AccountId: 011433970860
ContactId: b0f4eeec-3ed9-4d23-b1c1-3a4a229cdae5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 555239 ms
Total Talk Time (AGENT): 302839 ms
Total Talk Time (CUSTOMER): 95127 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/b0f4eeec-3ed9-4d23-b1c1-3a4a229cdae5_20250403T13:47_UTC.wav
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[AGENT][NEUTRAL] Morning, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I was calling to check on my um
[CUSTOMER][NEUTRAL] Not
[AGENT][NEUTRAL] OK, you're the insured and you're needing to check on a claim status for yourself. Is that correct?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And Miss [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, and your policy number?
[CUSTOMER][NEUTRAL] 2, I mean 055, 1 2nd.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] 255-5607
[AGENT][NEUTRAL] OK, 2, and was it 2 5s? You said 255?
[CUSTOMER][NEUTRAL] The number 2 and 35 is 607.
[AGENT][NEUTRAL] 607.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you, one moment.
[AGENT][NEUTRAL] OK, and Ms. [PII].
[AGENT][NEUTRAL] Any information that I do provide for you today will be a vision of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is the same as the one that.
[AGENT][NEUTRAL] You gave me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you. And lastly, your email address?
[CUSTOMER][NEUTRAL] Um, I was changing it and that's when we got cut off. I think I got MSJM DP driver.
[AGENT][NEUTRAL] OK, we have something different.
[CUSTOMER][NEUTRAL] OK, so that means she got a chance. Is it [PII]?
[AGENT][NEUTRAL] Yes, ma'am. OK. Thank you very much for verifying your info to someone, but you all got disconnected.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. All right. So one moment.
[AGENT][NEUTRAL] OK, so Ms. [PII], the, the last
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] That I see that was reviewed for you was done on [PII].
[AGENT][NEGATIVE] And this claim was denied.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] And give me one moment to pull up the so that I can see the reason.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK, so one of the remarks on here states
[AGENT][NEUTRAL] To please date and sign.
[AGENT][NEUTRAL] In the enclosed release of information and this.
[CUSTOMER][NEUTRAL] Your phone keep going in and out.
[CUSTOMER][NEUTRAL] Your phone keep going in and out.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yes, ma'am. I'm sorry and I can't, I don't know why they.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] But it's
[AGENT][NEUTRAL] It states to please date and sign.
[AGENT][NEUTRAL] In the enclosed release of information on to our office. This form is necessary in order for APL to request additional information regarding your present claim.
[AGENT][NEUTRAL] There is also a
[CUSTOMER][NEGATIVE] I never received it.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] In one more moment.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] There's another remark. Yes, ma'am. Can you hear me?
[CUSTOMER][NEUTRAL] Ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, your phone keep going in and out, sorry.
[AGENT][POSITIVE] That's OK, and I do apologize as well.
[AGENT][NEUTRAL] OK, so the next remark states we have received your request for disability benefits. Before we can consider your request, we must obtain medical records to verify your disability is not the result of a pre-existing condition.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] We will be excuse me, contacting you again within the next few days requesting your assistance in providing the names and addresses of your medical providers.
[AGENT][NEUTRAL] Your complete and timely cooperation and supplying this information will assist us in obtaining these records timely if you have any questions or concerns as to why.
[AGENT][NEUTRAL] We are unable to consider benefits at this time, please do not hesitate to contact us.
[AGENT][NEUTRAL] So we have mailed you.
[AGENT][NEUTRAL] That explanation of benefits with those room on there, Ms. [PII]?
[AGENT][NEUTRAL] Along with the form that would need to be completed or signed, the HIPAA authorization.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Now, you may, let's see, just one moment. I'm looking at something.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] So that probably just, it hasn't had time to reach you yet.
[AGENT][NEUTRAL] Because this shows that this was requested on [PII], which means it would not have been mailed out until [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And actually, let's see, that would have been last Wednesday.
[CUSTOMER][NEUTRAL] OK, but when the doctor, the doctor who did, I'm sorry.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The doctor who did my um
[CUSTOMER][NEUTRAL] Who did the, the physicians part.
[CUSTOMER][NEUTRAL] Wouldn't that be what they need, instead of needing more?
[AGENT][NEUTRAL] Uh, they, it states that we.
[CUSTOMER][NEUTRAL] Cause my claim is for pregnancy.
[AGENT][NEUTRAL] Yes, ma'am. So it does show uh the doctor that we will need to request medical records.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] And there is that release.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] The HIPAA release that you will need to sign now I can see that you are set up in our portal.
[AGENT][NEUTRAL] Ms. [PII] on the online service center.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you should be able to upload your information.
[AGENT][NEUTRAL] Into the portal if you're not, if you're not able to do that.
[CUSTOMER][NEGATIVE] Yes, it don't work.
[AGENT][NEUTRAL] OK, because your policy is, I guess, because it's no longer active.
[AGENT][NEUTRAL] With APL
[AGENT][NEUTRAL] Let me look.
[AGENT][NEUTRAL] There is a fax number on the bottom of page one of your claim form.
[AGENT][NEUTRAL] Ms. [PII], and that is our secured fax line and to our claims division.
[CUSTOMER][NEUTRAL] OK, but I have, so you want me to face when I receive the paper because I haven't received nothing yet.
[AGENT][NEUTRAL] Yes, ma'am. Right. Because again, it's just not had time enough to, you should be receiving that within just the next few days because it would have been a
[AGENT][NEUTRAL] Mailed out last Thursday.
[AGENT][NEUTRAL] So that information within the next few days. If you have not received it, then you
[AGENT][NEUTRAL] can call us back.
[AGENT][NEUTRAL] At that time, but I'll probably give it through the weekend with a being Thursday.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because it usually takes about 10 business days for the information that's mailed to be received and obviously with you know.
[AGENT][NEUTRAL] With the mail service you could get it a little sooner or it may take longer.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] So is, well, you're certainly very welcome. Anything else, Ms. Was I can help you with at the moment?
[CUSTOMER][NEUTRAL] No, no, thank you.
[AGENT][POSITIVE] OK, well then, thank you for calling APL and I hope you have a very nice day.
[CUSTOMER][NEUTRAL] You too.