AccountId: 011433970860
ContactId: 72fa37a0-92a5-4ae6-9fc6-5d4f71f3ae93
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1172479 ms
Total Talk Time (AGENT): 725045 ms
Total Talk Time (CUSTOMER): 375376 ms
Interruptions: 11
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/72fa37a0-92a5-4ae6-9fc6-5d4f71f3ae93_20250324T17:08_UTC.wav
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[AGENT][POSITIVE] OK, thank you, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Well, happy Monday, [PII]. It's [PII].
[AGENT][POSITIVE] Happy Monday. How are you, ma'am?
[CUSTOMER][POSITIVE] I'm doing all right, but I have tried to help this gentleman. He's just panicking, bless his heart. Um, let me give you a policy number, you know, with this ability when it's not paid, you know, the bills don't stop, and he says he's about to lose his house.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Oh gosh.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It's policy number 2361828.
[CUSTOMER][NEUTRAL] For [PII], he's called and called and called and called.
[CUSTOMER][NEUTRAL] Um, I spoke with him last Thursday, so the issue I believe is.
[CUSTOMER][NEUTRAL] On that claim number 3576423, there is a portion on the physician statement that they did not put when the disability began or the anticipated return to work day.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, yeah, let's see.
[CUSTOMER][NEUTRAL] So I, I did give him that um information.
[CUSTOMER][NEUTRAL] Last week and he said he called the provider back and they still say that they faxed it last Wednesday.
[CUSTOMER][NEUTRAL] Which of course we don't have that on file.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] And he is having vision problems. That's um why he can't work.
[CUSTOMER][NEUTRAL] Um, just now we tried to call Ashner Clinic together to the disability department to see if we could get that refaxed. We did not have any luck con connecting with the disability department.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it looks like we.
[CUSTOMER][NEUTRAL] I'm putting it in the notes, the phone number and all that.
[AGENT][NEUTRAL] OK, it looks like we also don't have the employee statement which is.
[CUSTOMER][NEUTRAL] But he
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Oh God, I didn't. Are you sure? Because I think.
[AGENT][NEUTRAL] Well, that one, the [PII] 37, it says it's incomplete, so the, the remark code says the claim form submitted was incomplete in order for additional consideration to be given, please complete the statement of insured, which is the employee's portion.
[CUSTOMER][NEUTRAL] That might be, well, let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So we have a tenant physician, which that's the part that they.
[AGENT][NEUTRAL] Did not um put the.
[CUSTOMER][NEUTRAL] We need to make sure because I thought I checked on that.
[AGENT][NEUTRAL] OK, yeah, I'm double checking the documents now.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I might have missed it.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEGATIVE] I mean, he's so panicky and, you know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Ok my email just.
[CUSTOMER][NEUTRAL] And I get it because I was on, I mean, I.
[CUSTOMER][POSITIVE] I've been out of work before and didn't even have a disability policy and I worried about my home and, you know, yeah, I get it.
[AGENT][NEUTRAL] Yeah, yeah, same.
[CUSTOMER][POSITIVE] But the good [PII] gave me what I needed when I needed it.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Amen, sister.
[CUSTOMER][NEUTRAL] Got the authorization form policy holder statement.
[CUSTOMER][NEUTRAL] That's on page 2.
[CUSTOMER][NEUTRAL] So we do have that.
[AGENT][NEUTRAL] That, that's, that's his employer we need his portion. We don't have the insured statement.
[CUSTOMER][NEUTRAL] Oh, I got you, got you. Hang on. State statement of insured.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh, I'll be ding ding dong it. I'm sorry.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEGATIVE] Are you kidding me?
[AGENT][NEUTRAL] OK, I see statement of insured though.
[CUSTOMER][NEUTRAL] I really thought we had
[AGENT][NEUTRAL] On page 3.
[CUSTOMER][NEUTRAL] Yeah, I thought we had.
[CUSTOMER][NEUTRAL] I thought the only thing that I could find was the.
[AGENT][NEUTRAL] Oh, I think it's 2 pages though.
[AGENT][NEUTRAL] Let me, let me just pull up this form because I need sometimes it helps to like see the whole thing because.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You know what I mean? like sometimes I just truly, I'm just like I don't know. I don't know what's missing. Let me just see.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Yeah, I know.
[AGENT][NEUTRAL] Uh, let's see. OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Ah.
[CUSTOMER][NEUTRAL] I'm trying to get we were trying to get that form.
[CUSTOMER][NEGATIVE] Faxed over with the physicians completed portion but uh we we're not having any luck.
[AGENT][NEUTRAL] What number did you call for um that.
[CUSTOMER][NEUTRAL] And he has been trying you can see in the notes.
[CUSTOMER][NEUTRAL] So we at first we started with the number on the claim form for Doctor [PII] or whatever his name was and then he said no, it's from Ashner Hospital. So then I looked where this was faxed from.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And we called there and they transferred us to the disability department and that phone number is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] option 3.
[AGENT][NEUTRAL] OK, it says option 2 on the form that they submitted, but OK.
[CUSTOMER][NEUTRAL] And then the lady gave me the medical records phone number as well we did not go there.
[AGENT][NEUTRAL] OK, so statement of insured we're missing page 2. We have page one which goes through asking like section F where it asked about like the initial.
[AGENT][NEUTRAL] Dot uh disability details and then page 2 goes into like their physician information, continuing disability details and a signature so we don't have page 2. I'm gonna see if there's an EOB note as well on this claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] He just, he's like, can I just talk to somebody and let them know I'm trying or is there any way if it's just a date, can we, you know.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, so we're missing page two of his form and we do not have, let me see what that was again, DM 326.
[AGENT][NEUTRAL] The verified disability from the.
[AGENT][NEUTRAL] Position
[AGENT][NEUTRAL] Which was on this I believe.
[CUSTOMER][NEUTRAL] I wonder why she told me to hit option 3 instead of 2.
[AGENT][NEUTRAL] I don't know because like like I said on that form that was faxed over from [PII] um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let's see tending physician statement they put codes and then they like I said they didn't put the date it began or his anticipated return to work, um, and then.
[AGENT][NEUTRAL] Let me see what all we have here.
[AGENT][NEUTRAL] They first treated, they put that but that doesn't necessarily mean.
[AGENT][NEUTRAL] That's when
[AGENT][NEUTRAL] And then they have um.
[AGENT][NEUTRAL] Disability FMLA cover sheet. So on the bottom of that it says this form is to be used for FMLA or disability forms only disability desk phone and it gets that number but it says option 2.
[CUSTOMER][NEGATIVE] And see he can't make calls because he can't see.
[AGENT][POSITIVE] God bless him.
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Would he be willing to let me try and get in touch with them um and contact like I know he's panicked and he wants to talk to someone there's not anything I can do for him um I mean I can talk to him if he really really needs it but if I can call him back, I'm going to try and reach out to them using that option too.
[AGENT][NEUTRAL] And actually I'm going to
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] When did they say they sent the other fax?
[CUSTOMER][NEGATIVE] [PII] and see I have access to the faxes and we have nothing.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] That's not, I mean, everything, no, it's just the [PII] today.
[AGENT][NEUTRAL] There's nothing out there for the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And there's nothing in the disability queue.
[AGENT][NEUTRAL] That you're aware of
[CUSTOMER][POSITIVE] Did not see anything in the queue.
[AGENT][NEUTRAL] OK. [PII].
[AGENT][NEUTRAL] Yeah, I don't see anything there. I'm gonna check.
[AGENT][NEUTRAL] The pending for [PII] too because just in case it's there or not I mean I don't see any new documents or whatever under his name but I just wanna like double check and make sure we don't have it hidden somewhere.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yeah, I don't see that anywhere, um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And like I said I don't see that any new documents have come through and we normally would if it's been out there so.
[AGENT][NEUTRAL] Let me, oh, OK.
[CUSTOMER][NEUTRAL] And he hung up
[AGENT][NEUTRAL] What I'm gonna do if he calls back let him know that you've spoken to someone in claims you can give him my name if you want to um I'm actually about to go to lunch but um.
[CUSTOMER][NEUTRAL] Me too. I was supposed to at [PII].
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I'm going to try and contact them as soon as I get back and I'm going to use that option too that's on there and if I can't get through I'm going to send an email because they provided an email also um.
[AGENT][NEUTRAL] And I'm going to see if I can get them to refax.
[AGENT][NEUTRAL] And let them know that we.
[AGENT][NEUTRAL] Did not have any additional information that we're, you know, we've been informed that it was sent on the [PII], however, we do not have that. I may, I mean my email or the care team email because I can send it through the care team um.
[AGENT][NEUTRAL] If I'm not able to contact them, you know, I can use that. What is it that template or whatever that comes from the your team instead of your personal information.
[CUSTOMER][NEUTRAL] Mhm. Right.
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] Just encourage them to try and resend it somehow even I, I know we're not supposed to encourage email but at this point this poor guy and his panic if the fax was successfully sent on their end and some reason we didn't get it or it's been misplaced, I would prefer email at this point.
[AGENT][NEUTRAL] Um, so I don't know. I'll just have to see if I can reach them, um, and if not, like I said, I'll email them. Does he have an email on file?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] He does. I may.
[CUSTOMER][NEUTRAL] He does, but he's got vision problems so he can't read it.
[AGENT][NEUTRAL] That's right, so he can't really read it. I was gonna say like I can copy him on it that way he knows that we've been in contact with him through email, but I don't know how how much good.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I would, yeah, I would go ahead and copy them.
[AGENT][NEUTRAL] Just so he has it because he can always get like a family member or someone to be like yeah this is you know they're reaching out on your behalf or whatever OK um.
[CUSTOMER][POSITIVE] And at least he has it, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Let us both go. I will.
[AGENT][NEUTRAL] Make a note after.
[CUSTOMER][NEUTRAL] I'm just gonna call him back real quick and just let him know that you're gonna continue to try to contact them and you he should hear back from you this afternoon. How about that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, yes, um, because if I can't reach them I will still contact him and let him know like this is the steps we've taken we are reaching out, um, when you call him back let him know that we don't have that second page of his statement that has his signature and date like the date he signed it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh God
[AGENT][POSITIVE] So that will need to be it's uh I mean I know he's panicked but that's literally all we need we need to get in contact with them and we just need him to send his form so I mean I know you're really good at reassuring people but just just reassure him like it's gonna be OK we're gonna help you we're gonna we're gonna get this done you send this part, let us try to reach them and we'll go from there. I will contact him this afternoon directly with whatever I was able to do whether that's.
[CUSTOMER][NEGATIVE] He's gonna panic
[AGENT][NEUTRAL] Call them and actually speak with someone or whether that's having to send an email and waiting on them to contact me back.
[CUSTOMER][POSITIVE] I mean look at the way he signed his authorization form bless his heart.
[AGENT][NEGATIVE] Yeah, you probably can't even see like the lines and stuff if he's having that severe.
[CUSTOMER][NEUTRAL] Mm mm, he can't.
[AGENT][NEGATIVE] I mean, cause the doctor said that like it's so bad that he's having to.
[AGENT][NEUTRAL] I mean, his wife signed on his behalf.
[CUSTOMER][NEUTRAL] How is he gonna send that form?
[AGENT][NEUTRAL] On the
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] On the first page, what was that page?
[AGENT][NEUTRAL] Was that his? Oh yeah, that's the authorization. So that's her signature because of his eye issues I'm assuming.
[AGENT][NEGATIVE] And then he did sign like he didn't even yeah he did he did sign but like like we said he can't really see the box so it you know what it reminds me of and this is awful but it truly reminds me almost like a stroke victim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That goes off to one side or someone that has like weakness on one side whether they're left or right-handed, they're weak and so it kind of goes off, but his is just more not being able to see the line where it needs to be.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It does.
[AGENT][NEUTRAL] So, but.
[CUSTOMER][NEUTRAL] OK. Tell me what because now I'm, now I'm, uh, now, yeah, wait a minute.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Now I'm, I feel like I've been going, and now I'm dizzy. Which page was it?
[AGENT][NEUTRAL] We need page 2.
[AGENT][NEUTRAL] Um, of the insured.
[CUSTOMER][NEUTRAL] And was it even completed at all?
[AGENT][NEGATIVE] No, we do not have it at all.
[CUSTOMER][NEUTRAL] OK, so let me get to those claims and forms, you know.
[AGENT][NEUTRAL] So it's page 3 of the 8 page document, but as far as his part, it's gonna be the 2nd part where his signature is at.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I wanna get that pulled up and just I'm gonna go ahead and email it to him and so maybe his wife can.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] See, he last worked the [PII].
[AGENT][NEUTRAL] The employer verified that he last worked the [PII] and then the physician said if I'm not mistaken, he was seen the [PII].
[CUSTOMER][NEUTRAL] Is it the um physician's names, last name, first name?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is that the portion he needs the page he needs to complete?
[AGENT][NEUTRAL] It is, and that's really like.
[AGENT][NEUTRAL] I mean if he has his physician's name and contact numbers, you know, great get someone to fill that out for him um he does not have to do the continuing disability details because this is not this is his initial it's not continuing disability so he doesn't have to do that part. We just need at least one physician and contact number.
[AGENT][NEUTRAL] I know and I'm sure he has it because he provided that with you because you said you tried to reach out that Doctor [PII] or something.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And they said that he was saying.
[AGENT][NEUTRAL] Date symptoms first appeared, accident occurred was [PII].
[CUSTOMER][NEUTRAL] Wonder if I can email just this page.
[AGENT][NEGATIVE] But they didn't do the day.
[AGENT][NEUTRAL] Uh, you should be able to.
[CUSTOMER][NEUTRAL] One
[AGENT][NEUTRAL] Oh, he was first treated on the [PII], so he was working the [PII]. They said that it first occurred on the [PII], and they got him into the office on the [PII].
[AGENT][NEUTRAL] So, it's really just filling out that part where it says disability began.
[CUSTOMER][NEGATIVE] I can't do just that page.
[AGENT][NEUTRAL] I mean, which is crazy, but.
[CUSTOMER][NEGATIVE] I could fax just this page, but I can't email just this page. Why? Why, why, why?
[AGENT][NEUTRAL] Um, you should be able, when you have it pulled up, do print.
[AGENT][NEGATIVE] If you're looking at it just to print that page or just put in page 3 and it should save just that page like to uh uh an Adobe Acrobat or something like that.
[CUSTOMER][NEUTRAL] No, it doesn't because print is just.
[CUSTOMER][NEUTRAL] Let's see, hang on, save this PDF file.
[AGENT][NEUTRAL] Pages.
[AGENT][NEUTRAL] Custom.
[CUSTOMER][NEUTRAL] OK. What page was it?
[AGENT][NEUTRAL] Page 3, page 3.
[CUSTOMER][NEUTRAL] 3.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Did it did it did it did it.
[CUSTOMER][NEUTRAL] Maybe, maybe
[CUSTOMER][POSITIVE] Hot ding ding dong.
[AGENT][NEUTRAL] OK, so I.
[CUSTOMER][NEUTRAL] I'm gonna, I'm just gonna go ahead and email this to him and see if his wife or someone can.
[CUSTOMER][NEUTRAL] Help him with that.
[AGENT][NEUTRAL] OK. Oh, I see Doctor [PII]. OK, ophthalmology. And you said you already tried to contact them?
[CUSTOMER][NEGATIVE] Yeah, but he said that's not the right place to call because we needed to call.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Well that's who filled out the form though.
[CUSTOMER][NEUTRAL] I know, but he said it came from [PII]. That's why I was confused too.
[AGENT][NEUTRAL] I'll I'll call both of them.
[AGENT][NEUTRAL] And see if I can figure something out like we have a disability claim form on file you know and just kind of go over the situation and just be like you know we're missing some information here is there any way that it can be it looks like it was filled out by your office and signed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Can you
[AGENT][NEUTRAL] You know,
[AGENT][NEUTRAL] Refill out this particular portion and send it back to us and then if they're like well you know whatever the case may be then um then I'll call [PII] because if they're the ones that filled it out they're the ones that would need the information from because it was they were referred from this Doctor [PII] to Doctor [PII] and it looks like he's the one that filled it out so yeah I'll reach out to them first.
[CUSTOMER][NEUTRAL] Yeah, I know.
[AGENT][NEUTRAL] But either way I'm gonna call I'll email, I'll do what I have to do um I may actually because I think Doctor [PII]'s fax number was provided.
[AGENT][NEUTRAL] Yes, what I might do is I may send that portion of the form back to them and ask them to please.
[CUSTOMER][POSITIVE] Complete it.
[AGENT][POSITIVE] Yeah, complete this portion because we have everything else we need this portion completed and see if they will get that filled out.
[AGENT][NEUTRAL] And I'll put it as urgent.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But yeah, I'm gonna call, fax all the things.
[CUSTOMER][NEUTRAL] All right, let me give him a quick call back.
[CUSTOMER][NEUTRAL] And I'll let him know and then I'll tell him that you're gonna call him. I've emailed him that page through of that claim form so when you call him if you'll just check and.
[AGENT][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Tell him reiterate to have his wife or someone help him complete that portion and get it back to us.
[AGENT][NEUTRAL] OK, I will, I will.
[CUSTOMER][POSITIVE] And hopefully, we can get him taken care of.
[AGENT][POSITIVE] Yes, because as soon as we get that we have everything. It's just a matter of getting it pulled and processed.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, OK. I will do everything I can. You're welcome.
[CUSTOMER][POSITIVE] beans. All right. Thank you, [PII].
[CUSTOMER][POSITIVE] I appreciate you. You're awesome.
[AGENT][POSITIVE] Alright, no problem.
[AGENT][POSITIVE] You're awesome.
[CUSTOMER][POSITIVE] Thanks. Uh, you're awesome. You're awesomer.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thanks, [PII]. Take care. Bye-bye. Bye-bye.
[AGENT][POSITIVE] You're welcome. OK, you too.
[AGENT][NEUTRAL] Bye.