7a0-b4a9-4bbb-b112-40458316bcee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 479130 ms
Total Talk Time (AGENT): 170443 ms
Total Talk Time (CUSTOMER): 186177 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/4674b7a0-b4a9-4bbb-b112-40458316bcee_20250603T19:09_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, [PII], my name is [PII], and I'm calling from Dealer Supply and Lumber Company, and I submitted a claim for one of our employees online on [PII], and I was just gonna try to get some information on the status of that claim.
[AGENT][NEUTRAL] OK, [PII], um, do you have the policy number for that member?
[CUSTOMER][NEUTRAL] Um, it looks like it's 231-012-2.
[CUSTOMER][NEUTRAL] And I do have the confirmation number where I submitted it.
[AGENT][NEUTRAL] And then can you verify your email address for me and the phone number?
[CUSTOMER][NEUTRAL] Yes, it's [PII] and the phone number is [PII].
[AGENT][NEUTRAL] OK, and then lastly the address for your group.
[CUSTOMER][NEUTRAL] OK, do you need the mailing or the physical?
[AGENT][NEUTRAL] Uh, either one is fine.
[CUSTOMER][NEUTRAL] OK, uh, the mailing is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, perfect. Thank you.
[CUSTOMER][NEGATIVE] I went brain dead on that number.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, and this was for [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me see what we see you.
[AGENT][NEUTRAL] OK, so we got the claim form completed for [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Looks like we were, we didn't get anything from the attending physician. So, did he go to, I assume he went to the hospital, correct? Is that right?
[CUSTOMER][NEUTRAL] He did. He went to the Augusta Burn Center.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He went, I think he went to the emergency room and then they like flew him to the Augusta burn center.
[AGENT][NEUTRAL] Yeah, it, it looks like we we need actual, so all we have is just that claim form.
[AGENT][NEUTRAL] And so we need like some type of medical documentation that shows you, you know, what, what hospital he was at and then like with the diagnosis. Um is that something you might be able to provide maybe for major medical or
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yes, let me, will the EOB work or?
[AGENT][NEUTRAL] Well, it'll have to have, so what it, what it, yeah, it has to have actual, you know, like it'll have to have like procedure codes or it'll need the actual diagnosis. It could be like hospital admission summary, um, physician notes, discharge summary, something that shows what happened. Yeah.
[CUSTOMER][NEUTRAL] Uh, probably not, no.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I have the paperwork that was sent. We also had to file it on um.
[CUSTOMER][NEUTRAL] His short term disability as well, so let me, is that something I can upload to the portal?
[AGENT][NEUTRAL] Um, so.
[CUSTOMER][NEUTRAL] Or how do I need to get that sent in?
[AGENT][NEUTRAL] Um, can you fax it to us?
[CUSTOMER][NEUTRAL] Uh yes, I, um, no, we, we have incoming facts, not outgoing, we have, what about email?
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] I
[AGENT][MIXED] Well, no, email won't work. We don't actually have a secured email, but yes, the portal will be fine. You can upload via your group dashboard.
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] OK, um, let me look it it looks like the website has changed since I did the.
[CUSTOMER][NEUTRAL] Um, when I submitted the claim, uh, start a new claim.
[AGENT][NEUTRAL] It has, you're gonna have to create.
[AGENT][NEUTRAL] Yeah, you'll need to create an entirely yeah totally new account, um, you'll have to start completely over.
[CUSTOMER][NEUTRAL] Oh, OK, I did that now once once I'm at the home screen, where do I go? my group?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] At the dashboard? OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And then how would I upload the documents?
[AGENT][NEUTRAL] Um, there should be, do you have something that says upload files or?
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] Mm mm I have let me go in employees and let's see if it would if it'll, I don't even know that it shows his claim.
[AGENT][NEUTRAL] I believe I have.
[CUSTOMER][NEUTRAL] On here uh is what I was looking for online that's why I ended up calling because I couldn't even see where the claim there.
[CUSTOMER][NEUTRAL] No, and see when I pulled up his name.
[CUSTOMER][NEUTRAL] Uh, [PII], like on the portal, I can't even see any open claims.
[AGENT][NEUTRAL] OK, I think it's the timing. It looks like we just released the EOB, so typically there's a little bit of a lag there, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It probably upload within the next day or two,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But I think, let me see.
[CUSTOMER][NEUTRAL] I think I have.
[CUSTOMER][NEUTRAL] Um, this is the paperwork that the doctor sent.
[CUSTOMER][NEUTRAL] For his um.
[CUSTOMER][NEUTRAL] Short-term disability and it tells actually what happened.
[AGENT][NEUTRAL] OK, that, that would.
[CUSTOMER][POSITIVE] It gives all kind of stuff.
[AGENT][NEUTRAL] Yeah, that should suffice if it has like diagnosis codes, um, and then, you know, explains what happened, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][POSITIVE] Good work.
[CUSTOMER][NEUTRAL] I just can't like it will let me start a new claim like.
[CUSTOMER][NEGATIVE] It'll let me file a new one but I don't see where I can actually add anything.
[AGENT][NEUTRAL] OK, um, I think once it loads, you should be able to, I would try again at the end of the day tomorrow and see if it's loaded by then.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Is that like I said, there is a little bit of a lag time from when we finalize and then when it's getting, especially since we've switched over our websites, um, still getting everything switched over so um give it till the end of the day tomorrow and see if that works. If not, give us a call back and we'll see if we can troubleshoot a little bit further.
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][POSITIVE] OK, that sounds good, [PII]. Thanks for your help.
[AGENT][NEUTRAL] OK, anything else I can help with today?
[CUSTOMER][POSITIVE] That's all. Thank you so much.
[AGENT][POSITIVE] OK. Thank you for calling APL. I hope you have a great day.
[CUSTOMER][POSITIVE] You too thank you bye bye.