AccountId: 011433970860
ContactId: 596a64bd-4ee4-4ca8-b4a4-76a7a2f82012
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 571979 ms
Total Talk Time (AGENT): 175212 ms
Total Talk Time (CUSTOMER): 218058 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/596a64bd-4ee4-4ca8-b4a4-76a7a2f82012_20250523T20:46_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, hi, so, my name is [PII], and I'm calling, I received a uh benefit check for my supplemental insurance, and I was going over the explanation of benefits, and I noticed on there that uh
[CUSTOMER][NEUTRAL] They, there were 2 months that were not accounted for, and I was just curious if that comes on a separate check. I know there was some back and forth with the claim, uh, and they requested more information and stuff like that, but I just wanted to see what the status of those those other two months were.
[AGENT][NEUTRAL] OK, sure, I can assist you and this is for disability?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm, OK, um, may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the policy number if you have it?
[CUSTOMER][NEUTRAL] Uh, let's see, is it um policy number is gonna be 02265585.
[AGENT][NEUTRAL] Thank you. And for security, may I have your date of birth, mailing address and email address on file, Mr. [PII].
[CUSTOMER][NEUTRAL] Yeah, it's [PII] [PII]. It's gonna be my last name, [PII].
[AGENT][POSITIVE] Mm. Thank you.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] OK, where are the 2 months missing?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Is that a separate disability?
[CUSTOMER][NEUTRAL] No, it's all the same claim. Yeah, it should be, so I know some of the stuff that I submitted like the, um, there's an independent medical examiner reported the details, um, all of the treatments and over the the whole treat the portion of the injury, and I know that it's in there as well as I believe.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] The the doctor certification letter, um, I wanna say that there's some back and forth like, oh it didn't have the dates that they needed or whatever, um, and they had to certify the other dates, but I resubmitted it and it should have all those dates on the doctor's form. So one of them is like a 19 page document, and then the other one's, uh, it should be a form that should be coming from uh Doctor [PII]'s office at [PII] that should have all the dates certified.
[AGENT][NEUTRAL] Yeah right.
[AGENT][NEUTRAL] OK. Um, I'll have to get an examiner. Um, if I cannot get an examiner, can I get one to call you back?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so let me try to get a claims examiner or claim support on the line, OK?
[CUSTOMER][NEUTRAL] Yeah, do you, do you, do you see that? do you see those dates and all that stuff in there? Is that in the paperwork?
[AGENT][NEUTRAL] I don't see it. Um, that doesn't mean they're not here. Um, the person who processed the claim needs to go back and see if she can find those dates, um, because they're the ones that do research on the claims. Um, so let me just go ahead and get them on the line and see if they can find those dates, OK? One moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APO. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII], how are you? This is [PII].
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] I'm good, I'm good, thank you. Um, I have a member on the line that he's calling about his disability and he said that there's some checks missing from the check he's just received, um, like there's some months that are missing and I don't see them, so I'm not sure exactly what he's calling about. He said that he spoke to somebody and they were able to see it. They were just asking for additional information which he sent to us. That's what he said, OK?
[CUSTOMER][NEUTRAL] Is the policy number?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] The policy number is 2265585.
[CUSTOMER][NEUTRAL] OK, and his name?
[AGENT][NEUTRAL] His name is [PII].
[AGENT][NEGATIVE] Rude. I don't know how to say that.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And he's looking for some claims. He said [PII], which I checked the uh new policy because I see there is another one, but I didn't see those dates.
[CUSTOMER][NEUTRAL] What is the other policy number?
[AGENT][NEUTRAL] It's 2508727.
[AGENT][NEUTRAL] What they do is DMO to um.
[AGENT][NEUTRAL] And then send it out.
[AGENT][NEUTRAL] Oh I think I just process one and then process another one.
[AGENT][NEUTRAL] Maybe
[CUSTOMER][NEGATIVE] But like that one denied the workers' comp.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that's that's the one for uh.
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] Is that [PII] [PII]?
[AGENT][NEUTRAL] Or it's just [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah, I see that one but I don't see like a bunch of things.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So I've seen it then that's only [PII].
[CUSTOMER][NEUTRAL] Uh, give me a second.
[AGENT][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] You can go ahead and send him over and I can be looking at just in case he has some more questions.
[AGENT][NEUTRAL] Sure, and the callback number is the same one in the system, the [PII], and I did verify all this information, OK?
[CUSTOMER][NEUTRAL] OK, alright.
[AGENT][POSITIVE] OK, thank you. Here he comes. Thank you for holding and being patient for me, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I've got a representative on the line and she's gonna assist you from here. She's in the claim support team, OK?
[CUSTOMER][POSITIVE] OK perfect thanks so much.
[AGENT][POSITIVE] Miss speaking. You're welcome.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Thank you for calling APO. This is [PII], and how are you?
[CUSTOMER][POSITIVE] Yeah hi [PII] I'm doing well thanks.
[CUSTOMER][NEUTRAL] OK, and she said she had a you had a couple of questions about some dates that were missing on your claim, is that correct? So I, I was yeah I finally received uh my claim check and I was going over the explanation of benefits and I noticed that uh 2 months 5-16 to 723 was left off and I know that uh you guys had requested additional information. I got the request.
[CUSTOMER][NEUTRAL] Uh, it looked like a [PII]. I got it back from the doctor certifying those dates on the physician's statement and then on [PII] I got an email from service claims and says thanks so much for your help. I processed your forms for carrier review and we'll be waiting on an update so you it looks like you guys processed those months on [PII], um, for those additional dates. It didn't make it on this check. I know because there was some back and forth, uh, getting all the dates because it's all the same claim, um, that, that I, I wasn't sure if.
[CUSTOMER][NEUTRAL] For some reason it got left off or if there's another check that's coming and they're still processing that that those additional two months.
[CUSTOMER][NEUTRAL] OK, so for the um.