AccountId: 011433970860
ContactId: b8f0128d-57f0-45a5-8520-58b20c68e51c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 426380 ms
Total Talk Time (AGENT): 224897 ms
Total Talk Time (CUSTOMER): 147390 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/b8f0128d-57f0-45a5-8520-58b20c68e51c_20250303T17:01_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, who would I speak? Well, I've already spoke to a rep this morning in regards to an accidental life insurance policy. Um, it was for my son, he passed away, um, but I have a question because she needed me to get another document, and I was told I wasn't able to get it. So could you help me in regards to a policy for the life insurance?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, let's see what we can do. May I have your name and contact number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And what's a callback number just in case we get disconnected, Ms. [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you. And uh do you have a policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, my son, his name was [PII], policy number 02570546.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] OK. And um let me have um for security to make sure that I have the right policy pulled up. May I have the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And um so you called this morning and I see that they asked for a primary EOB?
[CUSTOMER][NEUTRAL] A who? Say it again.
[AGENT][NEUTRAL] A primary primary explanation of benefits.
[CUSTOMER][NEGATIVE] Right, so I just spoke with [PII] and they're telling me he needs a power of attorney. There was no power of attorney. She was the AMA rep stated that she couldn't give me that information, and I'm like, well, the insurance company is requesting this.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So how do I, what do I do?
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] Cause there is no power of attorney. He's not here. There was never one appointed.
[AGENT][NEUTRAL] Uh
[AGENT][NEGATIVE] No, and the power of attorney will not work, no. um.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Let me see what else can you try to get because um yeah, the the power of attorney is, is basically when somebody's leaving and they cannot um handle things, so they, they appoint somebody and that person has the authority to call and do everything. But in these cases, usually they just ask for like information about um either if you're over state or any information that will help them um help you to get that information, but um.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] Yeah, because that, that's gonna be a must for us. We're gonna need that, do you know if they can just send it directly to us without having to send it, send it to you?
[CUSTOMER][NEGATIVE] Oh wow, I didn't ask for that, and mind you, I have apne myself, but this is so weird. I was on the phone for literally an hour. The call kept dropping and I was on the landline, and they, they just kept it, it was a mess. So you want me to ask if they could just send it to you guys.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] To us directly um for a claim, yes.
[AGENT][NEUTRAL] For claim process if they cannot give you the information if they can send it directly to us, if not, if they can give you like instructions of what else can you send um to to get that information um.
[CUSTOMER][NEUTRAL] And they're saying like this.
[AGENT][NEUTRAL] Maybe you probably need to speak to somebody else, um.
[AGENT][NEUTRAL] In regards of that, I'm, I'm sorry, I just don't know what else because I know that a power of attorney is definitely not gonna work, but um.
[AGENT][NEUTRAL] Yeah, I'm not really sure what are the rules or regulations.
[CUSTOMER][NEUTRAL] But have you had this issue before when they don't want to release the explanation of benefits?
[AGENT][NEUTRAL] We don't know their rules in the back, um, with every primary insurance we don't know what are the rules uh so.
[AGENT][NEUTRAL] We don't really know if uh what they asked for. Um, the only thing I know is like what we asked for, which is the primary will be or additional information if we need to, but I'm not sure exactly what are the rules and regulations on the primary insurance.
[CUSTOMER][NEUTRAL] Because they sent the um [PII] sent the billing but the rep I spoke to this morning, she was like, no, that's not what you needed, the billing because they said the original billing.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] They don't have a copy of the explanation of benefits, they can send it as well.
[CUSTOMER][NEUTRAL] Who, Jackson Hospital?
[AGENT][NEUTRAL] Uh-huh, yes, they should have a copy.
[CUSTOMER][NEUTRAL] That's what I'm
[CUSTOMER][NEUTRAL] That's what I'm stating like they sent a back package with like 700 pages of billing.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] But you guys don't want that. The rep I spoke to earlier, she said that's not what you guys wanted because I sent an original. I mailed in original and I faxed over a few pages of the of that and the um and the other documents you requested.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, we, we're just needing the, the primary explanation of benefits. We're needing that because that's part of a claim. Uh, our claims consist of three documents. The first one, the claim form, the second one is the itemized bill, which is, it looks like that's what you sent.
[AGENT][NEUTRAL] And the third part is going to be the copy of the primary explanation of benefits. So it looks like we're missing the, the third one, which is the explanation of benefits from the primary insurance. And you can either get that through the major medical, through the primary insurance or it may be the hospital or the place that
[AGENT][NEUTRAL] He had service have a copy and they can send it to us because they usually have to get a copy from the primary insurance so I don't know if if it's gonna be easier for you to contact the hospital and see if they have a copy if they can send it to us if they can fax it to us or if they can provide you with a copy and you can send it to us.
[AGENT][NEUTRAL] Or what else our house, you can get a copy, but we're just gonna need that document.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, your fax number again?
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 94942318773659423.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, that is correct. Mhm.
[CUSTOMER][POSITIVE] Thanks.
[CUSTOMER][POSITIVE] OK, let me try to figure it out. Thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank