AccountId: 011433970860
ContactId: 8b1eea90-6366-45ad-90c6-1fa7566d15bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 825559 ms
Total Talk Time (AGENT): 276646 ms
Total Talk Time (CUSTOMER): 466454 ms
Interruptions: 3
Overall Sentiment: AGENT=0.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/09/8b1eea90-6366-45ad-90c6-1fa7566d15bd_20250609T20:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, excuse me, yeah, good afternoon, [PII]. Yeah, I'm looking to get information on my claim, um, see if there's any updates, um.
[CUSTOMER][NEUTRAL] If you, if you could, um, um.
[AGENT][NEUTRAL] Yeah, I can help you with claim status. Um, who am I speaking with?
[CUSTOMER][NEUTRAL] 00, OK, yeah, sure, my name is [PII] and I have a policy number if you need it, um, right, oh, sure, so that's uh 2607315.
[AGENT][NEUTRAL] OK. Policy number?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] And I had a question while you're chewing and walking there typing that in. um, so I'm on short term, um, for my physician on disability and trying to get all this approved. It's been a long process, kind of, uh, elongated, um, but, um, I know that, you know, I guess where I'm out, um, they, um, some type of way I don't know what's going on with the insurance, but I noticed I couldn't get back in on the portal, um, to check it myself so I don't know if you can check the status.
[CUSTOMER][NEUTRAL] And um right. So that's why I called, that's why I called, right, right.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, I can help you with that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Can I get a good call back number in case we get disconnected [PII]?
[CUSTOMER][NEUTRAL] Of course, so that's uh area code [PII].
[AGENT][NEUTRAL] And can I get you to verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Of course, uh, [PII].
[AGENT][NEUTRAL] And the address that we have on file?
[CUSTOMER][NEUTRAL] Oh yeah, [PII].
[AGENT][POSITIVE] Thank you so much. Alright, let me look.
[CUSTOMER][NEUTRAL] Co.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you have the claim number that you were uh trying to get the status of or the date of service?
[CUSTOMER][NEUTRAL] Uh, I don't have that in front of me. Um, might be able to find it, but.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Let me see
[CUSTOMER][NEUTRAL] I thought that would be all on, you know, showing showing in your system.
[AGENT][NEUTRAL] Let me see here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm showing, um, I only see 2 claims.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] It looks like the first one was denied um.
[CUSTOMER][NEUTRAL] Well, I know there was something about the paperwork wasn't um totally my employer was taking a long time to get it turned in yeah OK yeah I did see that.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm, yeah, that's that's the first one and let me see the second.
[CUSTOMER][NEUTRAL] I, I printed that, you know, while, while I was still able to get out, yeah, I did print that. No, it should be here in my.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So to look look for it.
[AGENT][NEUTRAL] And the other one is um we're just waiting to requested medical records.
[AGENT][NEUTRAL] And so we're waiting for that. Mhm, those are the only things, so, go ahead.
[CUSTOMER][NEUTRAL] Right, OK.
[CUSTOMER][NEUTRAL] OK, now talk to my, OK.
[CUSTOMER][POSITIVE] OK awesome awesome OK thanks for that update. I, I talked with my physician last week and she mentioned um well actually her her nursement.
[CUSTOMER][NEUTRAL] Excuse me, [PII], she mentioned that yeah, that because I had talked with you guys last week too or the week before, and you, you, you updated me. That's what was going on. So she mentioned, yeah, well, you know, we did get a fax from them from you guys and we're gonna fax that back over, you know, uh, so you guys may have received that already. I'm thinking that was last week she was working on faxing that back over but.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] But um maybe that's not showing in your.
[AGENT][NEUTRAL] Let me look here.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEGATIVE] Yeah, no, this has been, you know, we, I've been over a month, month and a half. This is ridiculous, and you know I'm not, you know, coming to you, but I'm my goodness, I mean, you know, I paid into the benefits and I'm not getting any service, right, you know, the bill collectors are coming like.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] been drawn out.
[CUSTOMER][NEUTRAL] And some of that was on my employer too, the person kind of a rogue person, she said she turned it into HR and never did, and I found out. So HR apologize and got it right over to you guys, the form that, you know.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You can't play with people like that. I don't know what she was doing.
[AGENT][NEUTRAL] Yeah, it looks like I am seeing uh that we did try to call you just to let you know that uh we're, we're waiting for the medical records.
[AGENT][NEUTRAL] Um, I have not seen.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't see any of them, but let me check real quick. I can see if we got that, but it doesn't look like we have.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, OK. Hmm, oh my goodness.
[AGENT][NEUTRAL] Give me just one moment while I look it up and uh let me look into it a little bit.
[CUSTOMER][POSITIVE] 00, sure, I'm, uh, yeah, yeah, I got, I got plenty of time, take your time.
[CUSTOMER][POSITIVE] Appreciate it.
[CUSTOMER][NEUTRAL] Is it standard, um, you know, protocol that typically if my physician had sent that that usually you guys, uh, you know, get it back in the system or does it take some time, maybe it's sitting on someone's desk or I'm not sure.
[AGENT][NEUTRAL] Um, it depends on the medical provider and how long it takes them to get it to us. Um, typically, what I suggest, if it's, if it's taking a little bit longer because we give them, I believe, 30 days.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh, since we request records from them, we give them 30 days to turn that in.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I see, OK.
[AGENT][NEUTRAL] If you think that that takes a little bit too long, uh, I, I suggest you get a copy of your medical records and see if you can send it in on your behalf. Um, but let me check and see if we got anything.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I, I think that's what I was kind of asking, um, as you're chilling and walking there, let me know if I'm putting too much on you, but I think that I was asking. I, I, I kind of take it that they, they did forward it back, um, maybe they didn't, but so what I was asking is would that just sit on someone's desk over at your, you know, at your venue at, you know, APL or?
[AGENT][NEUTRAL] Uh, typically when they give it to us it gets looked at by our medical examiner and then they process it and then it goes back to claims and claims decide and based off of that recommendation it gets approved or we see if we need more information um but typically we we have our medical examiner look at it.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, it's not letting me.
[CUSTOMER][NEUTRAL] Well, maybe it's that maybe that maybe that's OK, thanks for the information. Maybe that's what's going on at a possibly, but I'm sure they're usually a little prompter than that. I think that was last Wednesday I talked to them on the that was on the uh.
[CUSTOMER][NEUTRAL] They said they were gonna fax it back over like on the [PII], [PII] or [PII].
[AGENT][NEUTRAL] Yeah, it looks like we requested those medical records uh on the [PII].
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh, so 6 days, um, so.
[CUSTOMER][NEUTRAL] Mm, so that's what I mean. Maybe it's sitting on his desk, the medical examiner or or or.
[AGENT][NEUTRAL] Yeah, it could be with them. uh, I'm, I'm not able to pull that up.
[CUSTOMER][NEUTRAL] Right, or prompt anyone to, yeah, just say Mr. [PII]'s been waiting a long time. Can we, can we.
[AGENT][NEUTRAL] You mean
[AGENT][NEUTRAL] Yeah, because we give them 30 days from the time, so um.
[CUSTOMER][NEUTRAL] No, I understand. Uh, no, I understand, but what I'm saying is if my phys, if my physician did their part, is there any way you can prop your, your team me example, OK, Mr. [PII], it's almost going on 2 months and can we get this moving, please, you know, is what I'm kind of asking of you. Is there anything?
[AGENT][NEUTRAL] Yeah, you could
[AGENT][NEUTRAL] Right, yeah, once it's 30 days, um, let me see what we do after 30 days.
[CUSTOMER][NEUTRAL] Well, why do you keep mentioning that? Are you mean you get an examiner 3? I, I, I don't know why you.
[AGENT][NEUTRAL] No, no, no, no, no, we give your medical, we give your provider 30 days to give it to us, but I can't see it just yet, um, so I don't know what the status is just yet.
[CUSTOMER][NEUTRAL] Well, well, that's what I'm saying.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh, OK, I'll check with them because I, I believe they got it in. I, I believe she understood the urgency and I believe they got it in. So what I'm saying is it's probably sitting on your medical examiner's desk. Is there any way you can prompt that, but I will, I will reach out to my, you know, physician and make sure, but I'm just saying is there anything you can do on your end.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Yeah, that's what I was going to ask is just double check and see um because I'm not able to see it if it's with our medical examiner I'm unable to see it if you would like I can try and transfer you to claim support and maybe they'd be able to help you. Would you like me to try that?
[CUSTOMER][NEGATIVE] Unfortunately.
[CUSTOMER][NEUTRAL] Uh, sure, sure, why not?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me just one moment, OK?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK appreciate it.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] with the care team at APL. I have a Ruben Valentine on the line, uh, policy number 2607.
[AGENT][NEUTRAL] 315.
[AGENT][NEUTRAL] And he calls a couple times a week checking on his uh short term disability claim.
[AGENT][NEUTRAL] Uh, I do see that we requested medical records from his provider and then I saw someone, uh, had talked to him saying that they still need that. Uh, he said that they, he called them and they said that they turned it in. When I tried to click and open it up, it was saying that it wasn't letting me do it like through Onase so I think I need to restart my Onase, um, but I didn't know if you would be able to look into that for me, um, since I'm unable to, but it's for.
[AGENT][NEUTRAL] The only claim on there but it's the inactive one, claim 3608609.
[AGENT][NEGATIVE] And I'm unable to pull it up. I've, I've all double clicked it and I've looked it up and my on base is doing something funky.
[CUSTOMER][NEUTRAL] We still need, we still need medical records we haven't received anything.
[AGENT][NEUTRAL] OK, we still haven't gotten anything?
[CUSTOMER][NEUTRAL] But you can send them over, yeah, but if you send them over you can.
[AGENT][NEUTRAL] OK, yeah, because he was asking some questions of the process that I just don't know the answer to.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] OK, and um what is your name one more time?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII], OK, I'll introduce you to him, um, and let him know that I'm transferring him. Thank you so much.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] All right [PII], are you still there?
[CUSTOMER][NEUTRAL] Uh, yeah, I'm still here.
[AGENT][NEUTRAL] I, I have [PII] from claim support and she's gonna help you with uh those questions that you had regarding your claim, OK?
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] OK, OK, OK, great, good.
[AGENT][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Good afternoon. Thanks for calling APO this is [PII] and how can I help you? Uh, yeah, good afternoon, [PII]. Yeah, um, I'm calling to, I, I, as I talked with your associate there, your rep, um, about my claim, and, um, I talked with my physician last week. I guess you guys have requested, um, medical records, a little bit more information and uh she understood the urgency of the nurse and and she said you guys had faxed it over, which I appreciate.
[CUSTOMER][NEUTRAL] And that she was gonna fax it back over, so I'm pretty sure that they did that, um, that was last Wednesday I believe, um, or no, actually it was last [PII]. So, um, your, um, team member mentioned to me that it's kind of hard for her to tell if that has, um, you know, that said with a metal examiner or not so I was wondering if there's any way to prompt that so we can expedite this. It's been, you know, almost two months.
[CUSTOMER][NEUTRAL] OK, so as of today we have not received that information back from the doctor's office, so we're still waiting on medical records.
[CUSTOMER][NEUTRAL] Oh OK, um, how would you know that, uh, because yeah, they, they, they mentioned to me that they were gonna get it out that week last week, uh, could it be sitting in one of your uh queues or. No, sir, once it comes in it's uh it is put in the system and I'm not showing that we have received anything as of today.
[CUSTOMER][NEUTRAL] OK, OK, well I'll reach back out to them and as your um associate, uh, mentioned it, if it's easier then maybe I'll go by and pick them up myself and make sure to get back over to you guys because this is just, you know, taking forever so um is that something I could do?
[CUSTOMER][NEUTRAL] No, usually they have to be submitted in by the doctor's office.
[CUSTOMER][NEUTRAL] Oh, OK, so she may have gave me wrong information. OK, person that was just on the phone, OK, um, OK, alright, well I'll reach out to them and, um, and see what, you know, what's going on so we can get this moving, right? It's been a long time. OK, um, alright, I'll let them know. I appreciate it. Uh, one other thing, no, one other thing I did no one other.