AccountId: 011433970860
ContactId: 7cdf8582-43ce-41d9-adbb-fcb7dccd1d82
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1276579 ms
Total Talk Time (AGENT): 428928 ms
Total Talk Time (CUSTOMER): 355440 ms
Interruptions: 7
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/7cdf8582-43ce-41d9-adbb-fcb7dccd1d82_20250513T15:28_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], I am helping a friend fill out some paperwork for you guys, and she faxed over a a copy of her medical provider's, uh, form that you guys sent to her, um, and I think she might have used the copy that she received in the mail and you guys said it was not legible so can you, is there any way you could send her a copy of the blank form via email so she can fill it out again?
[AGENT][NEUTRAL] OK, so you're calling on behalf of an insured, is that correct and you're needing to find out how to get another form?
[CUSTOMER][NEUTRAL] Yes, yes, and I don't.
[CUSTOMER][NEUTRAL] Yes ma'am, I didn't need anything. I was hoping you could help since I don't need any information or anything. I'm just trying to get you to send a copy of a blank form to her. Yes ma'am. She didn't have time to sit on hold today.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK. So, yes, well, I can make a note regarding our call, but I'll be very limited as to, because I'm gonna have to pull up the member's information, verify some things with you first for security. So who am I speaking with, please?
[CUSTOMER][POSITIVE] Absolutely, I understand.
[CUSTOMER][NEUTRAL] Sure, sure. My name is [PII].
[AGENT][NEUTRAL] And [PII], do you have an E on your first name or not?
[CUSTOMER][NEUTRAL] Yes, ma'am, I do.
[AGENT][NEUTRAL] OK. And [PII]?
[CUSTOMER][NEUTRAL] Uh there's no Y, it's just [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][POSITIVE] And then a good callback number for you please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My number is [PII].
[AGENT][NEUTRAL] Thank you. And what is the policy number for the member you're calling about, [PII]?
[CUSTOMER][NEUTRAL] It is 02549121.
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, and any information that I provide is a verification of benefits and not a guarantee of payment. So first off, [PII], I'll need to verify, as I stated, several things with you for security. So what is the insured's name and date of birth?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Her name is [PII] and her birthday is [PII].
[AGENT][NEUTRAL] Thank you and the home mailing address for her please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][POSITIVE] Thank you. And the phone number for her, please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Thank you. And then her email address and this is her work email.
[CUSTOMER][NEUTRAL] Um, OK, it's [PII].
[AGENT][POSITIVE] OK, thank you so let me look.
[AGENT][NEUTRAL] Let me just, let me look at a few things on here.
[CUSTOMER][POSITIVE] Sure, sure. I appreciate your help, [PII].
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] If I can determine which form exactly was sent to her.
[AGENT][NEUTRAL] I could email it to that email address for her on file, but I've just got to see if I can locate that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I have a copy of it.
[CUSTOMER][NEUTRAL] Yeah, I have a copy of it, but it doesn't have, you know, it doesn't have like a, a name or anything. It just says um like source and it's like primary care physician, chiropractor, specialist, general physician. It's just got, it's just a list of like provider information.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And so what is she needing? You said you have, OK.
[CUSTOMER][NEUTRAL] And that's all it is.
[CUSTOMER][NEUTRAL] Well, she, so I guess she mailed, she was mailed a copy and she filled it out with her like handwriting and she faxed it over and then she got some kind of notification that the fax document they received was illegible. And so we were just trying to get a blank copy so we could fill it out digitally, um, and she could print that and resend it so hopefully it wouldn't be have legibility problems.
[AGENT][NEUTRAL] OK, so you don't have the blank form. She used the only form that was sent to her, is that correct?
[CUSTOMER][NEUTRAL] We don't, yeah, we don't have the blank exactly she wrote on it, yes, mhm.
[CUSTOMER][NEUTRAL] Lesson learned we'll make copies from now on.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm just trying to see if I can determine.
[AGENT][NEUTRAL] OK, do you mind letting me place you on hold for just a moment?
[CUSTOMER][POSITIVE] No problem. Sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] Deferring.
[CUSTOMER][POSITIVE] Good morning. Thanks for calling ATO. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII], it's [PII]. How are you?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] I'm alright, thank you. Other than I need somebody to help me to look to see if I, uh, tell me exact exactly which form and where to find it to send to the this insured via email because she wrote on the one that we mailed and then we denied it because it's not legible, um, the policy is 254-912-1 for Miss [PII].
[CUSTOMER][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's the health, the current and former healthcare provider list.
[AGENT][NEUTRAL] According to the note.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, check for pre-ex based on effect your coverage return your medical history.
[CUSTOMER][NEUTRAL] I wanna say that's gonna be the.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Is it gonna be the [PII]?
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] I don't, I don't know.
[AGENT][NEUTRAL] And I don't, where do I even find that?
[AGENT][NEUTRAL] A blank one.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] See, let me see.
[AGENT][NEUTRAL] Or do I need to
[AGENT][NEUTRAL] I mean, I don't want to send a hub request for that, but I mean.
[CUSTOMER][NEUTRAL] See, I know that we
[AGENT][NEUTRAL] I know it's not part of the claim form.
[CUSTOMER][NEUTRAL] You all don't have a list.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I wanna say that it is just the claim form and they're able to write down.
[CUSTOMER][NEUTRAL] Uh, see, medical history because we used to have one. Let me, let me see if I can pull it up.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] One.
[CUSTOMER][NEUTRAL] Forms and templates because I don't know where you are will find yours, but we have ours in SharePoint.
[CUSTOMER][NEUTRAL] Where we go to it's called forms and templates.
[AGENT][NEUTRAL] Oh yeah, it's. Oh yes, see, I don't have that one.
[AGENT][NEUTRAL] I'm looking at what she submitted.
[AGENT][NEGATIVE] It's not legible.
[CUSTOMER][NEUTRAL] What did she submit? It was.
[AGENT][NEUTRAL] Um, denim base.
[CUSTOMER][NEUTRAL] Uh, let me look up, see what she put it in here.
[CUSTOMER][NEUTRAL] OK, give me one second.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I mean, I can't. I was just gonna email it, but I mean I guess I can send a request. I see that it looks like.
[AGENT][NEUTRAL] It was requested for it to be mailed mail requests submit the former and current healthcare providers list that was done yesterday.
[AGENT][NEUTRAL] But if I was able to email it.
[AGENT][NEUTRAL] I'll just email it to her.
[CUSTOMER][NEUTRAL] Oh come on, By 25.
[CUSTOMER][NEUTRAL] 121.
[CUSTOMER][POSITIVE] Get a love on base.
[AGENT][NEGATIVE] On base is so slow. Ah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] So slow.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so I'm gonna have to say that I have never seen this one before.
[AGENT][NEGATIVE] Oh [PII], if you've not seen that [PII], I'm in trouble.
[CUSTOMER][NEUTRAL] I am serious. I have never seen this.
[AGENT][NEUTRAL] Oh, [PII]. OK. Well, what, mm, OK.
[CUSTOMER][NEUTRAL] Primary care.
[CUSTOMER][NEUTRAL] Let me see who, uh, let me see who.
[CUSTOMER][NEUTRAL] Uh, who did this? [PII].
[CUSTOMER][NEUTRAL] Alright, hold on, let me look and see. This is, uh, can't.
[AGENT][NEGATIVE] Treating physician form is not legible.
[AGENT][NEUTRAL] I don't
[AGENT][NEGATIVE] Yeah, that, that specific form is not anywhere.
[AGENT][NEUTRAL] And it's not part of the cancer claim form. I just looked at that again and I didn't think it was. I've never seen that, but.
[AGENT][NEGATIVE] It's not.
[CUSTOMER][NEUTRAL] I've never seen this one. So this must be some new uh.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] For cancer.
[CUSTOMER][NEUTRAL] Loss cancer treatment and services.
[CUSTOMER][NEUTRAL] I've never seen this one.
[CUSTOMER][NEUTRAL] OK, so I'm going back through all the form to see and I'm not.
[CUSTOMER][NEUTRAL] OK I need to figure out what this one is.
[CUSTOMER][NEUTRAL] An affidavit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I've never seen this one.
[CUSTOMER][NEUTRAL] I've never
[CUSTOMER][NEGATIVE] And I can't even see the claim form number on the bottom.
[AGENT][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] So it is the APL form.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I guess you can just go ahead and send it over.
[AGENT][NEUTRAL] Send a hover class?
[CUSTOMER][NEUTRAL] And um
[AGENT][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let's see, miscellaneous correspondence.
[CUSTOMER][NEUTRAL] Nope, doesn't have a claim form number on the bottom of it.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Cause there's a copy of it in the one that they sent her in um.
[CUSTOMER][NEUTRAL] I wonder, can is the way that we can upload this one.
[AGENT][NEGATIVE] Where's the, I couldn't even find one. I don't see a blank one. I see the one that's not legible.
[CUSTOMER][NEUTRAL] You, you say you were gonna.
[CUSTOMER][NEUTRAL] Under the miscellaneous correspondence for 429.
[AGENT][NEUTRAL] Well, I went into, uh, just, I went into the non blanks. Let's see.
[CUSTOMER][NEUTRAL] I mean it's in on base, a copy a copy of the letter.
[AGENT][NEUTRAL] Hold on. I'm, yeah, I was in on base.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][POSITIVE] Yeah, I'll just, OK, that's what I need right there.
[AGENT][NEUTRAL] Where in the world does that form come from?
[CUSTOMER][NEUTRAL] Yeah, and so you can um.
[CUSTOMER][NEUTRAL] I have no idea.
[AGENT][NEUTRAL] All right, now let's see, Lord, I've never, hold on, [PII], I don't know that I know how to do this because I've never.
[CUSTOMER][NEUTRAL] So I wonder if you go up to where it says send to.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Well, on my.
[AGENT][NEUTRAL] When I'm looking at this form I don't have a.
[CUSTOMER][NEUTRAL] In on base under the documents tab.
[CUSTOMER][NEUTRAL] You wanna share your screen with me?
[AGENT][NEUTRAL] Send 2 options.
[AGENT][POSITIVE] Favorites custom import map.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I can.
[CUSTOMER][NEUTRAL] Say it again. I'm sorry.
[AGENT][NEUTRAL] Um, hold on one second, yeah, give me one second. I will.
[AGENT][NEUTRAL] Maybe [PII], hold on.
[AGENT][NEGATIVE] It's not gonna let me because I call through the I can't. It's mm mm, cause I called you through just AWS so I can't share it.
[CUSTOMER][NEUTRAL] Oh, got you, got you, got you. OK, alright, so I was gonna say is like if you're on when you open the document up, um, opens up on the document tab and then there's like a little print like a little printer that says print, and next to it it says send to.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, see, um.
[AGENT][NEUTRAL] Oh mine, it doesn't. Oh shoot.
[AGENT][NEUTRAL] Hold on.
[AGENT][NEGATIVE] Well, it closed it completely out.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] So does she want it mailed or does she want it emailed?
[AGENT][NEUTRAL] Emailed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, let's see, I don't know why I can't.
[CUSTOMER][NEUTRAL] Let me know when you have it open.
[AGENT][NEUTRAL] Well, it.
[AGENT][NEGATIVE] Mm. This on base. I'm so tired of on base. I'm having trouble. Oh, it just closed all my own base out. Hold on, [PII], it's got to open back up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] And I
[AGENT][NEGATIVE] Mm. Ah, shut it down. I'm having to sign back in on base.
[AGENT][NEUTRAL] I can't email it though [PII] that's the thing she's saying it's in on base.
[AGENT][NEUTRAL] But I can't, yeah, I mean, I see it. Yeah, I mean, I see it, but I don't see any male option. Let me just tell the lady.
[CUSTOMER][POSITIVE] Yeah, that's what I was trying to let you know, yes you can.
[CUSTOMER][NEUTRAL] I'm gonna try to walk you through it.
[AGENT][NEUTRAL] Yeah, if I can get on base to open back up.
[CUSTOMER][NEUTRAL] Have you got a back open?
[AGENT][NEUTRAL] Mm mm. It's still thinking about it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, because you can, uh, I'm gonna show you how you can email it to her.
[AGENT][NEUTRAL] I tell it, I'm gonna hang up with, OK, hold on, let me just get it pulled back up first.
[AGENT][NEUTRAL] It's still on base is still trying to come up.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] This is crazy slow, especially when it has to completely reload.
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] OK, so you said print, click the print.
[AGENT][NEUTRAL] Because everywhere else it usually shows an envelope. I mean like says send to, oh there we go, send a mail recipient. I'm gonna do send a mail recipient. OK.
[CUSTOMER][NEUTRAL] Uh, no, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Alright, yeah, so don't do.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That's correct, and that's gonna email it to her. You'll be able to email it and put her information in the email it to her.
[AGENT][POSITIVE] I got you. There it is now, but it was not on the screen a moment ago. It did not have that, so I don't know why, but it's there now. But that's OK when I closed it completely out and it came back, it's there. So, thank you so much, [PII], for looking at this with me. I appreciate you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] That's fine
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Alright, no problem.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][POSITIVE] [PII], thank you so much for holding for me and I apologize about the lengthy delay. So I'm going to email the form I have located it. So let's see here.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just one moment and let me respond to somebody who was.
[AGENT][NEUTRAL] OK, so just a moment.
[AGENT][NEUTRAL] OK, so I will send this to her email address that is on file.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And she should have that and I did, it will come from [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I just put APL form in her subject line.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right. I will let her know that it's on its way. Thank you for all your help, [PII]. I really appreciate it.
[AGENT][POSITIVE] Yes, uh, well, I really appreciate your patience and me locating it. So, um, is there anything else, [PII] that I can help you with today?
[CUSTOMER][POSITIVE] No, ma'am. You have been most helpful. Have a great day.
[AGENT][POSITIVE] Well, thank you so much. It was my pleasure in helping you and I hope you have a very nice day as well.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Um, bye bye.