AccountId: 011433970860
ContactId: 5d9f7195-ad73-4349-bf8c-22123ea673ef
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1725020 ms
Total Talk Time (AGENT): 694764 ms
Total Talk Time (CUSTOMER): 1020193 ms
Interruptions: 8
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/22/5d9f7195-ad73-4349-bf8c-22123ea673ef_20250422T19:16_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] I didn't quite hear your name. Could you repeat your name, please?
[AGENT][NEUTRAL] Sure, my name is [PII] as well. Yes, can you hear me?
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yes, OK, so my name is [PII]. I am a uh client of uh.
[CUSTOMER][NEUTRAL] Co
[AGENT][NEGATIVE] Mr. [PII], you're breaking up.
[CUSTOMER][NEUTRAL] Trailer, so
[CUSTOMER][NEUTRAL] Can you hear me OK now?
[AGENT][NEUTRAL] I can hear you now. Yes, I can hear you now. Can you repeat what you said you were calling about something truck? I, I didn't get it.
[CUSTOMER][NEUTRAL] Hello, can you hear me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I'm driving a semi truck down the highway so you my signal may come in or may go out uh if you wanna call back number I can give it to you.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. OK, thank you. All right. And how may I assist you today, Mr. [PII]?
[CUSTOMER][NEGATIVE] OK, I've already uh gotten paperwork that I have filed with my job uh I spoke to one of your agents like yourself um I came across a problem with my employer.
[CUSTOMER][NEUTRAL] Uh, the doctor filled out his portion for the disability. I'm going to have surgery in June.
[CUSTOMER][NEUTRAL] I just got off the phone with my employer in the corporate office.
[CUSTOMER][NEUTRAL] They are they're gonna fill out their their portion of it and I'm talking about the APL form, OK, so that we understand what I'm talking about.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] They want to hold on to that form until [PII]. I started scratching my head. I said, wait a minute, wait a minute.
[CUSTOMER][NEUTRAL] Why do you wanna hold on to the form?
[CUSTOMER][NEGATIVE] So the young lady told me, well, that's because um your surgery isn't until the [PII]. I said, I understand that, but that form that you have, that doesn't even belong to you. That belongs to a, a private entity APL. You're supposed to send that information to them.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] So that they have it, so that they know what's going on with the doctor, uh, they have that information as well. So right now, this is the reason why I'm calling you. I don't know if there's a legal issue with this or not, but they're not going to release it until [PII]. I said if you do that, I'm gonna have to cancel the surgery because I can't go under the knife on the [PII].
[CUSTOMER][NEUTRAL] And you send the paperwork to whomever you're gonna send it to because I won't be in any shape to do anything about it. So can you at least send them a copy.
[CUSTOMER][NEUTRAL] Of this form.
[CUSTOMER][NEUTRAL] So she said, well we could probably do that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] But either way it goes, this is getting messy so I figured I would call someone which is you from ATL to give me some information on what I can do or if I can do anything at all.
[AGENT][NEUTRAL] OK. Um, do you have the policy number with you, Mr. [PII]?
[CUSTOMER][NEUTRAL] I do not. I'm on the road. uh, I'm sorry. All I can tell you is my, my social. I do have it, but it's not in front of me right now. I, I can't read it off to you. I know it starts with the number 2, yeah, I know it starts with the number 2, but I don't know it by heart.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm, it's OK. I understand.
[AGENT][NEUTRAL] It's OK alright let me have that social so I can pull up your policy.
[AGENT][NEUTRAL] Mr. [PII], can you hear me?
[CUSTOMER][NEUTRAL] What did you say?
[AGENT][NEUTRAL] Uh, may I have the social so I can pull up your policy?
[CUSTOMER][NEUTRAL] You need what? I'm sorry, I didn't hear you.
[AGENT][NEUTRAL] It's OK, the Social Security number so I can pull your policy.
[CUSTOMER][NEUTRAL] Oh, OK, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, here it is. All right.
[AGENT][NEUTRAL] And for security, may I have your mailing address and email address?
[CUSTOMER][NEUTRAL] Email address is [PII]. My address is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. Um, so I'll go ahead, I can go ahead and make a note. Um, it, it's OK if they hold on and send it after the [PII] because we will not consider benefits after the [PII] because it's after the fact, after the surgery. Um, so, um, basically, um, it's OK if they do that. If you wanna send your part and the physician's part, so we have that one.
[CUSTOMER][NEUTRAL] I don't, I hold on waiting.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Wait 1 2nd. I have to interrupt you. I can't send you anything because they have everything.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They have it all. And so that's, they have everything.
[AGENT][NEUTRAL] They have, oh, they have your part and the physician. Oh.
[CUSTOMER][NEGATIVE] They have, they have everything pertaining to the disability claim, and that's the reason why I said, why don't you just send them a copy after you fill out your portion, you can hold on to it if you want to hold on to it. But just send it to them. Now, something else that I want to bring up to you. I'm aware that you guys are not going to disperse benefits until after the [PII] because it takes 2 weeks. So I'm already aware of that. What I'm what I'm concerned about is this.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] If you're gonna sit back and fool around on the [PII], the [PII] is allegedly, supposedly the day of the surgery. Don't come calling me asking me questions about anything, because guess what? I just had surgery. I'm in no shape to answer questions. That's why I'm trying to do it in advance.
[CUSTOMER][NEUTRAL] I mean, everybody's trying to be nice, but you can't be nice with this. So I'm saying, hey, let these people get their information now. I realized that you can't do anything with it until after the [PII], but at least you have it. So therefore, when that day arrives, it's like, well, OK, Mr. [PII] goes to have surgery on the [PII], uh, we just got confirmation from his employer, we got a copy of it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So that way when I look at where I'm at with it on the [PII] I can go ahead and say OK let's go ahead and follow through with this.
[CUSTOMER][NEUTRAL] And that way all I have to do is wait 2 weeks and 1 week for them and the rest is history. But if I do it the way that they're talking about doing it, I guarantee you what's gonna happen is, is this, they're gonna send that form back to my job, which is in [PII], because they're in uh [PII]. It's gonna sit on my HR's desk. She's gonna be trying to call me like I'm ready to talk.
[CUSTOMER][NEUTRAL] I'm thinking someone's got a, got a uh uh a bit of disconnect here because I'm not gonna be in the mood to talk to anybody after knee surgery. That's why I'm trying my best to say listen, at least give them the copy of the paperwork. The last word I had with the lady in the corporate office for my employer was, I will give you the fax number.
[CUSTOMER][NEUTRAL] To APL you can at least fax that information all of it because they have it all right now fax that information to them so that they have it.
[CUSTOMER][NEUTRAL] That way they won't be asking well we still need your employer's information because without all of that information I've been through this before you all can't process the claim.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's all I'm gonna say.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, and I understand your point and I understand your frustration because, yeah, after you're out of surgery, you're not in a position of, of trying to get this resolved. Now, um
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, let me tell you how this is processed because that has a lot to do of what probably the the employer is trying to do.
[AGENT][NEUTRAL] Um, so basically, if they send a claim or if you send a claim right now, if you send us the claim form, the physician's form, the employer's form, and it has the date of [PII] for that surgery.
[AGENT][NEUTRAL] How the doctor is gonna know that you need 4 weeks or a month or 2 months because that's not gonna be determined after you have the surgery.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, the doctor.
[CUSTOMER][NEUTRAL] The doctor's putting that down there because he's an orthopedic surgeon and he already knows from doing knees. That's why it was, I mean, I, I even asked the, uh, I don't know who the young lady was. I said, well, let me make sure I do this right. The information, uh, the doctor puts in is what? Well, he's gonna put in the date of the surgery and how long he anticipates your recovery. So all that information is on, on whatever form it's on, uh, I think it was uh Area K.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh, no, was it? It was, it was some form in there where the physician fills it out. So I looked at it and I said, OK, this is all good. Um, but you asked a good question. You asked, how is the doctor gonna know because he's the, he's the surgeon. He's the one performing the procedure, and he has a pretty good idea of how long it takes for recovery for knee replacement. And that's what I'm having, knee replacement. Not in just one knee, but in both, in both knees, but not on the same day though.
[AGENT][NEUTRAL] Mhm, yeah.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm gonna do the left knee first and then uh I think in the paperwork, um, he put down return to work possibly by November, subject to change. Why? Because it depends on how I feel. I drive a truck for a living. I might not be able to.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Drive the truck and put any kind of real weight on my uh knee at that time. So he, he put down there subject to change. But um I asked the, the, I asked my employer, I'm sorry, I asked my employer who has all of the paperwork, I said, listen.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Why don't you forward the information because they gave me copies of it, but the copies that I have don't have their information in it.
[CUSTOMER][NEGATIVE] That's the problem and I, and it doesn't do me any good to send you what I have because trust me when I tell you this [PII] is gonna say well we still need the information from your employer.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] We still need that. All I have is uh all I have is a copy. I don't even think I have the original. They're holding on to the original, so that's another issue that may be a problem. That's why I said why don't you guys send.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] APL at least a copy of what you have put in and let's go from there and then I can contact APL and have them say, OK, we got all the information that's required we know that you're gonna have your surgery in June so that when [PII] rolls around, I, I can comfortably and confidently.
[CUSTOMER][NEUTRAL] have this surgery done without worrying about if I'm gonna have my benefits when I come out of surgery. Because I don't wanna have to try to do this afterwards because when I tell you that I'm by myself, I'm by myself. I don't have a whole bunch of people around me that can assist me in running around. It's kinda like.
[CUSTOMER][NEUTRAL] OK, this is getting ready to get real difficult real fast. So I'm trying to do it the easy way by letting you guys know ahead of time I'm gonna have surgery. I've had the doctor put his statement in my employer, and you said you understand why they're doing what they're doing. I don't understand it, but if you do, OK.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh, I, I feel like the paperwork, I feel like the paperwork that they're holding doesn't belong to them. So you should just put the information that's required on it and then fax it to the party that it belongs to, which is you guys, and that's the end of it.
[AGENT][NEUTRAL] OK. Well, Mr. [PII], uh, this is what's gonna happen and I'm just going by what I see day to day, claim by claim, member to member, and I'm just um giving you like a heads up so you understand a little bit why she's holding to that information, OK? Um, when we receive a claim, when we receive the claim form, that's a claim. OK? So that claim goes to a line.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEGATIVE] And then we have 7 to 100, up to 14 working days to process that claim. In 14 working days that claim is not even gonna be valid because it's until June.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So basically when it comes to time that they're gonna process that claim, they're gonna be like, well, this hasn't even happened, so it's not eligible for anything, we're just gonna go and send in a notice saying that you're not eligible just yet because of the date.
[AGENT][NEUTRAL] So it's just gonna be close, saying that you're not eligible just yet.
[AGENT][NEUTRAL] If the claim is sent after the surgery, like she's trying to do and your employer's trying to do, then once we receive that claim on the [PII], then we'll wait the 7 to 10 up to 14 working days to process the claim, and then it's going to be ready for approval because you already had the surgery, you already, um, you qualify for the benefits. So basically it's just the time frame.
[AGENT][NEUTRAL] It cannot come here too soon because it's gonna be denied and um it has to be basically after the fact, so you qualify for any benefits.
[CUSTOMER][NEUTRAL] Hm, I wonder why the other uh person I spoke to like you from APO didn't say that. Cause they had to know that I was doing it in the same format. They should have said something to me about that cause I didn't know that.
[AGENT][NEUTRAL] Yeah, I, I do apologize. I'm sorry, and I see the notes here and um yeah, she's a little bit new to the group and I, I do apologize if she didn't explain this to you. But yeah, we cannot get a claim too soon because it will be denied saying that you do not qualify just yet for the benefits.
[CUSTOMER][NEUTRAL] Hm, well,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Uh, all I can say is, is that, um, if they're gonna do it that way and what you said makes sense to me, I hope, I hope nobody's gonna be knocking on my door for information after surgery cause I can't, you know what I'm saying? I mean, I, I can't help you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, I.
[AGENT][NEUTRAL] I do understand. As long as you fill out your part and you know that the doctor fill his part and the employer is doing his part and they'll go ahead and send it all together on that um [PII], we're gonna have a full claim if we need any.
[AGENT][NEUTRAL] Uh, documentation like medical records, that's gonna be requested by us. That's why your portion had in the bottom like an authorization for us to get any medical records is, you know, is part of that form that you filled out on your portion.
[AGENT][NEUTRAL] That is for us to get that medical record. So at that point, we're not gonna ask you for anything. Um, we'll go ahead and get the medical records if it's required, if um we can get to, to the physician and the physician can give us all the information and we don't need any medical records, then we just go ahead and go along with the claim. So basically, but it has to be after the fact because like I said before, we don't want it to be denied because, oh, it's too soon to process this claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. Well, I appreciate you for explaining it to me because I, you're correct. I didn't understand it at first. I'm sitting up here trying to figure out, you know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You are on the ring.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You know, I, I call myself saving everybody a lot of headache, but I didn't know you had to wait like that. I didn't know you had to go through that. Um, uh, this is gonna be tricky then. I don't know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Yeah, uh, yeah, unfortunately, we need to, we need to wait. It's, it's a, it is a waiting, it's a waiting thing, um, and just, um, like I said, as long as you did your part and fill out your part and your doctor fill out his part and the employer go ahead and send in everything after the [PII], it will be fine.
[CUSTOMER][NEUTRAL] Well, see, that's the thing, that's, that's the.
[CUSTOMER][POSITIVE] That's the thing though, see, you made a very good point just now, more than you know.
[CUSTOMER][NEUTRAL] If I filled it out, I won't know that, because if we're, OK, everything you said to me makes perfect sense. It really does. The problem with it is, the [PII] is the day of the surgery. So if you're gonna start looking at my form and seeing if I did it right, what if I did it wrong? You think you're gonna be able to give it to me after surgery?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] No, that's what I'm saying. You're gonna wind up, it's gonna wind up in in dead in the water, because I'm gonna be sitting up like in in in la la land somewhere, and I'm not married, so it's kind of like, unless I can bring in a cavalry or somebody to interact for me, this whole thing is gonna go bust. That's my concern.
[AGENT][NEUTRAL] Hm, OK, uh.
[AGENT][NEUTRAL] If you, I, I'm not sure, uh, you told me that you already filled out your portion, OK? And, and your portion is, OK, it's really self-explanatory. It's your name, the last name, your date of birth, the address, your phone number, um, if it's a worker's compensation, which that's something you can answer. I'm pretty sure you did answer that question.
[CUSTOMER][POSITIVE] Yes I did yes I did.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, the name of your employer, so I'm pretty sure you, because it's really self-explanatory, it's really basic information that you need to fill out, um, so I don't think that's gonna be a problem and um basically the information that you have put has to match the physician's information which they did give you a copy.
[AGENT][NEUTRAL] So you should have those two to look at it and say, OK, yes, what I put in is what the doctor has before anything happens because you said that they did give you a copy. So it just needs to match on the information you're providing and the physicians is providing and then um the information that the employer is providing, if we have any questions, we're gonna call the, the, the employer.
[AGENT][NEUTRAL] If we have any questions about the doctor's form, we're gonna call the the employer or the physician. So basically those two are gonna go back to them. The only portion that we're gonna look into and if we have any questions of yours is basically your information which is not really complex at all. It's like so simple. It's just your personal information and some simple questions that I'm pretty sure you have answered correctly and just your signature which.
[AGENT][NEUTRAL] I'm pretty sure you can see if it's signed um so it has to have that signature the physician's name um.
[AGENT][NEUTRAL] As long as that two forms, which is page number 2 and page number 3 are fully.
[AGENT][NEUTRAL] Sealed out.
[AGENT][NEUTRAL] The rest if we need to, if we have any questions about the physician, we'll call the physician. If we have a question about the employer, we'll call the employer so it's not something that is gonna come back to you.
[CUSTOMER][NEUTRAL] So the information that I have, are you saying to me I can fax that information, a copy of that information to you guys? is that what you're telling me?
[AGENT][NEUTRAL] Mhm. You can.
[AGENT][NEUTRAL] You can if you want us to have that you can.
[CUSTOMER][NEUTRAL] OK, uh, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Again, it's just gonna go.
[CUSTOMER][NEUTRAL] I will do that. I will, I will fax it.
[AGENT][NEUTRAL] OK, and again if, if that's if you just wanted us to look into it and say, oh, OK, yeah, it looks like everything is correct based on what you send right now, but by the time that it is ready to process because again it's gonna go to a line to be processed any documents that we receive is just go straight to processing, OK?
[AGENT][NEUTRAL] So once they process they're gonna be like oh this is too soon. Now once we receive the information again from your employer after the [PII], then that's the one we're gonna process correctly because that will be correct, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK. Seems like a lot of complicated stuff, I swear.
[AGENT][NEUTRAL] But if you wanna send it.
[AGENT][NEUTRAL] If you wanna send it and let us look into it and then uh call back and say hey was that information is that all I needed to fill out? We can look at it and tell you, oh yes, it looks like everything is there or you know what, there's a discrepancy right here maybe you wanna get this check we can do that, OK? But yeah, it's not gonna be um basically payable after, OK.
[CUSTOMER][NEUTRAL] OK, well, I got, I.
[CUSTOMER][NEUTRAL] I got, I got most of it at home right now I'm, I'm at work. I'm driving the truck, but, uh, yeah, when I get home I'll look it over and I will uh go to my uh local uh FedEx store and have them, uh, uh, fax. I have your fax number information all at home, but, uh, I'll do that and um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] Then I'll ask you guys, like you said, hey, is that what you're looking for? Is that what you need? Is everything checked out? So that, cause I, I just don't want this to end up being the [PII], and have you guys hitting me up with a with a bunch of questions cause it ain't gonna go very well if it goes like that. Because I mean, I'm gonna be in pain, and I'm not gonna be in the mood to answer a bunch of questions, and I just think that that's the wrong way to do this. At least let's try to get the ball rolling.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] A little bit early. I mean, I understand what you're saying as far as the, the legitimacy of the whole thing, but at least let's try to get the ball rolling early so that when I come out of surgery, I don't get my phone ringing like Mr. [PII], Mr. [PII], Mr. [PII], cause I don't know what, I, I wouldn't want to talk to you cause I'm trying to heal.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I understand. But yeah, yeah, I, I, I truly understand and a lot of people try to do that, um, like you, they're concerned, they want to make sure that, you know, uh, if anything goes wrong, I wanna make sure that this is taken care of before I, I, I have those days that I need to be in rest because really you're gonna be in rest.
[CUSTOMER][NEUTRAL] That's, that's all I'm saying.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, but again, and it's just the way that the is processed because of the security for the policy and everything and the limitations and the policy restrictions and everything, so basically it has to be after the fact. So, um, and I understand you have nobody to help you with that, um, but again if you can send us what you have.
[CUSTOMER][NEUTRAL] Right, I mean, if I was married, yeah.
[AGENT][NEUTRAL] Mhm, yeah, I understand.
[CUSTOMER][NEUTRAL] Yeah, if I was married, if I was married, I would probably say, hey, you know what? Talk to my wife, let her handle it, you know, no big deal. But by just being me, you know, it's like, OK, this is gonna be a problem. But I'm glad you pointed it out to me, cause I, I was unaware, and as I mentioned before, I'm not trying to get anybody in trouble, uh, the young lady made it sound like it would have been, yeah, why don't you do it early. I said, OK, yeah, that would make more sense.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm. Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And she never told me once that, no, there's a process to it. And like even with my job, I'm glad you told me about that because I'm looking at them like, why are you holding a document that doesn't belong to you?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, it looks like they have experience on what they're doing.
[AGENT][NEUTRAL] It looks like they have done it more than once.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, yeah, yeah, yeah, but yeah, I will take your advice. Uh, thank you for pointing it out. Uh, when I get home I'll look over what copies I have and I will send those copies and then I will call and clarify if that's the information that you guys need and then we'll go from there and then I'll see how this ball rolls because this is man, this is who [PII].
[AGENT][NEUTRAL] Oh yeah
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] This is a lot of work. It's a lot of work. It it's not, it's not a way.
[AGENT][NEUTRAL] But yeah
[AGENT][NEUTRAL] It is, it is.
[CUSTOMER][NEUTRAL] It's, it's not like a walk in the park, like, OK, here you go, get, get busy, you know. I mean, I understand that people out there commit fraud, and that's mainly what's going on. So you you you guys have to protect yourself against people claiming fraud, so that's probably why a lot of these procedures are in place, not only from my employer's point of view, but from you all's as well. So, I just didn't think about it. I just said, well, I got the dollar for saving that's what.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] want, now I'm asking my employer, and then she started acting all funny. I'm like, uh oh. I said, [PII], what's going on? Well, I'm, I can't fill this out. I said, what do you mean? It's gotta have to go to corporate. I said, OK, how long is that gonna take? And she didn't say anything. I said, [PII], how long is that gonna take? So I had to call corporate myself, and she tells me, oh, that's not gonna be sent back until June. I said, well, [PII] is the day of the surgery.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, so what?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I said
[CUSTOMER][NEGATIVE] If there if if there's a, if there's a problem with it, who you gonna ask? Who you gonna call? Ghostbusters? I mean, come on, I'm in surgery, I'm coming out of surgery. You honestly think I'm gonna wanna have a conversation with anybody about insurance after surgery.
[CUSTOMER][POSITIVE] I'm gonna be trying to heal and get my mind right. Uh, I'm gonna be praying to [PII] that, hey, this was a good investment to have APL, uh, as, as a, as a, as a insurance coverage. Uh, I did everything right. instead, you know, it's like I gotta do a lot of work here, so I'm gonna try to stay calm and get through this, but I do thank you for pointing out, uh.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] What's going on? because I was unaware of all this other stuff. I, I thought once you filled out the paperwork, send it to you guys and it sits there until the day of the surgery and then I thought that you guys would probably call and do your verification and then go ahead and process my um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] My claim, I was unaware that it had a time lock on it. I didn't know all that, so it's.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] Yeah, yeah, it does, yeah, yeah, I understand, I understand, but yeah, that's what triggers us to process the claim if we get it like too early it's just gonna close on you and we don't want that because then you're gonna be like, but what happened? Well, it was denied.
[CUSTOMER][NEUTRAL] Oh my God, that is so, that is so crazy.
[AGENT][NEUTRAL] So yeah, yeah.
[AGENT][NEUTRAL] Yeah, it's just how it triggers. Mm.
[CUSTOMER][NEUTRAL] OK, well, listen, I
[CUSTOMER][POSITIVE] I, I appreciate what you told me. uh, I will do what you said. I will, um, I will send in the copies that I have and I will follow it up with a call to make sure that's done right.
[CUSTOMER][NEUTRAL] And I guess um I want to play it the way you just said. I mean, I got no choice, but I just hope that they don't ask me any questions on the [PII] cause.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm OK.
[CUSTOMER][NEUTRAL] I, I'm not gonna be talking.
[AGENT][POSITIVE] Just relax and just, just relax and be ready for your surgery.
[AGENT][POSITIVE] And hopefully everything will be smooth, OK? And um if you wanna register online and you wanna upload the documents online, you can do that as well, OK? So if you don't, if, if you if you have a way of scanning and just uploading it to your computer and that's easier, you can also do that, um, so you don't have to go to the fax area to do the faxes, but that's really up to you. That's an option. OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I'm not I'm not tech savvy, yeah, I'm not tech savvy enough for that, uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I understand.
[CUSTOMER][POSITIVE] But I, I'll get there, I, I'll get there, I'll get there one day.
[AGENT][NEUTRAL] OK, yes, yes, sir.
[CUSTOMER][POSITIVE] But, but listen, thank you, but listen, thank you, seriously, thank you. I appreciate it. Thank you.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] You're welcome. You're welcome, Mr. [PII], and you have a good afternoon.
[CUSTOMER][NEUTRAL] Have, have a, have a.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] You too. Be safe. Bye bye.