AccountId: 011433970860
ContactId: d2262770-395a-472e-bdbf-5b1882065a2e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1396729 ms
Total Talk Time (AGENT): 562368 ms
Total Talk Time (CUSTOMER): 483712 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/d2262770-395a-472e-bdbf-5b1882065a2e_20250311T15:18_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII]. I'm calling to find out, uh, if you received my.
[CUSTOMER][NEUTRAL] My fax letter yesterday that uh I mean I submitted my application.
[CUSTOMER][NEUTRAL] For my claim?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I want to know if it didn't received it yesterday.
[AGENT][NEUTRAL] OK, I can verify that for you, Mr. [PII], and what is your policy number, please?
[CUSTOMER][NEUTRAL] My policy number is 02432636.
[AGENT][NEUTRAL] 263-6. Is that correct?
[CUSTOMER][NEUTRAL] 263-6 yeah.
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] OK, thank you. And verify your date of birth, mail address, and email address for me, please.
[CUSTOMER][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] And my, my email address is [PII].
[AGENT][NEUTRAL] OK. And your mailing address.
[CUSTOMER][NEUTRAL] And that
[CUSTOMER][NEUTRAL] My my mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII]. zip is [PII].
[AGENT][POSITIVE] OK, thank you so much. And you say you sent a fax yesterday?
[CUSTOMER][NEUTRAL] Yes ma'am. I've been a flat just to do with my
[CUSTOMER][NEUTRAL] My my application for benefits.
[AGENT][NEUTRAL] OK, and do you know around what time you uh fax it over?
[CUSTOMER][NEUTRAL] That was around about [PII] [PII].
[AGENT][NEUTRAL] [PII]. OK. And you're in [PII]. Give me one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Today is the [PII]. OK, give me one moment. I'm just checking real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Sorry, my computer is running a little slow. I apologize.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Uh, yes, sir. I do show it has been received and it will be placed in line for processing.
[CUSTOMER][NEUTRAL] OK, so, uh, when, when could you tell me when more or less when you're gonna be uh ready to send out?
[AGENT][NEUTRAL] Uh, usually from time a claim is received, it's, um, takes 7 to 10 business days.
[CUSTOMER][NEUTRAL] Because yesterday when I called, the, the um the lady told me that it was in process dental.
[CUSTOMER][NEUTRAL] So, um, my check was in process to send out.
[AGENT][NEUTRAL] Well, there was a claim received on the [PII] and processed yesterday and so a check was mailed out today. It looks like an amount of 159233.
[AGENT][NEUTRAL] So is this information you submitted via fax yesterday, was it a continuing disability claim or is it another disability?
[CUSTOMER][NEGATIVE] This is a continued disability.
[AGENT][NEUTRAL] OK, because on the claim, I'm showing it shows initial disability, um.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] So what
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But it's, it will be placed in line for processing.
[CUSTOMER][NEUTRAL] OK, so, so what, how much is, how, what was the amount that mailed out yesterday? Could you tell me, please?
[AGENT][NEUTRAL] Uh, mailed out today. It's $1,592.33.
[AGENT][NEUTRAL] Looks like for the month of February.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For the month of February, so.
[CUSTOMER][NEUTRAL] So this one now would be for the month of uh March.
[CUSTOMER][NEUTRAL] So, so now I would have to send in another one for the month of March?
[AGENT][NEUTRAL] Um, not for the month of March. Well, and if it's a continuing disability, um,
[AGENT][NEUTRAL] You have to figure out, uh fill out the contained disability portion of the form, which like I said, I'm looking at the claim you submitted and it shows initial, initial disability.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I would say they can still process it, but it would just be processed, uh, probably as a regular claim or if the examiner looks at it and shows that it could be a disability or continuing, they can process it that way. So they give it about 7 to 10 business days for processing.
[CUSTOMER][NEUTRAL] Yeah, because
[CUSTOMER][NEUTRAL] Because they, they are, they are most supposed to be uh.
[CUSTOMER][NEUTRAL] $22,000 a month, right?
[AGENT][NEUTRAL] Yes, sir, but
[AGENT][NEUTRAL] Looks like for February, it's [PII], but um,
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] The first, the first, the first month, the first, uh.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The 1st 1st payment I received was [PII].
[AGENT][NEUTRAL] OK. Let me let you speak with an examiner and they can verify how they processed it and I'll let them know about the facts that came in. Do you mind holding for a moment?
[CUSTOMER][NEUTRAL] OK, ma'am.
[AGENT][POSITIVE] OK, thank you so much, Mr. [PII]. Hold on one moment.
[CUSTOMER][NEUTRAL] OK. You too.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Good morning. Thank you for calling ACL. This is [PII] speaking. How can I help you?
[AGENT][NEUTRAL] Hey, [PII], it's [PII]. How are you doing today?
[CUSTOMER][POSITIVE] Doing well, [PII], thank you. How are you?
[AGENT][NEUTRAL] I'm good. Um, well, I have an insured on the phone as regards to his disability and it looks like a claim processed yesterday and he faxed over a claim.
[AGENT][NEUTRAL] Yesterday as well, but um,
[AGENT][NEUTRAL] It hasn't been uploaded into the system yet, but I'm looking at it and it looks like he selected initial disability, so I didn't know if that would be an issue as far as processing, but he's wanted to know why when the first check he received was over 3000 and this last check he is uh that has been mailed out today is 1700.
[CUSTOMER][NEUTRAL] Mm, OK, let me try to take a look and see if I can help him. What's the policy number?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] 243-263-6.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't know if you can look at uh the faxes that came through, but I can give you the time to um when it came in if you want to see it or not.
[CUSTOMER][NEUTRAL] And that's for [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you're saying he sent an additional faxes yesterday but we can't see them yet or that's the fax that came in?
[AGENT][NEUTRAL] No, he sent in a fax yesterday and it um it hadn't been uploaded yet. Um, I could just able to see it and just looking on the fax, it looks like he marked it as an initial disability, which I'm thinking it should have been a continuing disability, so I don't know if that would make a difference.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And he's wondering about the check that would be mailed out today and why it was so small, and I, I explained it looks like it paid from [PII].
[CUSTOMER][NEUTRAL] Right, because he had a partial, he had an elimination period, then he had a partial took out premium out of that first payment.
[CUSTOMER][NEUTRAL] And then he was paid for December and then January as well so I'm certain that next one is just for February.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, but I only pay to the [PII], but um.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] OK, let me see if I can.
[AGENT][NEUTRAL] And he is thinking he should have got 2000.
[CUSTOMER][NEUTRAL] Figure out why.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let see if there's notes usually ship puts notes and um he's been verified.
[AGENT][NEUTRAL] Yeah, I verified all his information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now, so that mail from that stated from yesterday is not the mail he's talking about he sent in.
[AGENT][NEUTRAL] No, because he had called initially to verify if we've received his claim, which I did look on OnBase and I show it was received, but now he's inquiring about his benefits so why the check that is coming soon is not 2000 and how it, how we process as far as payments.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But I don't know if you, if you are able to look at the faxes that came through.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] If you're able to get on the on-base and look through the um where they have the index.
[CUSTOMER][NEUTRAL] I can, I can. Mhm.
[CUSTOMER][NEUTRAL] Yeah, I should be able to anyway let me see if.
[CUSTOMER][NEUTRAL] If it looks like 3 came in, is that right?
[AGENT][NEUTRAL] Uh, it came in on [PII] at [PII]:50.
[CUSTOMER][NEUTRAL] 3:10. Yeah. Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 44 seconds.
[AGENT][NEUTRAL] To be more specific.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] OK, and he's again questioning that amount of the 1733?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And I'm not sure why.
[CUSTOMER][NEGATIVE] Um, why he was only paid the 26 days, I don't see.
[CUSTOMER][NEUTRAL] Why that is.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It looks like it returned to work day at this point is 3:15.
[CUSTOMER][NEUTRAL] So I'm not certain, um, and I don't.
[CUSTOMER][NEUTRAL] I only see the faxes that were.
[CUSTOMER][NEUTRAL] Processed or I'm sorry the mail that was processed yesterday that stated for [PII].
[CUSTOMER][NEUTRAL] I don't see that.
[AGENT][NEUTRAL] Oh, you can see it.
[CUSTOMER][NEUTRAL] I don't see the facts that you're speaking of.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] I, I just pulled it up by documents, right? I mean, I don't see.
[AGENT][NEUTRAL] Um, if you go to APL Jack indexing.
[AGENT][NEUTRAL] And then under there that index research.
[AGENT][NEUTRAL] And if you go under, uh, what does that say? APL.
[AGENT][NEUTRAL] Lord, I can't
[AGENT][NEGATIVE] Oh, computers stink.
[AGENT][NEUTRAL] Or does it say APL source ID sorry. If you change that to fax, unless they already know, uh change it to fax.
[AGENT][NEUTRAL] And it shows all the faxes that came through.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If you go to one that says uh for [PII] or [PII]:25 at [PII] or at [PII]
[CUSTOMER][NEUTRAL] 3:44.
[AGENT][NEUTRAL] 350 44.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, OK, got it.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But, like I explained, it looks like if it's supposed to be continuing that he filled out the initial.
[AGENT][NEUTRAL] Instead of continuing portion.
[AGENT][NEUTRAL] I don't know if that would be an issue as far as processing um a continuing claim.
[CUSTOMER][NEUTRAL] I don't think so unless uh.
[AGENT][NEUTRAL] But the main thing is we did receive it, um, which I did verify with him, but he's now inquiring about payment that just uh was sent out or be sent out today.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Usually they they put a note in but usually they put a note in but this time they didn't so I'm not certain why.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Why it was only the 26 days. I don't see any notes telling us why that was.
[AGENT][NEUTRAL] Um, benefit paid up to the release to return to workday on [PII]'s claim.
[CUSTOMER][NEUTRAL] Only paid up to 226 last doctor form to release return to work on [PII], so that's probably why he completed that other form and now he's saying his return to work date is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] Huh.
[CUSTOMER][NEUTRAL] I believe because that's what it looks like to me.
[AGENT][NEUTRAL] Yeah, that's what it looks like too, now that I'm seeing it, um, paid up to release to return to workday.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] since you state he's still off work. So, well, I can explain to him the reason why it just shows that uh he was paid up to his return to work date.
[AGENT][NEUTRAL] Based on the initial claim received.
[CUSTOMER][NEUTRAL] Yeah, because like I said, that's what it looks like to me is that it, it, they, uh, Bessy states right in her note that um she informed him of the claim form being the instructions on the first form and sure will upload again he says.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] No return, uh, I think it means not return to work day or.
[CUSTOMER][NEUTRAL] You said
[CUSTOMER][NEGATIVE] NOR returned to work.
[CUSTOMER][NEUTRAL] OK, I mean, do you want me to speak with them?
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] Uh, it doesn't matter. I can, uh, let him know that it paid up to what it shows on his physician's claim or return to work, but we did receive his form, so I can explain that to him and if he has any other questions, I can transfer.
[CUSTOMER][NEUTRAL] OK, and it's just that one document that he's speaking of that, right? The one from yesterday that he uploaded?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, because I don't see that the physician so that part of the.
[AGENT][NEUTRAL] I know that's the reason was it's kind of confusing to me and that's why I was like, it looks like.
[CUSTOMER][NEUTRAL] You see that?
[CUSTOMER][NEUTRAL] Yeah, cause he filled in the information. It looks like u[PII] if according to [PII]'s note, we only have a physician form up to that [PII] that he's returning on [PII], so he needs to have that updated by the physician, um, and I think that's what [PII]'s notes telling him that the, um, he needs an updated physician form completed because of as of now, he can only get paid to up to the [PII] date.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Because the last doctor release form had him returning to work on [PII], so he would need to provide that to us from the physician and just that portion, you know, that shows because he did submit the other form, however, um, that physician form is not completed by the physician giving us that unless that I.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] He'll be out longer.
[CUSTOMER][NEUTRAL] So I overlook it, OK, yeah, because the attending physician form is blank that he submitted, um, with this fax, yep, mhm.
[AGENT][POSITIVE] Exactly, yeah.
[AGENT][NEUTRAL] All right. Well, I'll let him know.
[CUSTOMER][NEUTRAL] OK, if you need me, um, you can transfer if you need to, Kiki.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Alright, Ms. [PII], I appreciate you.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] I'm glad we figured it out.
[AGENT][NEUTRAL] Yeah, yes, I was like, I don't know.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] All right.
[AGENT][POSITIVE] Well I appreciate you. Have a great one. Bye bye.
[CUSTOMER][POSITIVE] Sure, you too. Thank you. Bye.
[AGENT][NEUTRAL] OK, Mr. [PII], thank you so much for holding. I spoke with an examiner and looks like this last claim that was just processed on yesterday, it paid up to the [PII] because it shows your physician, uh, from their initial form that your return to work date was [PII], and if that is incorrect or you still um haven't returned to work, then we need the physician's portion completed, because I, looking at the fact that you sent.
[AGENT][NEUTRAL] Yesterday, uh, the physician's portion is blank, it is, except for your like name, date of birth and social.
[CUSTOMER][NEUTRAL] It, it, it is, is it black?
[AGENT][NEUTRAL] Is blank. Yes, sir. The physician's portion is not uh filled out because the examiner paid it to [PII] of [PII] or [PII] because that's what your return to work date was from your physician.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yes, uh,
[CUSTOMER][NEUTRAL] You, you, um, received a letter from [PII] from my company and the letter saying that the [PII].
[CUSTOMER][NEGATIVE] To return back to work.
[AGENT][NEUTRAL] Uh, they will need a physician's portion. So if you, uh, don't return to work until the [PII] or [PII], then we will need that physician's portion, uh, completed where it shows when you're anticipated return to work.
[CUSTOMER][NEUTRAL] Would that mean that I had a full application?
[AGENT][NEUTRAL] I'm sorry, say again.
[CUSTOMER][NEUTRAL] That means that I have to to uh commit another application form?
[AGENT][NEUTRAL] Uh, the tending physicians portion. Yes, sir.
[CUSTOMER][NEUTRAL] Oh, from, from, from my, from my, from my provider?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, and, and uh.
[CUSTOMER][NEUTRAL] What what she said about the, the, the, the.
[CUSTOMER][NEUTRAL] The amount, the balance.
[AGENT][NEUTRAL] Well, the last claim was processed paid up until the [PII], which shows your physician has you return to work on the [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] What, what, what, what, what, what I'm looking at it, it's supposed to be.
[CUSTOMER][NEUTRAL] 3 months, 3 months that uh.
[CUSTOMER][NEUTRAL] Let's see, the first, the first payment was 3,259.
[AGENT][NEUTRAL] Yes, sir. That's because they paid, there was an elimination period of 14 days and so benefits start on the [PII] day, which was [PII], and they paid $1400 for that month. For January, they paid $2000 and then this last claim.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] For February, it paid the 1,59233, um, which shows that your return to workday for the uh physician's portion of the claim.
[AGENT][NEUTRAL] So if you are out longer than that, then we would need uh updated physician's portion of that claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, from my provider.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] All right then I will see what happened there then.
[CUSTOMER][NEUTRAL] I will check, I will check it out and, and, and see if I could get it from a provider because I'm, I'm, I'm not really I'm not released from from the.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] From my doctor yet, you know.
[AGENT][NEUTRAL] I understand, but um, yeah, they will need that physician's portion where it shows that you are still unable to work or still haven't returned to work.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK then, OK then, uh, I'll do that then and, uh, send it in.
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] OK, so, so I, I got, I got my, uh.
[CUSTOMER][NEUTRAL] Direct deposit, I, I received one.
[CUSTOMER][NEUTRAL] Application form from your office yesterday and uh so the the other claim I mean the other.
[CUSTOMER][NEUTRAL] Payment, I want I want it to be through my direct deposit please.
[AGENT][NEUTRAL] Well, the check has already been mailed and I don't show we received any direct deposit information as of yet. So any future payments, if you submit that form into us, any future payments will be sent as direct deposit.
[CUSTOMER][NEUTRAL] OK, OK, no problem. uh, yeah, OK, I'm gonna do that then when I send in the application, then at the same time I will send in the the form for my direct deposit.
[AGENT][NEUTRAL] OK. Yes, sir.
[CUSTOMER][POSITIVE] OK, then. Thanks for your help.
[AGENT][POSITIVE] You are welcome and uh thanks for calling APL. You have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.