AccountId: 011433970860
ContactId: 4cfcdb82-6a7b-45d7-b585-a251e59dd7c6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 671200 ms
Total Talk Time (AGENT): 252799 ms
Total Talk Time (CUSTOMER): 208930 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/4cfcdb82-6a7b-45d7-b585-a251e59dd7c6_20250403T15:05_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I'm just fine. I'm just checking on the status of the claim.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status and um may I have your name and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Uh, my name is [PII]. The telephone number is area code [PII].
[AGENT][NEUTRAL] OK, thank you. And do you have the policy number?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK, let me have that. Yes.
[CUSTOMER][NEUTRAL] You ready for it?
[CUSTOMER][NEUTRAL] 259-639-6
[AGENT][NEUTRAL] OK, thank you. And for security, may I have your date of birth, mailing address and email address?
[CUSTOMER][NEUTRAL] My date of birth is [PII]. My mailing address is [PII].
[CUSTOMER][NEUTRAL] Uh, you said my email?
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] As well.
[AGENT][NEUTRAL] Yes, uh-huh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. Thank you. All right. And let's see. OK. Let me check and see the last um information that I got here and this is for your disability, correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yeah, right.
[CUSTOMER][NEUTRAL] Short term, uh, I may have stated it wrong, but it's just a short term.
[AGENT][NEUTRAL] Yeah it's OK. No.
[CUSTOMER][NEUTRAL] Cause I'm supposed to have surgery.
[AGENT][NEUTRAL] Mm, OK. So it looks like uh the examiner uh has put a note here indicating that she received the physician claim form. Uh, we needed the authorization claim form.
[AGENT][NEUTRAL] Um, see, to request medical records it looks like good.
[AGENT][NEUTRAL] From [PII].
[AGENT][NEUTRAL] OK, so it looks like.
[CUSTOMER][NEUTRAL] I sent you that as well as from the surgeon.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. So, um, when did you send us the authorization claim form?
[CUSTOMER][NEUTRAL] OK. I can pull that paperwork out. Um, it was 9 pages and they also came from the surgeon that's supposed to do the surgery. Um, you don't have any of that?
[AGENT][NEUTRAL] Uh, I'm just looking at what the examiner because the, the claim goes to an examiner. The, the examiner is the one that um process the claim, view all the information and see what's missing or what she's needing to complete the claim. So they will notate the account, they will put some documents in the system, and then I'll go ahead and read what they have said about the claim, which that's what I'm doing and it looks like based on the information I see here she's asking for that.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, um, um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh boy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Now, the first initial facts that was sent to y'all was sent to y'all um.
[CUSTOMER][NEUTRAL] Um, [PII], but, um, cause I was told um.
[AGENT][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I was misinformed by my job that um
[CUSTOMER][NEUTRAL] All this stuff needs to be in [PII] by [PII]. The next facts.
[CUSTOMER][NEUTRAL] Which consisted of 9 pages cause I've been sending stuff crazy, like crazy 7 pages.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it consisted of the HIPAA privacy authorization form.
[CUSTOMER][NEUTRAL] It also consisted of the insurance premium payment form, um, it consisted of the, um, from the surgeon, the surgeon's um take.
[CUSTOMER][NEUTRAL] Uh, who else?
[CUSTOMER][NEUTRAL] What else?
[CUSTOMER][NEUTRAL] Hold on, let me go to this other file because like I said this, that would be the 2nd group of faxes I have sent y'all.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, yeah, that was on the [PII]. OK.
[CUSTOMER][NEUTRAL] So, uh,
[CUSTOMER][NEUTRAL] OK, that's not in there. So what, what, what, what are you missing? What do you tell me what are you missing.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and I'm just reading off what the note says here so it's just saying that we're needing the authorization claim form, so that's basically what we're what we're needing. But if you said that you send it, what I can do is, mhm, yes, the authorization claim form.
[CUSTOMER][NEUTRAL] The authorization.
[CUSTOMER][NEUTRAL] What type of authorization?
[AGENT][NEUTRAL] Yeah, it will, it will be the authorization to disclose the information that you said you already sent.
[AGENT][NEUTRAL] But that that is the one that OK. Uh-huh. Yes.
[CUSTOMER][NEUTRAL] Yeah, that, that hippa, is that what you're referring to?
[AGENT][NEUTRAL] Yes, um, so what I can do is, mhm, go ahead.
[CUSTOMER][NEUTRAL] Cause the last
[CUSTOMER][NEUTRAL] I'm listening. I apologize.
[AGENT][NEUTRAL] It's OK, no, no problem. Um, so what I can do is have an examiner look into it again and give you a call back or um.
[AGENT][NEUTRAL] If that's, if that's what you would like to do or um either I can try to get someone on the line, um.
[AGENT][NEUTRAL] I don't know which one would you rather do, have a call back or get somebody, try to wait and see if we can get somebody on the line right now.
[AGENT][NEUTRAL] So they can go over the paperwork and see if they really have that. So you wanna try to get somebody or you're gonna try to wait for that call?
[CUSTOMER][NEUTRAL] OK, I'll wait.
[CUSTOMER][POSITIVE] Yes, if you don't mind, please.
[CUSTOMER][NEUTRAL] If you don't mind, please, I, I'll wait for somebody, wait for you to get somebody on the line. Thank you.
[AGENT][NEUTRAL] Try to get somebody right now. OK, sure.
[AGENT][NEUTRAL] OK, OK, you're welcome one moment, OK?
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Hi [PII], how are you? This is [PII].
[CUSTOMER][NEUTRAL] Hi so how are you?
[AGENT][POSITIVE] I'm good and you?
[CUSTOMER][POSITIVE] I'm doing well thank you.
[AGENT][NEUTRAL] Yeah, yeah. Um, well, I have a member of disability, uh, on the line and um he's he's saying that we have the information that we're waiting for, um, and I asked him for a, you know, I told him about a callback and he said no, he wants to speak to somebody right now. So, let me go ahead and give you the information. Um, the policy number is 259-6396.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it looks like based on the note from [PII], uh, we're needing the authorization claim form, but he says that he sent it on the second batch that it is there that he don't know why we're asking for it again.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Well, let's take a look and see, and he said he sent it on the first claim or the second claim, or you're not sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Like the second batch, [PII], [PII], that's what he said he's supposed to be there.
[CUSTOMER][NEUTRAL] OK, let me just, I'll just pull up each one and his name, the [PII].
[AGENT][NEUTRAL] golfing, uh-huh, yes, mhm, golfing.
[CUSTOMER][NEUTRAL] OK, and that says callback number [PII]?
[AGENT][NEUTRAL] Yes, yes, and I did fully verify him, OK.
[CUSTOMER][POSITIVE] OK, and everything's verified. OK, great.
[AGENT][POSITIVE] Yes. All right, you're ready for him?
[CUSTOMER][POSITIVE] Alright, you can go ahead and put him through and I will assist them, yeah.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] All right. Thank you. Have a good day. Here he comes.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][POSITIVE] Thank you. Thank you for holding and being patient for me, Mr. [PII]. I got Ms. [PII] on the line. She's gonna assist you from here.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Not
[CUSTOMER][NEUTRAL] Hi Mr. [PII], my name's [PII]. I'm on a claim support team. Um, if you'll just bear with me for just a moment, I'm looking through the documents that you sent in. Um, Ms. So indicated that you said you sent in the form that we're asking for, and so I'm just reviewing that information, so bear with me for just a moment. I have to go in to each, uh, piece of, uh, each, each, uh, submission. OK, thank you. Yes ma'am.