AccountId: 011433970860
ContactId: b41e00f4-e18c-4546-9e61-1cc35a2998c8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2091158 ms
Total Talk Time (AGENT): 495146 ms
Total Talk Time (CUSTOMER): 1101341 ms
Interruptions: 35
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/b41e00f4-e18c-4546-9e61-1cc35a2998c8_20250606T21:13_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. How are you doing today? My name's [PII].
[AGENT][POSITIVE] Hey, I'm doing well. How are you?
[CUSTOMER][NEUTRAL] Good. Well, I'm gonna just play the music here for you. You hear that? So I, I just called back. I'm still on hold on my mobile phone, but I'm calling you on my landline right now.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I initially pressed option 4 for customer service.
[CUSTOMER][NEUTRAL] And I wasn't sure to press 2 or 4, and I'll share with you in a minute, but just so you know, I'm looking here at the timer on my mobile phone. I've been on hold for 1 hour and 25 minutes.
[AGENT][NEUTRAL] With APL?
[CUSTOMER][NEUTRAL] With APL dialing [PII]. So just so you know.
[AGENT][NEUTRAL] Oh my God.
[CUSTOMER][NEGATIVE] But anyways, I'm going to hang up there since I have you on the phone. Hi, nice to meet you. OK, that's shut off there.
[AGENT][POSITIVE] Hi, I'm so sorry about that. I'm glad you called us on the landline. I'm definitely gonna let them know. I don't think they're aware.
[CUSTOMER][POSITIVE] Yeah, no worries, I'm like.
[CUSTOMER][NEUTRAL] Yeah, no kidding, I mean.
[AGENT][NEUTRAL] That's crazy.
[CUSTOMER][NEUTRAL] Yeah, and who has landlines anymore, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah. So anyways, um, I'm calling because I'm gonna, I'm gonna upload some more um treatment and surgery and um patient status um forms for you guys for my current injury that I'm off on disability for. And for whatever reason, my password here on the APL website says it's not good. And like most firefighters that have obsessive compulsive disorder,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm pretty much dead set on my iPhone here. I go into my notes section.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have a, um, I have all passwords for anything you could think of from traveling to airline tickets, uh Ticketmaster, you name it, I have it on here. So when I go up here to my um
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My APL log in.
[CUSTOMER][NEGATIVE] It's a it's not working, so I don't know what happened.
[AGENT][NEUTRAL] Yes, so it's not anything that you're doing or entering. So we launched our uh the new website on last Friday and we've been having a lot of issues with the login, but also the new system, you know, like on the old system, it asks for your username and password. The new system you're gonna have to create it'll the the link says create OSC profile, you're gonna have to create a new account with the email address that you used previously and it'll sync the both together.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it's not you.
[CUSTOMER][NEUTRAL] OK, well, OK, so do you want to maybe give me the new website and I can try it with you on the phone if I may?
[AGENT][NEUTRAL] Oh, sure you can. Um, so the website is [PII].
[CUSTOMER][NEUTRAL] I'm sorry [PII].
[AGENT][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] OK, got you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Cool, thank you. Oh, OK, there we go.
[AGENT][NEUTRAL] And then to the top
[AGENT][NEUTRAL] And then to the top right corner, you'll see sign in.
[CUSTOMER][NEUTRAL] OK, I'll click on that.
[CUSTOMER][NEUTRAL] OK, oh, I'm on the same web page as I was on the other one.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Yes, but click create your.
[CUSTOMER][NEUTRAL] Oh, but this one doesn't say.
[CUSTOMER][NEUTRAL] Ah, got it. OK. The other one, the other website didn't have that create link there. OK, so.
[AGENT][NEUTRAL] And then go through like the the individual or insured, sorry.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] On the insured, OK, and then I'll click insured hit next.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, last name [PII], social security number.
[CUSTOMER][NEUTRAL] Or do you have my member ID there in front of you by chance or can I give you some information?
[CUSTOMER][NEGATIVE] Not a big fan of putting my
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Social Security, as you know, I mean, it's a little weird, but yeah.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, there's no member ID. It's, it's, that's asking for your full social.
[CUSTOMER][NEUTRAL] OK all right I'll put it in.
[CUSTOMER][NEUTRAL] Date of birth, OK, don't tell anyone.
[CUSTOMER][NEUTRAL] OK, [PII] [PII] [PII].
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] OK, next.
[CUSTOMER][NEUTRAL] OK, complete your account set up continue right.
[CUSTOMER][NEUTRAL] Please that email address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now it's asking me send verification code or do I hit new password or?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Oh, you have to do the same verification code first.
[CUSTOMER][NEUTRAL] What do you recommend?
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] OK, and then that'll text me I guess or email?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK, let's see text message and nothing's come up yet.
[CUSTOMER][NEUTRAL] Did you say email or text? I'm sorry.
[AGENT][NEUTRAL] You know, typically text, I believe it ask for the phone number, I didn't go through the steps with you, sorry, but it's, it's usually the text that it'll send.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, it might be an email. I just got an email. Beep beep. Let's see here.
[AGENT][NEUTRAL] You got an email?
[CUSTOMER][NEUTRAL] No, that wasn't it. That was from something from Microsoft, oh no, it is um.
[CUSTOMER][NEUTRAL] American Public Life account email verification code, emailed me, OK.
[AGENT][NEUTRAL] OK, yeah, email.
[CUSTOMER][NEUTRAL] So let's see [PII].
[CUSTOMER][NEUTRAL] I already forgot it hello [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so verify code.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK, new password. Let's see here. I'm just gonna try to stick with the old one if that's OK.
[CUSTOMER][NEUTRAL] OK, so let's go, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So the passwords at the same display name.
[CUSTOMER][NEUTRAL] I'll put just display name. What should just [PII], you think?
[AGENT][NEUTRAL] Yeah, uh, whatever you'd like it to be, that's what's gonna show on your dashboard.
[CUSTOMER][NEUTRAL] Yeah, uh, whatever you'd like it to be, that's what's gonna show on your dashboard.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then given name oh gosh.
[AGENT][NEUTRAL] Oh, you don't have to fill that out. You can just um
[CUSTOMER][NEUTRAL] Um, you don't have to fill that out you can just um.
[AGENT][NEUTRAL] Go next or continue.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK, now it says terms of use WW I agree to terms of use. I'm assuming I have to hit that, right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Policy accepted and I agree to that. OK, I'm assuming I take both of those.
[CUSTOMER][POSITIVE] Your account has been successfully created.
[CUSTOMER][NEUTRAL] OK, go to dashboard.
[CUSTOMER][NEUTRAL] OK, so now I can log in now.
[CUSTOMER][NEUTRAL] Alright, let's see if I can get in. It's gonna send another verification code, so you'll probably hear another dding.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] There it is.
[CUSTOMER][NEUTRAL] Come back here.
[CUSTOMER][NEUTRAL] There he is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Huh, what happened here?
[CUSTOMER][NEUTRAL] That um.
[AGENT][NEUTRAL] Is it giving you an error?
[CUSTOMER][NEUTRAL] It's yeah it's not working what's going on here? Log in.
[CUSTOMER][NEUTRAL] How did you know
[AGENT][NEUTRAL] Well, because we, we're having some issues with the website, but sometimes it works and sometimes it doesn't, so it might not be you.
[CUSTOMER][MIXED] Well, because we we're having some issues with the website, but sometimes it works and sometimes it doesn't so it might not be you. OK.
[CUSTOMER][NEUTRAL] Alright, so let's see here.
[CUSTOMER][NEUTRAL] Please
[CUSTOMER][NEGATIVE] Um, cancel.
[CUSTOMER][NEUTRAL] Back
[CUSTOMER][NEGATIVE] Don't keep this new.
[CUSTOMER][NEUTRAL] Yeah, what's happening here?
[AGENT][NEUTRAL] And uh Mr. [PII], what's your policy number?
[CUSTOMER][NEUTRAL] And um Mr. [PII], what's your policy number?
[CUSTOMER][NEUTRAL] What's my policy number? Uh, let me check real quick. Hang on.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Of course I, I didn't put that here on my.
[CUSTOMER][NEUTRAL] ERB here on my notes I just have my user name and password email.
[AGENT][NEUTRAL] OK, um, well, I, mm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Can you spell your last name for me? I can look it up with your name.
[CUSTOMER][NEUTRAL] Can you spell your last name for me? Uh, sure, thank you. Uh, and you know I'll put it in my phone once you, once you give it to me here. Uh last name is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] One moment
[AGENT][NEUTRAL] OK, so I'm just waiting for the policies to come up here.
[CUSTOMER][NEUTRAL] OK, so I'm just waiting for the policy to come up here. OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] What was your first name again? I apologize.
[AGENT][NEUTRAL] That's OK. My name is [PII].
[CUSTOMER][NEUTRAL] That's OK. My name is [PII]. [PII], name's [PII]. OK, cool. You're welcome. And am I spelling your first name correctly? [PII]? Uh no, it's [PII].
[AGENT][NEUTRAL] You're welcome. And am I spelling your first name correctly? [PII]?
[AGENT][NEUTRAL] OK, sorry about that, hold on one moment. OK.
[CUSTOMER][POSITIVE] No, no worries.
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Alright, it just popped up and it hold on one second.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And thank you so much for verifying your date of birth. Um, can you also verify your mailing address and email address on file?
[CUSTOMER][POSITIVE] And thank you so much for verifying your date of birth. Um, can you also verify your mailing address and email address on file? Yes, of course, thank you for asking [PII].
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Email address is [PII].
[CUSTOMER][NEUTRAL] My mailing address is [PII].
[AGENT][NEUTRAL] Thank you for that. And all the information provided is a verification of benefits, not a guarantee of payment. So hold on one moment, let me
[CUSTOMER][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So hold on one moment, let me.
[AGENT][NEUTRAL] Get to the screen so I can make sure. I'm just gonna go through the steps. Hold on one moment.
[CUSTOMER][NEUTRAL] At this screen so I can make sure I'm just gonna go through hold on one moment. Of course.
[AGENT][NEUTRAL] Was it giving you like a er like a user not found error?
[CUSTOMER][NEGATIVE] Does it give you like a er like a user not found error? It just kept circling like spiraling like in a circle, you know, over and over and over and over. I'm like, oh, that's weird.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, it's getting ready to send you another verification email. Hold on one second.
[CUSTOMER][NEUTRAL] OK, it's getting ready to send you another verification email.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And can you let me know if that code?
[CUSTOMER][NEUTRAL] Can you let me know that code.
[CUSTOMER][NEUTRAL] Let you know the code? Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Here it goes.
[CUSTOMER][NEUTRAL] OK, that code is [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Hm
[AGENT][NEUTRAL] What is this? I think it's just taking us a little bit to load on your side. But on my side, it says it's already an account set up. I'm wondering did it go through.
[CUSTOMER][NEUTRAL] Let's see, I think it's just taking us a little bit to load on your side because on my side it says it's already an account uh I wonder did it go through. Hmm, OK.
[AGENT][NEUTRAL] Hold on, I'm getting ready to go back. It just reset.
[CUSTOMER][NEUTRAL] Hold on, I'm getting ready to go back.
[CUSTOMER][NEUTRAL] It sent me two more passwords. OK, so let's try this 1 [PII]. Let me try this one here. [PII]. I'm writing these ones down [PII] not crazy. [PII]. So let's come back to this.
[CUSTOMER][NEUTRAL] OK, so let's see here go there.
[AGENT][POSITIVE] Hopefully, it'll go through for you now.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Ah, that last one worked.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] File a claim next.
[CUSTOMER][POSITIVE] I just want to go to my policy here, so X out of here. I just kind of wanna see what's going on here. We value your privacy da da da. OK, great.
[CUSTOMER][NEUTRAL] A message and your 10 digit phone number. Oh, OK. It doesn't have anything of mine. This is all brand new, huh?
[CUSTOMER][NEUTRAL] [PII]. Yeah, it's a whole new system.
[AGENT][NEUTRAL] Yeah, it's a whole new system.
[AGENT][NEUTRAL] But once it syncs, it'll show you like all your old claims and it'll sync the information. It might not be all right now though.
[CUSTOMER][NEUTRAL] But once it syncs it'll show you like all your old claims and you'll put the information it might not be all right now though. OK.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] And now it wants, now it's going to text me a code. That's why he emailed me and not.
[AGENT][POSITIVE] Thanks you.
[CUSTOMER][NEUTRAL] I see what happened. Yeah, OK, yeah, OK, so APL there it is, uh, that code here is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] 3.
[CUSTOMER][POSITIVE] Cool, um.
[CUSTOMER][NEUTRAL] d
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] New text message on your phone number has been verified and this text message notification.
[CUSTOMER][NEUTRAL] You're now subscribed to text message notifications.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. OK. We all have those, don't we?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] My gosh, OK.
[CUSTOMER][NEUTRAL] OK, well here it is here's my dashboard so right now um are you able to see um.
[CUSTOMER][NEUTRAL] Because I have some questions. Um, I was on injury, I'm still on injury. It's, it's gone beyond the year, but APL has not paid me out for the full year. The date of injury was [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] And I have surpassed the [PII] date to make it the full year. Here we are in June, but um I'm, I'm having continuous tendon problems. I filed a bilateral um hand, tendon, carpal tunnel, kind of everything. They just my hands just stopped working as a 30 year plus veteran. And so like APL, I think at one point said, oh, we've already paid you for this um for this injury, and I'm like, well,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] How could you pay me because I get the right wrist done, the left wrist done.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] The left pinky, the left thumb. Now I just had the right middle finger done two months ago.
[CUSTOMER][NEUTRAL] So I'm setting all this stuff up, but I'm now they're, they're, I don't know what's going on, but their surgeries, they put me under anesthesia, done at a surgery center. I'm uploading um the doctor's operative report, the surgery center, their line for line item of, you know, charges and everything, um, patient status reports that I'm still off on, you know, temporarily totally disabled. So I, I don't know what happened, but I'm uploading, but I'm getting denied when they paid out.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They start, they were everything was paying. I was getting covered and then all of a sudden it was just, yeah, OK, no more so.
[AGENT][NEUTRAL] Let me take a look at the.
[CUSTOMER][NEUTRAL] I've been meaning to call you guys, OK.
[AGENT][NEUTRAL] So do you, so it's like the
[CUSTOMER][NEUTRAL] So do you, so it's like the.
[AGENT][NEUTRAL] Like your most recent claims have been denied?
[CUSTOMER][NEUTRAL] Like your most recent claims have been denied.
[CUSTOMER][NEGATIVE] Yeah, I, I have not been paid out all the way because you guys don't pay beyond a year, right?
[AGENT][NEUTRAL] I'm pulling up your policy now so I can see all the benefits, but I do see like the last payment was [PII].
[CUSTOMER][NEUTRAL] I'm pulling up your um policy now so I can see all the benefits, but I do see like the last payment was [PII].
[CUSTOMER][NEUTRAL] Yeah, and it should have.
[CUSTOMER][NEUTRAL] And I don't, I don't think it was the full year. Maybe I'm wrong, but
[AGENT][NEUTRAL] Well, I can take a look and see. Um, do you mind if I place you on just a brief hold?
[CUSTOMER][NEUTRAL] I can take a look and see do you mind if I place you on a brief hold? Sure, happy to hold. And if you could check if it goes if it still pays beyond a year, because I also think I got an email from you guys saying something that my um my premium.
[CUSTOMER][NEUTRAL] Um, didn't go through. And it's like, well, I'm still off on I. So I don't think you guys charge um while the patient is still off or the insured is still off on disability, right?
[AGENT][NEUTRAL] So, in that case, most of the time, um, I'm gonna look and see if there's a waiver on the policy. If not, then it'll be taken out of whatever your
[CUSTOMER][NEUTRAL] So in that case most of the time, um, I'm gonna look and see if there's a waiver on the policy. If not, then it'll be taken out of whatever your
[AGENT][NEUTRAL] Like the $3000 benefit.
[CUSTOMER][NEUTRAL] Like the $3000 Got you.
[AGENT][NEUTRAL] Um, but the max of a claim is a year.
[CUSTOMER][NEUTRAL] Um, but the max of a claim is a year. OK.
[AGENT][NEUTRAL] But I can check and see how long.
[CUSTOMER][NEUTRAL] So then how do I let you guys, yeah, just because obviously if I'm not working I don't, I don't know if I should be continuing paying the premiums, you know what I mean, at 100 and I think I don't know, I think they're 179 roughly.
[AGENT][NEUTRAL] OK, let me see
[CUSTOMER][NEUTRAL] Ballpark
[AGENT][NEUTRAL] OK, so I see there's a waiver, so you're not paying the premium.
[CUSTOMER][NEUTRAL] OK, so I see there's a waiver, so you're not paying the premium.
[AGENT][NEUTRAL] All right, hold on one moment for me, OK?
[CUSTOMER][POSITIVE] Alright, hold on one moment for me OK? Of course, yeah, happy to hold.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hello Mr. [PII].
[CUSTOMER][NEUTRAL] Hello Mrs. Yes, [PII].
[AGENT][NEUTRAL] All right, thank you so much for holding. I apologize for that wait. So, I'm gonna um try to get a claims examiner on the line because from what I just looked at, it looked like it was from the first um claim was [PII], so it should have
[CUSTOMER][NEUTRAL] Alright, thank you so much for holding. I apologize for that wait so I'm gonna um try to get a claims examiner on the line because from what I just looked at, it looks like it was from the first um claim was [PII], so it should have.
[AGENT][NEUTRAL] Paid until [PII]. If it was the whole, um, if the doctor put you out for the whole
[CUSTOMER][NEUTRAL] [PII] if it was the whole um if the doctor put you out for the whole year yeah Yes.
[AGENT][NEUTRAL] Yeah, but I see the return to work date. Well, no, this was the first one because it kept getting extended, right?
[AGENT][NEUTRAL] Yeah, so, um,
[CUSTOMER][NEUTRAL] Yeah, so, um. And I'm still off, so yeah, because they're gonna be doing another surgery on the wrist again on a separate part of the outer part of the wrist.
[CUSTOMER][NEGATIVE] Um, so I just, you know, I'm, I'm submitting these claims, but now it's like I'm just not even getting paid anymore for the procedure or anything like that, um.
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] So let me do this. Let me, um,
[CUSTOMER][NEUTRAL] So let me do this let me um.
[AGENT][NEUTRAL] And I, because they're, well, let me see if anyone's available first. Um, I'm gonna get a claims examiner on the line. If I can't, then I'll send over an urgent request to them for Monday because I don't know if they leave at [PII] or [PII].
[CUSTOMER][NEUTRAL] And I because they're
[CUSTOMER][NEUTRAL] Let me see if anyone's available. OK, [PII] happy to hold. I don't know [PII] or [PII]. Sure, I get it and it's Friday. Hell, I don't blame you who wants to talk to someone that, you know, and I'm over on Pacific time so it's only.
[AGENT][NEUTRAL] And.
[AGENT][NEUTRAL] Oh yes.
[CUSTOMER][NEUTRAL] [PII] here you guys are Central time yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, well, let me see if someone.
[CUSTOMER][NEUTRAL] So, OK, if someone's available, that's fine, and if not.
[CUSTOMER][NEUTRAL] Monday's fine.
[AGENT][NEUTRAL] OK, um, hold on one moment for me, OK?
[CUSTOMER][POSITIVE] OK, um, hold on one moment for me OK? Sure, happy to hold.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you doing?
[CUSTOMER][POSITIVE] I'm good how are you, [PII]?
[AGENT][NEUTRAL] I'm good. I have a um insured on the other line who feels like he um should
[AGENT][NEUTRAL] should be um receiving more of his disability, like we didn't pay him the full year. Um, the policy number is 2248844.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Mm, OK, so the last one we received we paid through his return to work date.
[CUSTOMER][NEUTRAL] Of [PII].
[CUSTOMER][NEUTRAL] So if he wasn't, did he give yeah if he has additional dates if he's not returning to work.
[AGENT][NEUTRAL] Oh, so he needs to send, uh,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] As of [PII] then like if he didn't return then he needs his physician and his employer to fill out forms confirming he did not return and what his updated return to work date is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Otherwise he's gonna need to give us specific months or dates that he feels like he was not paid for so that we can research that.
[AGENT][NEUTRAL] OK, well, I will let him know and have him send it again.
[AGENT][NEUTRAL] Because
[CUSTOMER][NEUTRAL] OK, if you can if you have any issues, I'm, I'm here till [PII], so you can call back.
[AGENT][NEUTRAL] OK, no, I'm OK. I just
[AGENT][NEUTRAL] Yeah, it was a lot of them and then I went to the first one and saw June and I was like, um, yeah, so I'm gonna tell him.
[CUSTOMER][NEUTRAL] Yeah, so the most recent one just it shows that we process his waiver so we didn't charge him for premium and we paid him $1900 because my assumption, which I haven't looked at any of the paperwork, but the sha's pretty good with these, um, it shows under provider RTW which is returned to work of [PII], so we paid through 2-19 because he was supposed to be returning to work on [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So if that's not the case we're just gonna need updated information from.
[CUSTOMER][NEUTRAL] Like basically a new packet to say this has been extended both by his employer and his physician with an updated return to work.
[AGENT][NEUTRAL] OK. Employer and physician. OK.
[CUSTOMER][NEUTRAL] And we will backdate benefits, yeah, so if if he didn't go back, we'll, we'll backdate benefits and start paying him from the [PII] moving forward or up to whatever that new return to work date is if he hasn't exhausted benefits.
[AGENT][POSITIVE] OK. Well, thank you, [PII].
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][POSITIVE] Alright, have a good weekend.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] All right. Bye-bye.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Alright, thanks again for holding. So, um, we went through the papers, or she went through the papers with me.
[CUSTOMER][NEUTRAL] All right thanks again for holding so um we went through the papers or she went through the papers with me. OK. Basically we're gonna need the claim form.
[AGENT][NEUTRAL] Basically, we're gonna need the claim form.
[AGENT][NEUTRAL] And it's gonna have to be um the doctor's portion and your and your employer's um portion because on the last claim form we received, it said that [PII] was your last um or your return to work month. So if you, if you've been extended, then we'll just need an updated form from the doctor so we can pay you, you know, the remainder for that year.
[CUSTOMER][NEUTRAL] And it's gonna have to be um the doctor's portion and your and your employer's um portion because on the last claim form we received it said that [PII] was your last um or your return to work each month. Correct. So if you, if you've been extended then we'll just need an updated form from the doctor so we can, you know, the remainder for that year. OK, alright, we can backdate the payments for you.
[AGENT][NEUTRAL] And she said they they can backdate, we can backdate the payments for you.
[CUSTOMER][NEUTRAL] OK, got it. So just to confirm here, hang on, I'm trying to find a pen that works. What's going on here? OK, sorry about that. OK, so you need the, um, again, what was that again?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Um, the short-term disability claim form.
[CUSTOMER][NEUTRAL] physician statement short term or long term?
[AGENT][NEUTRAL] Mhm. The physician state.
[AGENT][NEUTRAL] Well, well, the form is short term for with APL.
[CUSTOMER][NEUTRAL] Well, well, the smart is short term for with APL.
[CUSTOMER][NEUTRAL] OK, so it'd be short term, so this would be the short, sure, if you don't mind.
[AGENT][NEUTRAL] Mhm. Did you want me to email you a copy?
[AGENT][NEUTRAL] OK, no, I don't mind at all. So I'll email you a copy of the disability claim form. So there's a portion that you sign, a portion that um your doctor signs, and then a portion that your employer signs, just saying that yes, you are still out, and then um we'll pay you from, so it looks like February was the last payment, so from March to May, because that will be the full year.
[CUSTOMER][NEUTRAL] OK, no, I don't mind at all. So I'll email you a copy of the disability claim form. So there's a portion that you sign, a portion that, um, your doctor signs, and then a portion that your employer signs saying that yes, you are still out, and then, um, we'll pay you from, so it looks like February was the last payment, so from March to May and that'll be the full.
[CUSTOMER][POSITIVE] Got it. OK, got it. So, so the employee mission. OK, cool, yeah, if you could make, I'll get it all filled out and get you everything uploaded and sent to you. Now email or uploaded to the website that you and I just created.
[AGENT][NEUTRAL] Mhm, um, you'll, you'll upload it to the website.
[CUSTOMER][NEUTRAL] Mhm, um, you'll you'll upload it to the website.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][POSITIVE] Alrighty, wonderful that sounds good. I we can do.
[AGENT][NEUTRAL] All right. Well, I'm getting ready to um
[AGENT][NEUTRAL] Oh, sorry.
[CUSTOMER][NEUTRAL] No, no, go ahead. Yeah, yeah, yeah, no, great, thank you. Go ahead.
[AGENT][POSITIVE] Oh, you're welcome. I just say I'm getting ready to email you now, so you should be receiving it in maybe about 5 minutes, um, and check your spam folder just in case as well.
[CUSTOMER][POSITIVE] Oh, you're welcome. I was just saying I'm getting ready to email you now so you should be receiving it in maybe about 5 minutes, um, and check your spam folder just in case as well. Oh, got it, great idea will it be coming from you personally, [PII]?
[AGENT][NEUTRAL] Um, no, it won't be coming from me personally. It'll be the care team, but uh, yeah, it's me sending it.
[CUSTOMER][NEUTRAL] Um, no, it won't be coming from me personally. It'll be the care team, but uh, yeah, it's me sending. OK, all right, sounds good.
[AGENT][POSITIVE] All righty. Well, was there anything else I can help you with?
[CUSTOMER][NEUTRAL] OK wonderful, no thank you, you've been so helpful and just maybe let someone know that I was on hold for 1 hour and 24 minutes before I hung up and called you guys on option 2.
[AGENT][NEUTRAL] Alright.
[AGENT][POSITIVE] Oh, I'm definitely
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So, so I pressed option 4 at the customer service and it was again 1 hour and 24 minutes so.
[AGENT][NEUTRAL] OK. Well, I will.
[CUSTOMER][POSITIVE] That's it that's all I have. Well, I will, well thank you so much for um giving us a call. It was a pleasure serving you and thank you for calling ATL. I hope you have a great weekend. Thank you [PII] you too.
[AGENT][POSITIVE] Well, thank you so much for giving us a call. It was a pleasure serving you and thank you for calling APL. I hope you have a great weekend.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Bye for now.