AccountId: 011433970860
ContactId: 990203b6-18e7-412c-8ce8-e88e5cd02619
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 419700 ms
Total Talk Time (AGENT): 126795 ms
Total Talk Time (CUSTOMER): 172545 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/990203b6-18e7-412c-8ce8-e88e5cd02619_20250409T16:39_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] with OS Benefits. I'm calling on behalf of one of my employees, Ms. [PII]. We had submitted a, um, a claim for her on, on, uh, [PII] I mean [PII], and, uh, we just, it's been taking a while, and I just, I wanna see what's going on and, and make sure everything's, uh, flowing smoothly because she is kind of.
[CUSTOMER][NEUTRAL] Reaching out to me and telling me hey look, uh, I don't know why it's taking me so long I just wanna be able to give her an answer to kind of put her at ease.
[AGENT][NEUTRAL] OK, what was the group number on that?
[CUSTOMER][NEUTRAL] Yes ma'am, it's 25054.
[AGENT][NEUTRAL] OK, give me just a moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And are you with the group or the broker?
[CUSTOMER][NEUTRAL] Uh, I'm with the broker.
[AGENT][NEUTRAL] OK, OK. Sorry about that. Let me check a different place.
[CUSTOMER][POSITIVE] No, no, you're good. I should have told you that from the beginning.
[AGENT][NEUTRAL] OK, I'm sorry, what was your name again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have the policy number of the patient?
[CUSTOMER][NEUTRAL] Yes ma'am I do um it's 258-30002.
[AGENT][NEUTRAL] And her name was [PII], is that right?
[CUSTOMER][POSITIVE] Yes ma'am, that's correct.
[AGENT][NEUTRAL] You have her birth date?
[CUSTOMER][NEUTRAL] Uh, yes, give me one second, I'll look it up in our system.
[CUSTOMER][NEUTRAL] Um and it's [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, it looks like.
[AGENT][NEUTRAL] We processed it on [PII] and we're requesting medical records.
[CUSTOMER][NEUTRAL] OK, OK, so, so that was requested on [PII], um, so I guess it's just a matter of the provider getting back to y'all and then it and then I guess once you all get those documents do you know like roughly how long it would take to process through just because.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] She is um you know she's out of work so she she doesn't really have any savings per se so this is it's kind of um I guess becoming a um a time sensitive situation for her um is there any way that you can give me like a ballpark that I can tell her that this could be like once they receive the documents from the provider how long it would take to process finish processing the claim?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Typically it takes about 7 working days.
[CUSTOMER][NEUTRAL] So another 7 after the 12 that we've been waiting.
[AGENT][NEUTRAL] Receipt
[AGENT][NEUTRAL] Yeah, so it looks like, let me see what we're missing. Let me pull that up real quick.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] So, it looks like we've requested records from the healthcare provider.
[AGENT][NEUTRAL] So if if if she wants to.
[CUSTOMER][NEUTRAL] Yes ma'am, and and that that that wasn't that wasn't required, right? Like when I submitted the form or anything like that per se?
[AGENT][NEUTRAL] Um, so for disability, we need, um, 3 things. We need the statement from the provider, so her healthcare provider, we need her statement.
[AGENT][NEUTRAL] And then if this is a group policy, we need the employer statement.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, let me see what.
[CUSTOMER][NEUTRAL] Yeah, so, so I got, I got all that information, um, put in there I guess there was some, was there like some type of discrepancy or something that's the reason why they're requesting additional, uh, supplemental material.
[AGENT][NEUTRAL] Yeah, I'm looking to see what we.
[CUSTOMER][NEUTRAL] Because I, I, I mean I do this pretty often so I, I'm just doing what I usually do and and um I'm just curious if there was some type of discrepancy that's the reason why they um requested additional.
[AGENT][NEUTRAL] Yeah, I don't know what they're needing. So do you want, I can transfer you to the claims department. They have access to more information than I do. Um, all I can really give.
[CUSTOMER][POSITIVE] Yeah, yes, definitely, if you could do that, that'd be awesome.
[AGENT][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And can I get your callback number?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][POSITIVE] And I'm sorry, will you tell me your name one more time? I'm so sorry.
[CUSTOMER][POSITIVE] Yeah, no, you're so good. It's uh [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], give me one moment, OK?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Hi, um, this is [PII] on the care team, and I have a broker on the line. Um, they submitted a short-term disability on behalf of a member and the claim is requesting medical records, and he had some questions on what what is needed, and I, I can't exactly tell what's needed either, so.
[CUSTOMER][NEUTRAL] OK [PII], um, what's the policy number?
[AGENT][NEUTRAL] Uh, policy number is 2583002.
[CUSTOMER][NEUTRAL] OK, just one moment.
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] Yes, that's correct, and I have [PII] on the line from the OS Benefits Inc.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] And do you have a call back?
[AGENT][NEUTRAL] I do. It's [PII].
[CUSTOMER][NEUTRAL] And the patient information has all been verified, [PII]?
[AGENT][NEUTRAL] Yes, it has.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And it's on it um I see I see what it is OK um you can go ahead and transfer him and I will help him.
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] You're welcome, [PII] have a great day.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thanks.
[CUSTOMER][NEUTRAL] Hi [PII].
[CUSTOMER][NEUTRAL] Hi ma'am.