AccountId: 011433970860
ContactId: 9a21a405-56ff-4d63-9a16-b9bac2e1dd12
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 427899 ms
Total Talk Time (AGENT): 216874 ms
Total Talk Time (CUSTOMER): 120344 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/9a21a405-56ff-4d63-9a16-b9bac2e1dd12_20250217T16:55_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 the care team. How are you doing today?
[AGENT][POSITIVE] I'm good how are you [PII]?
[CUSTOMER][POSITIVE] Hey, I'm wonderful. I have a question about a disability um claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK awesome so I am trying to help um Miss [PII] out her claim number is 3559417.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, so I show that we needed the insured statement, the doctor's statement, and the employer claim portion. My question is she's not a UBTA member, so there's not actually an employer portion on that claim form. So is there something we're needing particularly from her employer?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, let me check.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let me get out here.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so when they are reviewing the claim forms online.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] There should be one for just regular or disability. So the
[CUSTOMER][NEUTRAL] Yeah, that's what I have pulled up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Statement of the insured is her part attending physician and then page 8 is the policyholder's statement that's her employer's statement.
[CUSTOMER][NEUTRAL] OK, so the.
[CUSTOMER][NEUTRAL] The insured doesn't fill that out they're not considered the policy holder?
[AGENT][NEUTRAL] Right, so the group actually holds the policy, um, but.
[AGENT][NEGATIVE] And I don't know why it says policy holder and not employer but um that is what that is so that is their employer statement and then the first two pages pages 2 and 3 are where are the information that they fill out.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and then I can't view it yet because it's not like look like I don't know I can't view it while it's a 0. are you able to tell me if she got page 8 filled out on that when she resubmitted or do I need to let her know she needs to get that filled out by your employer?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, let me, um.
[CUSTOMER][NEUTRAL] Sorry, I'm responding back to an email, so like I.
[AGENT][NEUTRAL] No, that's OK.
[CUSTOMER][POSITIVE] I just wanna let her know exactly what we need so you guys don't have to keep asking.
[AGENT][NEUTRAL] Yeah, of course.
[AGENT][NEUTRAL] OK, let me see what all we have out here.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] I don't know if anybody's pulled it yet so let me go to the queue and see if I can find it there and then if not I'll look in the folders.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] There it is, OK.
[AGENT][NEUTRAL] OK, it's 11 pages.
[CUSTOMER][POSITIVE] Oh goodness.
[AGENT][NEUTRAL] Yeah, so let's see what she did here.
[AGENT][NEGATIVE] It could just be like 6 pages and a whole bunch of blanks, honestly.
[CUSTOMER][NEUTRAL] Oh, and sometimes they'll have like that cover letter from the OSC mission, yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, OK, so there's her hipA release, OK.
[AGENT][NEUTRAL] This is looks like her physician's statement that's the sound.
[AGENT][NEUTRAL] Statement of insured. OK.
[AGENT][NEUTRAL] OK, so statement of insured.
[AGENT][NEUTRAL] See if this is hers. Uh, it doesn't, yeah, that's her portion. OK, so there's hers and she signed and dated that.
[AGENT][NEUTRAL] And then this is her physician.
[AGENT][NEUTRAL] Close fracture, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it looks like we have her physician statement and her insured statement so it looks like we have both of those we're just needing that policyholder or employer statement.
[CUSTOMER][NEUTRAL] OK, so we need page 8 filled up from her employer, um, and.
[CUSTOMER][NEUTRAL] Uploaded to us.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK perfect I will include that back in my email I'll make sure I attach the.
[CUSTOMER][NEUTRAL] The claim to it and just let her know all we need is page 8.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Um, that is really confusing. I've spent, I mean, I've been here for, I mean, a while now, 6 months, and I've bought this whole time that was for the policyholder to fill out like the.
[AGENT][NEUTRAL] Yeah, I don't really know why truthfully I mean my understanding and the way it was explained to me is that the group itself or the employer holds the policy and the insured is obviously like.
[AGENT][NEUTRAL] I don't know. I, I don't, I don't even really know how to explain it because I, I've always, anytime I have my own insurance regardless of whether it's APR or not, I am considered the policy holder because that's my policy, um.
[CUSTOMER][NEUTRAL] Well, all the insurance policyholders like we say like it's the policyholder listed on the ID card or like you know what I mean so.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right, yeah, so I don't know if they're planning on renaming that or anything. Um, I don't think it's truthfully, I don't think it's like that under all of them. I think like when you look at um like a cancer form.
[CUSTOMER][NEUTRAL] It's the UBTA wants the employer.
[AGENT][NEUTRAL] Yeah, so I mean I, but not all of them are like that. I'm not really I'm not really sure why honestly, but um, yeah, that is what that is as far as the disability is concerned. It is the employer's statement.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Well, you know, thank you for taking the time to.
[AGENT][POSITIVE] No problem
[CUSTOMER][NEUTRAL] I know I know I'll be able to tell people.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] Oh goodness, OK, well if you need anything else or if she has any more questions just let me know OK?
[CUSTOMER][POSITIVE] Perfect, thank you so much. I appreciate your time today. Take care you too bye bye.
[AGENT][POSITIVE] You're welcome. Have a good day, [PII].
[AGENT][NEUTRAL] All right, bye.