AccountId: 011433970860
ContactId: 9f660596-5915-4249-bc10-9ca777aca30d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 687940 ms
Total Talk Time (AGENT): 254675 ms
Total Talk Time (CUSTOMER): 258252 ms
Interruptions: 1
Overall Sentiment: AGENT=0.1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/9f660596-5915-4249-bc10-9ca777aca30d_20250311T15:25_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], it's [PII]. How are you doing today?
[AGENT][POSITIVE] Doing well, [PII], thank you. How are you?
[CUSTOMER][NEUTRAL] I'm good. Um, well, I have an insured on the phone as regards to disability and looks like a claim processed yesterday and he faxed over a claim.
[CUSTOMER][NEUTRAL] Yesterday as well. But um,
[CUSTOMER][NEUTRAL] It hasn't been uploaded into the system yet, but I'm looking at it and it looks like he selected initial disability, so I didn't know if that would be an issue as far as processing, but he's wanted to know why when the first check he received was over 3000 and this last check he is uh that has been mailed out today is 1700.
[AGENT][NEUTRAL] Mm, OK, let me try to take a look and see if I can help him. What's the policy number?
[CUSTOMER][NEUTRAL] Uh, um,
[CUSTOMER][NEUTRAL] 243-263-6
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I don't know if you can look at uh the faxes that came through, but I can give you the time to um when it came in if you wanna see it or not.
[AGENT][NEUTRAL] And that's for [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you're saying he sent an additional faxes yesterday but we can't see them yet or that's the fax that came in?
[CUSTOMER][NEUTRAL] No, he sent in the fax yesterday and it um it hadn't been uploaded yet um I could just able to see it and just looking on the fax it looks like he marked it as initial disability which I'm thinking it should have been a continuing disability so I don't know if that would make a difference.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] And he's wondering about the check that would be mailed out today and why it was so small and I, I explained it looks like it paid from [PII].
[AGENT][NEUTRAL] Right, because he had a partial, he had an elimination period, then he had a partial, took out premium out of that first payment.
[AGENT][NEUTRAL] And then he was paid for December and then January as well so I'm certain that next one is just for February.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, but I only pay to the [PII], but um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me see if I can.
[CUSTOMER][NEUTRAL] And he is thinking he should have got 2000.
[AGENT][NEUTRAL] Figure out why.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] See if there's notes usually she puts notes in um he's been verified.
[CUSTOMER][NEUTRAL] Yeah, I verified all his information.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, so that mail from that stated from yesterday is not the mail he's talking about he sent in.
[CUSTOMER][NEUTRAL] No, because he had called initially to verify if we received his claim, which I did look on OnBase and I show it was received, but now he's inquiring about his benefits so why the check that is coming soon is not [PII] and how it, how we process as far as payments.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But I don't know if you, if you were able to look at the faxes that came through.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] If you're able to get on the on base and look through the um where they have the index.
[AGENT][NEUTRAL] I can, I can. Mm.
[AGENT][NEUTRAL] Yeah, I should be able to anyway, let me see if.
[AGENT][NEUTRAL] Yes it looks like 3 came in, is that right?
[CUSTOMER][NEUTRAL] Uh, it came in on, uh, [PII] at [PII].
[AGENT][NEUTRAL] 310. Yeah. Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] 44 seconds.
[CUSTOMER][NEUTRAL] To be more specific.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] OK, and he's again questioning that amount of the 1733?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And I'm not sure why.
[AGENT][NEGATIVE] Um, why he was only paid the 26 days, I don't see.
[AGENT][NEUTRAL] Why that is.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It looks like it returned to work day at this point is 3:15.
[AGENT][NEUTRAL] So I'm not certain, um, and I don't.
[AGENT][NEUTRAL] I only see the faxes that were.
[AGENT][NEUTRAL] Processed or I'm sorry the mail that was processed yesterday that's stated for 310.
[AGENT][NEUTRAL] I don't see that.
[CUSTOMER][NEUTRAL] Oh, can I see it?
[AGENT][NEUTRAL] I don't see the facts that you're speaking of.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] I, I just pulled it up by documents, right? I mean, I don't see.
[CUSTOMER][NEUTRAL] Um, if you go to APL Jack indexing.
[CUSTOMER][NEUTRAL] And then under there that index research.
[CUSTOMER][NEUTRAL] And if you go under uh what does that say? APL.
[CUSTOMER][NEUTRAL] Lord, I can't
[CUSTOMER][NEUTRAL] Oh computers think.
[CUSTOMER][NEUTRAL] Or does it say APL source ID sorry. If you change that to fax unless they already know, uh change it to fax.
[CUSTOMER][NEUTRAL] And it shows all the faxes that came through.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If you go to one that says uh for [PII] or 3 [PII] at [PII] or at [PII]
[AGENT][NEUTRAL] 344.
[CUSTOMER][NEUTRAL] 350 44.
[AGENT][NEUTRAL] Oh, I'm sorry, OK, got it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But like I explained, it looks like if it's supposed to be continuing that he filled out the initial.
[CUSTOMER][NEUTRAL] Instead of continuing portion.
[CUSTOMER][NEUTRAL] I don't know if that would be an issue as far as processing um a continuing claim.
[AGENT][NEUTRAL] I don't think so unless uh.
[CUSTOMER][NEUTRAL] But the main thing is we did receive it um which I did verify with him but he's now inquiring about payment that just uh was sent out or be sent out today.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Usually they they put a note in but usually they put a note in but this time they didn't so I'm not certain why.
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] Why it was only the 26 days. I don't see any notes telling us why that was.
[CUSTOMER][NEUTRAL] Um, benefit paid up to the release to return to work day on last fishing's claim.
[AGENT][NEUTRAL] Only paid up to 226 last doctor form to release return to work on [PII], so that's probably why he completed that other form and now he's saying his return to work date is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Huh.
[AGENT][NEUTRAL] I believe because that's what it looks like to me.
[CUSTOMER][NEUTRAL] Yeah, that's what it looks like too now that I'm seeing it, um, paid up to release to return to work date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] It's state he's still off work, so, well, I can explain to him the reason why it just shows that uh he was paid up to his return to work date.
[CUSTOMER][NEUTRAL] Based on the initial claim received.
[AGENT][NEUTRAL] Yeah, because like I said, that's what it looks like to me is that it, it, they, uh, Betsy states right in her note that um she informed him of the claim form being the instructions on the first form and sure will upload again he says.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] No return, uh, I think it means not return to work day or.
[AGENT][NEUTRAL] He said
[AGENT][NEGATIVE] NOR returned to work.
[AGENT][NEUTRAL] OK, I mean, do you want me to speak with them?
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] Uh, it doesn't matter. I can, uh, let him know that it paid up to what it shows on his physician's claim or return to work, but we did receive his form, so I can explain that to him and if he has any other questions I can transfer.
[AGENT][NEUTRAL] OK, and it's just that one document that he's speaking of that, right? The one from yesterday that he uploaded?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, because I don't see that the physician so that part of the.
[CUSTOMER][NEUTRAL] I know. That's the reason why it's kind of confusing to me. And that's why I was like, it looks like.
[AGENT][NEUTRAL] You see that?
[AGENT][NEUTRAL] Yeah, cause he filled in the information. It looks like um if according to [PII]'s note, we only have a physician form up to that 226 that he's returning on [PII]. So he needs to have that updated by the physician, um, and I think that's what [PII]'s note telling him that the, um, he needs an updated physician form completed because of, as of now, he can only get paid to up to the [PII] date.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Because the last doctor release form had him returning to work on [PII], so he would need to provide that to us from the physician and just that portion, you know, that shows because he did submit the other form, however, um, that physician form is not completed by the physician giving us that unless that I.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] He'll be out longer.
[AGENT][NEUTRAL] So I overlook it, OK, yeah, because the attending physician form is blank that he submitted, uh, with this fax, yep, mhm.
[CUSTOMER][POSITIVE] Exactly, yeah.
[CUSTOMER][NEUTRAL] All right. Well, I'll let him know.
[AGENT][NEUTRAL] OK, if you need me, um, you can transfer if you need to, [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All right, Ms. [PII], I appreciate you.
[AGENT][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] I'm glad we figured it out.
[CUSTOMER][NEUTRAL] Yeah, yes, I was like, I don't know.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Well, I appreciate you. Have a great one. All right. Bye.
[AGENT][POSITIVE] Sure, you too. Thank you. Bye.