AccountId: 011433970860
ContactId: b94eb5c7-492c-4ac6-8668-357008ed9ae9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1586439 ms
Total Talk Time (AGENT): 559651 ms
Total Talk Time (CUSTOMER): 962727 ms
Interruptions: 14
Overall Sentiment: AGENT=1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/b94eb5c7-492c-4ac6-8668-357008ed9ae9_20250320T21:29_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] Uh, good afternoon, [PII]. My name is [PII], and I need some help or guidance regarding uh a claim that I made. I have a policy number. I have a claim number, um.
[AGENT][NEUTRAL] What's the policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK. It's 00447859.
[CUSTOMER][NEUTRAL] I can hear you now.
[AGENT][NEUTRAL] Thank you. Do you mind verifying your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] Yes, uh [PII].
[CUSTOMER][NEUTRAL] And I live at [PII].
[AGENT][POSITIVE] And a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you. I've got your policy pulled up, Ms. [PII]. How can I help you?
[CUSTOMER][NEUTRAL] The, uh, reason I was calling, it's in regards to um.
[CUSTOMER][NEUTRAL] The claim that was uh.
[CUSTOMER][NEUTRAL] I guess the deposit date that you're showing on your claim form is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And this is connected to the claim prior to that, uh, and that had a claim or deposit date of 10-25-24.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And on [PII]:25 to 24 um.
[CUSTOMER][NEUTRAL] What I was responding to, um, on the second one was the daily hospital expense benefit and the inpatient expense benefit.
[CUSTOMER][NEUTRAL] At that time I had only sent you.
[CUSTOMER][NEUTRAL] The first copy of the itemized billing from MD [PII], so you only paid or responded to that one day for one.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And his hospital stay was between 41 and discharge was at [PII].
[CUSTOMER][NEUTRAL] And you're basically asking me to respond back uh with the full itemization. I sent you EOBs showing you all of the physician charges during the hospital stay.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And when I sent you the itemization and this is your response back on [PII], you did pay the full benefit for the hospital stays for the entire hospitalization period, um, the gap between 4/2 and 410, but there was no look back to the physician charges.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, I do need to, um, well there's several options. I will need to get this to one of our adjusters to review. They can give you a call back um if that would be OK.
[CUSTOMER][POSITIVE] Oh, that'll be fine. Yeah, absolutely, absolutely.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] So hang on just a second, let me, I just wanna make sure we get all of this that we need to review.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I'm getting this request started so if you'll bear with me just one second.
[CUSTOMER][NEUTRAL] Certainly.
[AGENT][NEUTRAL] I've got to put in and this is for [PII], correct? Just making sure.
[CUSTOMER][POSITIVE] That is correct, my husband [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Appreciate you bearing with me while I get all this information in.
[CUSTOMER][NEUTRAL] The only other thing that I will question when he or she calls me on your [PII] um.
[CUSTOMER][NEUTRAL] Report on the physician, the physician expense benefit they're listing it from 42 to 49 and that's actually 42 to 410.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So we.
[CUSTOMER][NEUTRAL] The ELBs take it all the way through 4:10.
[AGENT][NEUTRAL] So what we need to do is look for the charges submitted for [PII].
[CUSTOMER][NEUTRAL] Correct, uh, [PII] actually because you paid [PII]. You paid basically one day of the hospital room and one day of the doctor.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I just wanna make sure.
[CUSTOMER][NEUTRAL] Until you got the full itemization mhm.
[AGENT][NEUTRAL] Yeah, just make sure I put this correct.
[CUSTOMER][NEGATIVE] And I talked to [PII] uh back on [PII], and I asked her I said now since I've already provided you the EOBs on those physician statements, do I need to redo it again? she said, no, no, as long as you do the itemization they basically wanted the itemization just to clarify the hospital days and then they would go back and pick up what they didn't pay the first time.
[AGENT][NEUTRAL] OK, so 423 4 1020, got it.
[CUSTOMER][NEGATIVE] That's why I was quite sick.
[CUSTOMER][NEUTRAL] 410.
[CUSTOMER][NEUTRAL] Discharge it.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] So you're calling, um, you're wanting them to look at the physician charges?
[CUSTOMER][NEGATIVE] The omission, yeah, exactly, the omission of benefit on the physician charges.
[CUSTOMER][NEUTRAL] For that same hospital stay.
[AGENT][NEUTRAL] And that that [PII], is that a good number they can call you?
[CUSTOMER][NEUTRAL] It is, it is, mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have my own separate claims that I have questions on, but I just wanna address this first before I go into that animal. Mine's a bigger animal than this.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah I think it's just I think it's an oversight, but I just need to clarify where I am and what they need because one of one of the.
[CUSTOMER][NEUTRAL] You know, it's the same thing. It's physician expenses and they paid one day, not the other, yet it's the same doctor, it's the same hospital. It's, it's very strange.
[AGENT][NEUTRAL] Y'all have, y'all have gone through it, haven't you?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Oh bless, bless your heart.
[CUSTOMER][NEUTRAL] We really have.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So is it, is this going to be for the same dates of service? No, this is in [PII]. I tell you what I'm gonna do, um, I can just let this adjuster know that you also have some questions regarding your claims.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then that way they can look at it before they call and they can go over that with you that, does that sound like a good deal?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Oh, that's a good idea. Absolutely. Um, my home day, I think I got it here.
[CUSTOMER][NEUTRAL] Um, my client, what date is actually better for them to look at the, I mean, I, it shows a direct deposit date, but that's the day that they pro[PII] the claim.
[AGENT][NEUTRAL] Do you have the claim number and.
[CUSTOMER][NEUTRAL] I do, I do. It's number 354.
[CUSTOMER][NEUTRAL] 0996
[AGENT][NEUTRAL] That's the one I had pulled up. That's what I thought.
[CUSTOMER][POSITIVE] And I would and I would be I would be the claim on that one, yeah, that one's got a, a lot, a lot of pull back on that.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Can I ask you something, [PII], when I call in asking, uh, for example, in this particular instance it has nothing to do with these particular claims, but when I call in to clarify a benefit on my policy and they give me instruction as to what to follow what you know what forms I need to fill out, what forms I need to submit, is that documented on your system?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, we, we put.
[CUSTOMER][NEUTRAL] When benefit information is given to me.
[AGENT][NEUTRAL] Yes ma'am, it's, it should be in the notes now it may not be specific benefits like um for example if you called in and wanted to know what's covered under your plan, you know, we would give general benefits so it wouldn't have the exact benefits given.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] Mhm. Well, let me give you a direct example of what I asked her about, um, I asked her about medical equipment benefit on the policy.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I remember expressly that she put me on hold and went to a benefit counselor and came back.
[CUSTOMER][NEUTRAL] Because it was it was in specifically, it was a shower chair. I'm under Medicare and Medicare doesn't cover a shower chair. They cover all of the equipment, but not that. And I was a fall risk before my surgery. So when she, when she gave me, when she went back because she wanted to clarify, I said, what do I need to provide? I know I have medical equipment coverage on this benefit because it's been paid to my husband in the past.
[AGENT][POSITIVE] Oh, you did, you definitely needed that.
[CUSTOMER][NEUTRAL] So she went back and she came back and she said it is covered, but they, what they will need is not only uh a receipt for the equipment, but also a doctor's prescription for that item that it was needed for you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And that's and I thought that makes sense. It makes sense. So I did not purchase it until after I got the prescription so that I could have full documentation, but that was, that's one of the questions I will have for them or or her.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And that should have been, I'm hoping that that was noted on your system.
[CUSTOMER][NEUTRAL] That that information was given to me and that's what I followed.
[AGENT][NEUTRAL] Will you be sure, um, whoever calls you, it'll probably be tomorrow. I don't know that they, they will get to this.
[CUSTOMER][NEUTRAL] Oh absolutely I understand because it's super late already. I'm on I'm I'm in Central time and I don't know even I don't, I think you're in Eastern time, aren't you? Oh, you are too, OK.
[AGENT][NEUTRAL] We are too.
[AGENT][POSITIVE] We're in Central, yeah, so that's good.
[CUSTOMER][NEUTRAL] Yeah, but I, I, it's.
[AGENT][NEUTRAL] And we're open until [PII], but I, I think a lot of them leave the adjusters leave at [PII] or even earlier, so.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I don't call that often [PII] so I'm hoping that when you finish doing your thing if you'll go back on the notes and see if you can trace back that call.
[AGENT][NEUTRAL] Do you know what date it was?
[CUSTOMER][NEUTRAL] Not let's see, it would have had, let's see, oh wait a minute, wait a minute, I can tell by the, I can tell by my receipt because I would have, it would have been before that.
[CUSTOMER][NEUTRAL] Let's see, let's see where do I have that receipt at.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, looks like.
[AGENT][NEUTRAL] Would have been after the [PII] submission?
[CUSTOMER][NEUTRAL] Uh, I submitted it, but, um, the, the information I would have gotten from her before my surgery would have been before October. I'm guessing it might have been August maybe.
[AGENT][NEGATIVE] Gotcha.
[AGENT][NEUTRAL] Uh, yeah.
[CUSTOMER][NEUTRAL] I have.
[AGENT][NEUTRAL] I see a call on.
[AGENT][NEUTRAL] I see a call
[AGENT][NEUTRAL] Regarding medical equipment benefit.
[AGENT][NEUTRAL] Wants to know if it can be prescribed by PCP or does it have to be a specialist?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's it. What's the date on that, on that note?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Oh, you're wonderful [PII] thank you that that saved me a lot of paper digging right there.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm. I see.
[CUSTOMER][NEUTRAL] What did, what did she document that I needed?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Uh, I see, it has to be prescribed by a physician, so PCP would would suffice.
[AGENT][NEUTRAL] Um, advised benefit will pay the actual expense incurred not to exceed $500.
[AGENT][NEUTRAL] For 5 calendar years.
[CUSTOMER][NEUTRAL] That's it.
[CUSTOMER][NEUTRAL] And you see, I provided them the prescription and the receipt.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And they kicked it back that they wanted.
[CUSTOMER][NEUTRAL] Uh, an EOB statement. My insurance's response to that.
[CUSTOMER][NEUTRAL] Well, I paid for it. My insurance didn't pay for it. That's so, OK, I need to use that and hopefully they'll, the adjuster will look at that and maybe reevaluate it.
[AGENT][NEUTRAL] Mhm and I would when they call you Miss [PII], you just give them all your concerns about these claims, and they may have to research it even further after the call because I'm, I, I put in the notes that um ask them to review the claims for data service 42 to 410 that's claim number on your husband, that's claim number 354-0855.
[AGENT][NEUTRAL] And 352-247-6.
[AGENT][NEUTRAL] And I gave him your call back number and that you would like to know information regarding the physician physician's charges for the inpatient stay for for [PII] and also needs um they need to review your claim 354-0996 and that you have questions regarding the benefits paid and not paid on that claim.
[CUSTOMER][POSITIVE] Awesome, that's it. That's it.
[CUSTOMER][NEUTRAL] And I'll spend the rest of the afternoon writing down what I, what I'm really targeting and then because I really would like to get it faxed to them and not and not give them information that they don't need or is not necessary if they already have it then I don't want to have to duplicate things.
[AGENT][NEUTRAL] Yeah, just
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] And let me ask you, do you have a copy of your policy?
[AGENT][NEUTRAL] Certificate? OK, just wanna make sure you have that.
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] I do, but it's so, it's so ancient. It's so ancient.
[AGENT][POSITIVE] Well, we can send another copy for you, if you would like.
[CUSTOMER][NEUTRAL] I mean, I've had this policy since I was, uh, God, I was.
[CUSTOMER][NEUTRAL] You know, that probably wouldn't be a bad idea going forward, um.
[AGENT][NEUTRAL] I can ask them to mail you a copy of your policy.
[CUSTOMER][NEUTRAL] I took this policy out when I was probably [PII] of age. I'm [PII].
[AGENT][NEUTRAL] And and this one has been active since [PII], so yeah, you've had, you've had it, I mean you had prior to that, but this policy has been active since, yeah, [PII]. Whoa.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Really? Yeah, it's
[CUSTOMER][NEUTRAL] Yeah, and all it was is.
[CUSTOMER][NEUTRAL] Yeah, my, yeah my grandfather policy, uh.
[CUSTOMER][NEUTRAL] I had to change it in [PII] because um.
[CUSTOMER][NEUTRAL] Well, the policy I did have it paid 3 times the charges.
[AGENT][NEUTRAL] Oh, yeah.
[CUSTOMER][NEUTRAL] And those policies don't exist anymore and in [PII], the premium would have probably, it would have tripled, and I just couldn't afford it so I went with what I knew I could afford and thank goodness I kept it for as long as I have.
[AGENT][NEUTRAL] Yeah, that's one of the things you hope you don't ever need to use, but when you need it, it's so good to have it.
[CUSTOMER][POSITIVE] Yeah, it really has, uh, it really did save me, save us, it really did.
[AGENT][POSITIVE] And I'm so glad that you are paying attention.
[CUSTOMER][NEUTRAL] But it's uh it's hard keeping up with the, it's hard keeping up with the the documents and that's just something it's not, it's not in your control but um the description sometimes are so vague about.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What you need
[CUSTOMER][NEUTRAL] Yeah, like one particular will say, in fact this one will say it to me we need additional information in order to re-review this, but it doesn't tell you what you need.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And that's not, what does that tell me?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] You know, that, that there's certain things that when those things kick back, I can't tell you how unnerving that is to me.
[AGENT][NEUTRAL] It just says.
[AGENT][NEUTRAL] I can imagine
[CUSTOMER][NEGATIVE] Because you, it's too gray.
[AGENT][NEUTRAL] Well
[AGENT][NEUTRAL] Well, first, you're going through everything and that makes it hard, you know, just to even keep up with and
[AGENT][NEUTRAL] Yeah, I can only imagine.
[CUSTOMER][POSITIVE] Well, [PII], I'll tell you what, um, having a voice like yours right now, it calms me down totally because had it been somebody aggressive or defensive, I, I would have been a totally different person.
[CUSTOMER][NEGATIVE] And it's not fair to you. You're not in control of it. You're not handling the claim, but when I submit something I want something I, I, I'm always so courteous on my, on my letter. I want you to take utmost.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Care of this claim. I want you to review it, take your time, review it carefully and respond. That's I've, that's all I've ever asked of y'all.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] And most of the time it, it does, but
[AGENT][POSITIVE] And that's what you deserve.
[CUSTOMER][NEGATIVE] But sometimes these gray areas I just kind of like, uh, but you're right, I was in the middle of it and I just, I couldn't deal with it. I, I read it and I filed it away. I said I can't, I can't deal with this. I gotta deal with me right now. I just, I will when I get my mind settled and my body back in control, I can, I'll deal with it.
[AGENT][NEGATIVE] Yeah, and cancer.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yeah, and you know, we're any time along the way, you just call us.
[AGENT][POSITIVE] You know if you have a question, please don't hesitate to call us. It it is better that you call us and we can take care of your questions and if you don't get, you know, the satisfactory answer, call back, you know.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] just
[CUSTOMER][POSITIVE] Well, let me ask you something, [PII]. Uh, since you found you were so nice to find that note.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This note should be dated [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that's when I spoke with [PII] and.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] She gave me a lot of information that day, which was great. It, it really kind of filled a lot of voids for me that day.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But she said at that point, you know, during our conversation, we got toward the end of it, uh, [PII], unfortunately, had too many hospitalization periods with MD [PII], long hospital stays. And when I was looking at my benefit, um, long time ago, I realized that he had a um a recovery benefit.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] As long as you're in the hospital for 10 amount of days.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] And I said, well, I only remember that benefit being paid once, and that was his first hospitalization back in [PII]. I remember specifically that it had a recovery and they paid his uh pain medication leaving the hospital. They paid for everything. They responded so fully.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] And I said, I know he's been hospitalized so many times, but there's a few times where it exceeded more than 7 days, 7 to 10 days. And I said, but I never saw a recovery benefit paid.
[CUSTOMER][NEUTRAL] And she said, well, I saw, I see that back in [PII] in [PII], he was hospitalized for a good length of time.
[CUSTOMER][NEUTRAL] Um, and I said, well, can, does it explain why it wasn't paid or why wasn't it part of the claim? And.
[CUSTOMER][NEUTRAL] She said, you know what, I'm gonna submit an inquiry to the original adjuster regarding the recovery benefit omission on those two hospitalizations, and you'll hear back directly from them, but I never got anything regarding that.
[AGENT][NEUTRAL] You never, uh, I do see where.
[CUSTOMER][NEUTRAL] And then of course I went in, and then of course I got really sick and I just, I, I just now I'm looking at all these notes that I've had and I was like, wait a minute, come to think of it.
[AGENT][NEUTRAL] That she, um, yeah.
[AGENT][NEUTRAL] I let you
[CUSTOMER][NEGATIVE] I didn't get a response.
[AGENT][NEUTRAL] Yeah, so I do see that she stated that she would have had the claims reviewed to see if payment can be made.
[AGENT][NEUTRAL] I don't know what the outcome of that and let me give you another I'm, I'm gonna give you a little side tidbit, OK? We have, you can always email if you ever want to email a request to review a claim.
[CUSTOMER][NEUTRAL] Sure. Sure.
[AGENT][NEUTRAL] You can send an email to the care, it's to [PII].
[AGENT][NEUTRAL] [PII] if you want to list questions that you need responses to the care team will get that to uh.
[AGENT][NEUTRAL] Claims adjuster and then they should respond to that email with your answers and then you have documentation just a little just a little hint.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] If you feel like it, you know, you may not feel like it.
[CUSTOMER][NEUTRAL] Well, let me, uh, let me ask you something when something, yeah.
[CUSTOMER][NEUTRAL] But is there an overseer to that adjuster?
[AGENT][NEUTRAL] We have supervisors, yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Every person that he works here has a supervisor.
[CUSTOMER][NEUTRAL] Because there was a, there was a time period where I had one particular adjuster. It was, it was a change because before, I mean, years ago, you all handled it by alphabet, by the last name.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So it was always the same adjuster and now I understood from [PII] that that that has changed. Now it's basically whoever gets the next one gets the next one.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] But I thought it strange that she was going to go back to the original adjuster.
[CUSTOMER][NEGATIVE] And not a supervisor to oversee it. What did happen.
[AGENT][NEUTRAL] And you can even you can even in the email request that a supervisor review the claims.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm just, I'm just trying to help you out.
[CUSTOMER][NEGATIVE] Yeah, I, I, no, I, I, because I'm not comfortable. I'm no longer, I never, I didn't get, I wasn't comfortable with her from then on.
[CUSTOMER][NEGATIVE] Because I thought, you know, don't just flat out deny it. You need to look at it. You need to look at it and tell me what you need. Is there something missing. Don't just say it's not covered.
[AGENT][NEUTRAL] That's
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] So, and yet to
[CUSTOMER][NEGATIVE] Uh, or it's not a benefit that's.
[AGENT][NEUTRAL] Yeah. Now don't you mention my name.
[CUSTOMER][NEUTRAL] But you know what, [PII], I'm gonna
[AGENT][NEUTRAL] Don't you mention my name if you send that email you just send an email that you would like a supervisor to review this claim.
[CUSTOMER][NEUTRAL] I'm gonna ask
[CUSTOMER][NEGATIVE] No, no.
[CUSTOMER][POSITIVE] No, no, no, no, no, that, that, but that's helpful though, that's helpful because that's, that's really, I just need a second set of eyes on it. That's what I needed on those especially on those older ones, not this one. This one is, is a, I think this one just didn't get a look back. I don't, this one I don't, I don't really, I think they can clarify and I think they can, they can clarify this thing really quick.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Absolutely. Well, and you need to.
[AGENT][NEUTRAL] You know,
[AGENT][NEUTRAL] Yeah, and you can send an email just to request a supervisor call you to care team.
[CUSTOMER][NEUTRAL] But the older ones, mm.
[AGENT][NEUTRAL] I'm just trying to help you out because you know some of these things need to be resolved and or at least you know that they have you know been reviewed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And the issues are resolved because these are your benefits, Ms. [PII], you know, you're paying for these benefits and we do care about you. I just want you to know we care about you and we do want you to get your benefits.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Thank you, I appreciate that. But yeah, can I ask you to uh redefine that email address that you want me to use spell out it's spell out [PII] basically one word.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] It's
[AGENT][NEUTRAL] One word, yes ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] At
[CUSTOMER][NEUTRAL] And then AM oh at AM.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] So for your major concerns or?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] You know,
[AGENT][NEUTRAL] You can send that email. I'm part of the care team, but I'm, I'm on the phone.
[CUSTOMER][NEUTRAL] OK, and it's it's always good to reference my name, my policy number, and if I have a claim number reference, that would probably be helpful, right? It's easier for them to look at.
[AGENT][NEUTRAL] Policy number.
[AGENT][POSITIVE] Yes, ma'am, it would.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK, I can do that.
[CUSTOMER][NEUTRAL] That's one thing about me is I've I've retained every document.
[CUSTOMER][NEUTRAL] That I've ever been sent.
[AGENT][POSITIVE] That's amazing.
[CUSTOMER][NEUTRAL] Because it's, I always had the intention of going back, I'm going back on this.
[AGENT][POSITIVE] So important.
[AGENT][POSITIVE] So important.
[CUSTOMER][NEUTRAL] And now, and now I need to start, you know, even if it's just one at a time.
[AGENT][POSITIVE] I'm so proud of you.
[AGENT][NEUTRAL] You may have to have another room in the house just for the documents, right?
[CUSTOMER][NEUTRAL] Yeah, it's a, it's in two buckets, 22 plastic bins, but they're filed in an in order so it's something I can get to it's just the time it's just and it's not so much the time it's the mental, it's the mental you gotta get your, your, your mind in that place.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Right, and the energy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And today I thought today is the day. I got to do this today.
[AGENT][POSITIVE] I'm so glad you got me. I'm, I
[AGENT][POSITIVE] It's been such a pleasure to assist you. I wish I had all the answers, but they will need time to go back and review.
[CUSTOMER][POSITIVE] Oh, that's no problem. I'll wait to hear from them and then I'll start, uh, make clarifying my own notes on my claim that way I can get uh get a hold of the documents that they truly need.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] And if you're ever not happy with something, always ask to speak to a supervisor. I'm not telling you that either, am I?
[CUSTOMER][NEGATIVE] No, you're not.
[AGENT][NEUTRAL] You know what I'm talking about.
[CUSTOMER][POSITIVE] But I appreciate, I appreciate the I appreciate the guidance though I do, I certainly do.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Well, that's what we're here is to help you.
[CUSTOMER][POSITIVE] Alright [PII], then I'll wait for the call and I appreciate your time and help this afternoon.
[AGENT][NEUTRAL] That's why we're here.
[AGENT][POSITIVE] I have put in that request and hopefully you'll hear back from, from them tomorrow. If you have any problems, they call us, OK?
[CUSTOMER][POSITIVE] I will do. Thank you so much.
[AGENT][POSITIVE] All right. Thank you, Miss [PII]. It's been a pleasure to assist you and I hope you have a great evening.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][POSITIVE] Thank you, [PII]. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye bye.