AccountId: 011433970860
ContactId: a4401472-d2e5-4a95-8aeb-00e143af2605
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 511920 ms
Total Talk Time (AGENT): 258024 ms
Total Talk Time (CUSTOMER): 212912 ms
Interruptions: 2
Overall Sentiment: AGENT=2.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/a4401472-d2e5-4a95-8aeb-00e143af2605_20250225T19:04_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, my name is [PII], and, and I turned in a missing document that was needed for my employer just if, if there's any, uh, changes in status yet.
[AGENT][POSITIVE] It would be my pleasure to check that.
[CUSTOMER][NEUTRAL] A disability.
[AGENT][POSITIVE] Yes, sir, it will be my pleasure to check the claim status for you. Do you have your policy number available?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yeah, that'd be a minute if there's something else I can give you, uh.
[AGENT][NEUTRAL] I can look it up by your social if that's OK.
[CUSTOMER][POSITIVE] Yes, uh-huh, [PII], I'm sorry.
[AGENT][NEUTRAL] Yeah, let me get to that screen. I apologize. My computer was taking just a minute. I apologize.
[CUSTOMER][NEUTRAL] Yeah right.
[AGENT][POSITIVE] I'm ready for that social.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] All right, thank you, Mr. [PII]. And can you verify your date of birth, current mailing address, email, and phone number?
[CUSTOMER][NEUTRAL] Yeah, uh, date of birth [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And uh email address [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And phone number [PII].
[AGENT][POSITIVE] All right, thank you, sir.
[AGENT][NEUTRAL] Let's see, so I'm seeing that we did receive a document on the [PII].
[AGENT][NEUTRAL] It has not been processed as of yet. That was yesterday that we received it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh, OK, I just, just checking. I appreciate it.
[AGENT][POSITIVE] Well it's my pleasure, and I do see that you have an active online account on our portal. Once that document has been processed, if you signed up for text messaging, it could take up to 24 hours, but you can click on that claim number and view the claim decision once it's processed. You'll also receive something by mail as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, cause it's kind of weird. I had thought I turned in everything, but my agent.
[CUSTOMER][NEGATIVE] Was telling me well I only needed to turn in a W2 so that's why I didn't turn in that extra form. So then I got a letter from you guys saying something about benefits. I'm, I'm gonna use the word denied, so I'm like, what's going on? And I, and so I would have been and turned that form in is that is that what I'm saying, you know, if I had known exactly what to do. So that's why that last form is running late, yeah, that's what happened.
[AGENT][NEUTRAL] And that was from your employer?
[CUSTOMER][NEUTRAL] Yeah, uh-huh.
[AGENT][NEUTRAL] OK, yeah, as long as your employer completed that statement.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Portion of the form. Let me just pull that up and let's just make sure that that's what we have while I've got you on the line.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And the accident that's another thing I'm kind of blind on what was to turning on because she.
[CUSTOMER][NEUTRAL] She didn't help me much with that either, but go ahead, I'm sorry.
[AGENT][NEUTRAL] OK, well, let's take a look at this, and then I'll look at your accident policy for you as well.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][POSITIVE] I do apologize, just waiting on my computer.
[CUSTOMER][NEUTRAL] Uh, you alright.
[AGENT][NEUTRAL] And you know when we're in this.
[AGENT][NEUTRAL] age of everything right now, it should be right now.
[CUSTOMER][NEUTRAL] Ain't it ain't that true? Ain't that the truth.
[AGENT][POSITIVE] I used to be the most patient person in the world.
[CUSTOMER][NEUTRAL] Yeah, I was doing good for the last 2 weeks until I found that I needed that document. I'm like, what? I could have been and did that.
[AGENT][POSITIVE] Yeah, you know what? I'm looking at the document that we have and so I'm glad.
[AGENT][POSITIVE] Uh, policy holder statement that is your employer's portion and so I'm glad we've got that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Accident, I'm lost on that one.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's take a look at that also. Give me just a second to pull that policy up.
[CUSTOMER][NEUTRAL] So that so the employer part was OK then.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see what's going on with your accident.
[AGENT][NEUTRAL] OK, so there's no charges submitted.
[CUSTOMER][NEUTRAL] That's what I don't understand cause she didn't, I wasn't told I had what, what to do. I was just told just to send some proof. So I sent my MRI statement in the day I went to get the MRI. I don't know, that's all I knew to do, so I needed to send other things, statements.
[AGENT][NEUTRAL] Mhm. So there were no charges submitted, so we need something from that MRI facility with the charges listed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the diagnosis code.
[AGENT][POSITIVE] And you can actually call them.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me see.
[AGENT][NEUTRAL] You can ask them. I'm gonna give you two types of forms. They may be on either one, and we can take either one.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can request that form from them.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] The first form is a CMS 1500, that's C as in Charlie, M as in Mike, S as in Sam, 1500.
[CUSTOMER][NEUTRAL] But yeah.
[CUSTOMER][NEUTRAL] Hold up, let me, let me make sure you, yeah, because I wanna get this correct.
[AGENT][POSITIVE] Take your time.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah with this form it should be the information needed so.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is CMS.
[AGENT][NEUTRAL] Mhm. C as in Charlie, M as in Mike, S as in Sam, 1500.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1500, OK.
[AGENT][NEUTRAL] Or a U as in umbrella, B as in Bravo, 04.
[AGENT][NEUTRAL] UB 04.
[CUSTOMER][NEUTRAL] OK, they know these forms.
[AGENT][NEUTRAL] They will. Those are actually the type of forms that they submit claims on to um insurance providers.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Got you, got you. So get one of them asks for one of them from the MRI people.
[AGENT][NEUTRAL] Mhm. And that will have your charges and diagnosis codes, so that's, should be what they need.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] See, I didn't know this. It just, it goes back to when I didn't know to turn in another phone.
[AGENT][NEUTRAL] Yeah, so if you submitted a claim form, if you get those forms off of our website, the first page there's instructions is what's to need what as to what is needed to submit claim document for processing.
[CUSTOMER][NEUTRAL] That's what I should have just did it myself, but you know you get these agents and thinking, uh just do this, just do that, we got it, don't worry about it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, and, and I reckon they try maybe.
[CUSTOMER][POSITIVE] So thank you.
[AGENT][NEUTRAL] No, I'm sure they do try.
[CUSTOMER][NEUTRAL] Yeah, but they, they, they try, they probably just got their hands in so many cookie jars that, you know, it is what it is, but no hard feelings.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, so always.
[AGENT][NEUTRAL] Yeah, so always on our claim forms on the front page, there are instructions as to what documents are needed.
[CUSTOMER][NEUTRAL] OK, and, and then as far as you guys have direct deposit, I can do that as well because I I know I've seen that on your account.
[AGENT][NEUTRAL] So if you
[AGENT][POSITIVE] Oh, absolutely. Absolutely.
[CUSTOMER][NEUTRAL] To that, OK.
[AGENT][NEUTRAL] And you can do that at any time. In fact, I would do that before we process your disability if you want that to go to your bank.
[CUSTOMER][NEUTRAL] Alright, I'm
[CUSTOMER][NEUTRAL] Right now.
[AGENT][NEUTRAL] Versus coming by check.
[CUSTOMER][NEUTRAL] I'm gonna do that and then I, yeah, there's a process I can upload that as well, correct to you guys that doctor.
[AGENT][POSITIVE] Mhm. That's right. So it's just that you're just gonna put in your banking information and it will activate the the direct deposit so any claims processed will go directly to your bank account and I tell you that's a lot quicker than the mail these days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you. So I
[CUSTOMER][NEUTRAL] Yeah, so basically just uh fill out the form and then upload it back the way the same way I did that last time.
[AGENT][POSITIVE] Exactly.
[CUSTOMER][POSITIVE] Thank you. Alright, I'll be doing that. I appreciate you.
[AGENT][POSITIVE] Oh, it's been a pleasure. Is there anything else I can help you with today?
[CUSTOMER][POSITIVE] You you've helped me out a lot, thank you so much.
[AGENT][POSITIVE] Well, if you need any further assistance, Mr. [PII], don't hesitate to give us a call. We're here for you, OK?
[CUSTOMER][POSITIVE] Alrighty thank you mhm.
[AGENT][POSITIVE] And thank you for calling APL. You have a wonderful day. Hope you get to feeling better.