AccountId: 011433970860
ContactId: da8b73e4-59f1-4b83-8964-af91d82eab50
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1212079 ms
Total Talk Time (AGENT): 656703 ms
Total Talk Time (CUSTOMER): 533604 ms
Interruptions: 13
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/07/da8b73e4-59f1-4b83-8964-af91d82eab50_20250407T15:18_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is Mr. [PII]. I filed a claim and they sent me a thing online.
[CUSTOMER][NEGATIVE] That said it was completed and it gave me, you know, the access to it, but when I got to it it showed me nothing and there was nowhere to get into anything.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, Mr. [PII], so you've received a notification about a claim that was reviewed and you're wanting to check the status on it since you weren't able to see that online yet.
[CUSTOMER][NEUTRAL] I need an
[CUSTOMER][NEUTRAL] Yes, well, it said it was completed. I just wanna know what, yeah, the status is or what it's.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yeah, so, well, I
[CUSTOMER][NEUTRAL] Because it won't let me in.
[AGENT][POSITIVE] I can help you with that. And what is a good callback number for you, please?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And your policy number, please?
[CUSTOMER][NEUTRAL] Uh, well, I don't know, dear, to be honest.
[AGENT][NEUTRAL] OK, is the, are you the subscriber on this plan, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah, yes.
[AGENT][NEUTRAL] OK, what is your full social and I can look it up that way.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And which policy is your claim on, Mr. [PII]?
[CUSTOMER][NEUTRAL] I believe it was under the short term or the accident or whatever. I, I think it was I think they put it under short term, I believe.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, yes, uh, so give me one moment to get that information pulled up.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] OK, and Mr. [PII], any information that I do provide today would be a verification of benefits and not a guarantee of payment. I will need to verify several things with you first for security. 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 for you is the same as the one that you provided for me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, thank you and lastly your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do see that on [PII] you did have a claim that was processed, so went through our nightly processing. There has been a benefit issued, Mr. [PII] in the amount of $4,771.32.
[AGENT][NEUTRAL] And that was issued via check.
[AGENT][NEUTRAL] Now, I can see that you're
[AGENT][NEUTRAL] And they also included um it states in your notes that this benefit was paid up to your next evaluation with the ortho on [PII].
[AGENT][NEUTRAL] And we're requesting an updated disability claim form for benefits to be paid beyond 323.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that was
[CUSTOMER][NEUTRAL] Well, yeah, see, I could because I put on my original statement that I was supposed to go to get my MRI on that day but I couldn't and I just recently filed for Medicare.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] And there was some issues, so I called back and told them I had to go back. I called the the appointment, the doctor, and I said that I needed to get that straightened out before I come into Medicare because I don't know if I could pay for, you know what I'm, you, you understand what I'm saying.
[AGENT][NEUTRAL] Sure. Mhm. Right.
[CUSTOMER][POSITIVE] Yeah, and they said no problem when you get that straightened out we'll make another appointment and then I can come in and get my MRI.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And they said, OK,
[AGENT][NEUTRAL] OK, so as of
[CUSTOMER][NEUTRAL] But they never said anything to me there where you're at.
[AGENT][NEUTRAL] OK, so the information would have been mailed to you along with it, it should come with a check with your benefit payment, the additional forms.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh huh
[CUSTOMER][NEUTRAL] I don't believe I've got that yet.
[AGENT][NEUTRAL] Now you
[AGENT][NEUTRAL] Probably not, since that.
[CUSTOMER][NEUTRAL] When was it issued? Do you know yeah.
[AGENT][NEUTRAL] Yeah, because of it being mailed. Now the claim went through our processing on [PII], so that was just on, um, let's see what Thursday, yes, Thursday. So the check wouldn't have been mailed out till Friday. Now, you can.
[CUSTOMER][NEUTRAL] Because I, yeah
[CUSTOMER][NEUTRAL] Right, OK.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, so probably.
[AGENT][NEUTRAL] Since you're set up on the portal, our online service center, you know, where you can log in, you can add in direct deposit information there, Mr. [PII] so that if there are future benefits that you know you're gonna be filing for that we can pay.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] You we can electronically deposit it instead of you know having to issue that paper check. Now I can email you the user guide for the portal if you would like that it's and it does give you some information.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yes, well, here's the here's the thing, dear, now I, when they sent me that information I can get into the portal.
[CUSTOMER][NEGATIVE] And I can see where the where flags pops up to add your add your uh so I can get there but it doesn't show me anything else as far as where the claims at how you're doing any updates and none of that stuff I can't get into and I and I couldn't understand why and a matter of fact, yesterday when I tried to get into it, it wouldn't even take my email address.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Were you logged trying, were you using a phone or a computer?
[CUSTOMER][NEUTRAL] Because I, when I
[CUSTOMER][NEUTRAL] I was using my phone just as I did to begin with. I don't have a computer.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that's maybe part of the issue.
[CUSTOMER][NEUTRAL] So and I was trying to get and I.
[CUSTOMER][NEGATIVE] Yeah, I was trying to get in and it wouldn't even take so I put forgot my email or forgot my password.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And so then it sent me to a prompt to put my email address in in order to send me to where I could reset it and then it said on my email that it said that it didn't recognize my email and I I said oh boy here now we got an issue so I couldn't get in, couldn't do nothing I don't know what's going on.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so part of it is that the our portal, it does not have full functionality on a mobile device like it does on a computer so that may be part of it now I can the user name that I show for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Is [PII] and the number [PII] and the [PII] is the only thing um capitalized in your username.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK got that OK.
[AGENT][NEUTRAL] But now I can email you that direct deposit information form along with the user guy, Mr. [PII], and from time to time people do say that they can upload documents, some things that we have been told that at this time it doesn't allow at times it will. So it's kind of a, a fluke when it happens, but I think that that's probably.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] The main issue because when you're logged in you should be able to see claim numbers and click on those to have access to your EOBs um but if you'll give me a few minutes I'll send you an email that has some of that information.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, now, but one other thing here, OK, but now one other thing, it says as far as the before any more payments they need an update. Well, now what do I do there? What do I do there now?
[AGENT][NEUTRAL] Attached to it.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] OK. So if your doctor, your doctor will have to complete their portion of the claim form, mhm.
[CUSTOMER][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] They did already. I sent it in.
[AGENT][NEUTRAL] Because, right.
[AGENT][NEUTRAL] And we showed that that was for up to benefits were paid to 323.
[AGENT][NEUTRAL] So if it's, if you're still off of work and for us to be able to pay any future benefits beyond [PII] date, then yes, we would have to have.
[AGENT][NEUTRAL] The updated
[CUSTOMER][NEUTRAL] So they gotta, I gotta go through my doctor again.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] He, he referred me to my, to a surgeon.
[AGENT][NEUTRAL] If
[AGENT][NEUTRAL] So whoever currently has you off of work at this time is who would have to complete that.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] I
[CUSTOMER][NEGATIVE] Good God man this is ridiculous.
[CUSTOMER][NEGATIVE] It's ridiculous. I gotta pay this guy every time I go to to get a paperwork from him.
[CUSTOMER][NEUTRAL] Uh, so now where do I get the paperwork? Well, you know, it's.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEGATIVE] Uh, you know, it'd be different if I could, if I knew this, if I knew this stuff ahead of time. Now it's slammed on me in the middle of nowhere when I because for what I can't, I couldn't get in. I couldn't figure out what my situation was, and you tell me what my situation is, and now I gotta go back to my doctor again.
[AGENT][NEUTRAL] Now I can
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] So yes, sir, on the claim form, it does give that on the initial forms that you submitted, it does explain all of that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Uh, I, it's a fine print, I suppose.
[AGENT][NEUTRAL] It's on page one.
[AGENT][NEUTRAL] Of the instructions.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Cause it's, yes.
[CUSTOMER][NEUTRAL] OK, now how do I get the how do I get the forms again dear?
[AGENT][NEUTRAL] Now, I can email them to you. I can email you another disability claim form.
[CUSTOMER][NEUTRAL] Yeah, please, do I, do I only need, do I only need the doctor's portion this time or do I gotta do the whole thing again?
[AGENT][NEUTRAL] Well, each month that you're out, you always have to submit the claimant statement, which is your section. And if your return to work date is extended beyond what is initially set by your physician, then at that point, then your doctor and UTBA which helped you since I see that this is her, you know, the Universal Trucking Benefits Association.
[CUSTOMER][NEUTRAL] That comes from my doctor.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] You know how they helped you with that employer section of the claim form.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] But that it those.
[AGENT][NEUTRAL] Their contact.
[CUSTOMER][NEUTRAL] Those you don't need anymore.
[AGENT][POSITIVE] Yes, we would have to have that.
[CUSTOMER][NEGATIVE] Oh God dog man, so I gotta fill the entire 3 or 4 pages uh all over again every stinking month.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Well, only if you return to work date changes. For example, if your doctor had placed you off of work for 10 number of months.
[CUSTOMER][NEUTRAL] That is
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Well right now I'm indefinite.
[CUSTOMER][NEUTRAL] Well right now I am indefinite until I go to my till I go to my surgeon because he referred me to a surgeon.
[CUSTOMER][NEUTRAL] That's the situation I'm in right now.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm off indefinitely until I go to a surgeon.
[AGENT][NEUTRAL] OK, so there is this place that he has to put a date in at this point and if once that date comes around and you have not returned to work, then they would have to complete additional information, you know, the forms at that point.
[CUSTOMER][NEUTRAL] Right, right, but didn't, didn't, but, but if he put in there, he put that in on the first set of paperwork.
[AGENT][NEUTRAL] Showing that.
[AGENT][NEUTRAL] 323.
[CUSTOMER][NEUTRAL] That I was supposed to go to my so I was supposed to go to the.
[CUSTOMER][NEUTRAL] Surgeon, that's the date I was supposed to go to my surgeon, but I could I couldn't get my Medicare straightened out in order to go there so I didn't, so I wouldn't have to pay out of pocket for all this stuff.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because it's the first time I signed up for Medicare and and I have an issue. I have well I was having issues with it now I don't and I'm getting it set up for my appointment so I can go see him. I'm just calling you to find out what my status was, but my status as far.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So if he
[CUSTOMER][NEUTRAL] So if he put 323, which I don't believe he did, I think he put indefinite.
[AGENT][NEUTRAL] I'm gonna, I'm gonna look to, I'm gonna look at the actual document because
[CUSTOMER][NEUTRAL] On that paper
[CUSTOMER][NEUTRAL] Yeah, I, I I was supposed to go to the.
[AGENT][NEUTRAL] I don't think they can put indefinite.
[AGENT][NEUTRAL] I don't think that that can be.
[CUSTOMER][NEUTRAL] Well, I think he put
[AGENT][NEUTRAL] But I'm gonna look. It's still trying to load.
[CUSTOMER][NEUTRAL] Uh, I don't know if he put OK.
[CUSTOMER][NEUTRAL] Because I thought he puts some time because I remember kind of briefly going over it, you know, and.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I, I think he put something to the, to the effect that.
[CUSTOMER][NEGATIVE] Yeah, I, I, I, I, I know it wasn't no return date. I know there was no return day back to work because he sent me to the surgeon.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And I told him that I had an appointment on the [PII].
[CUSTOMER][NEUTRAL] [PII] I think it was [PII] or [PII], so that's why the [PII] or [PII] keeps popping up.
[CUSTOMER][NEGATIVE] But I didn't make that appointment. I had to call and cancel because I didn't have my what you call my what's called set up my, uh, Medicare.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Because I didn't want to go in there and pay for this on my own, you know what I mean?
[AGENT][NEUTRAL] Sure. Oh, yes, sir. I understand.
[CUSTOMER][NEGATIVE] So I said I, I, I, yeah, well, I explained that to them too over there and they said, OK, soon as you get it straightened out, call us back, get another appointment and I said nobody said anything about going back to my doctor again.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, I'm sorry, it's kind of overwhelming.
[AGENT][NEUTRAL] Oh, no, you're, I understand. No, I, I understand.
[CUSTOMER][NEUTRAL] So answer could you answer me this? Now if I go to the surgeon and I'm under the care of that surgeon from there on out, he's the one you'll need information from as far as when return date is not my physician.
[AGENT][NEUTRAL] No. Just currently whoever is continuing to keep you off work at this point is who would need to, to complete the paperwork. Then if you change to a different doctor and they, you know, at that point, they're the ones that have you off of work, then yes, sir, that training doctor at that point would have you.
[CUSTOMER][NEUTRAL] OK, OK, so that would be the.
[CUSTOMER][NEUTRAL] Right, the surgeon, OK.
[CUSTOMER][NEUTRAL] OK, right, right, I got you, OK.
[AGENT][NEUTRAL] Correct. So, so this does, they did put on here.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] They do have on here 324.
[AGENT][NEUTRAL] For an evaluation, you know, that's, they wrote that in as correct. So since that has changed, that's why we have to have the additional.
[CUSTOMER][NEUTRAL] So I think that was
[CUSTOMER][NEUTRAL] That was for the surgeon.
[CUSTOMER][NEUTRAL] Yeah, that was
[CUSTOMER][NEUTRAL] OK, so I'll go back to him. I'll get a new date.
[AGENT][NEUTRAL] Note from them staying.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'll call and set up a date since I got my Medicare straightened out. I'll call up set a date to go to my surgeon. I'll go back to my doctor and have him fill that portion out again so I fill my portion out his he fills his portion out and that's all I need to send in.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] And let's see, um, actually, and then UTBA it looks like [PII] helped you uh.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] For with the completion of that portion of it, the, can you still hear me?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yes I can. I thought that I thought you cut out.
[AGENT][NEUTRAL] You can hear me OK? So yes sir, then the UTBA representative, which their phone numbers are gonna be on the first page, page one.
[CUSTOMER][NEUTRAL] Yeah I can hear you.
[AGENT][POSITIVE] How they helped you the first time they will help you with that they will do that section for you.
[AGENT][NEUTRAL] Showing that you are still off of work. But um your remarks on here, on your claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Does state that this payment indicates your disability payment for this month. Please contact us immediately you're released from your doctor's care or if you've returned to work so that your claim doesn't become overpaid, and then it goes on to state in order to assist you during this period of disability, please have the following information completed on the enclosed claim form, so you should have a claim form. Also, I'm gonna email it, but you should receive one in the mail as well.
[AGENT][NEUTRAL] Uh, the insured portion to be completed by you, the physician's portion to be completed by your doctor, and the employer complete their portion. So you and I have already been over that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, so each month, each, each month or as determined by the doctor, so now.
[CUSTOMER][NEUTRAL] Now, if the doctor says, OK, if I gotta get surgery.
[CUSTOMER][NEUTRAL] And say that's gonna be.
[CUSTOMER][NEUTRAL] 4 or 5 months because if I gotta get this shoulder surgery done.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And I had my other one done years ago and I was off for 8 months.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Now, so I know, so now if he says OK, come back in 3 months, then I'm then I'm OK up to that 3 months for a 3 month evaluation.
[AGENT][NEUTRAL] Well, you would still have like right from them, but you still have to send in your section.
[CUSTOMER][NEUTRAL] Without getting the paperwork filled out.
[AGENT][NEUTRAL] The claimants section each month.
[CUSTOMER][NEUTRAL] So my section just only my section.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, OK, alright, I just, I just wanna get this all figured out before I.
[AGENT][NEUTRAL] Yes. So one more time, hypothetically, right, hypothetically, if your doctor today completed your forms and said your returned away work was [PII], OK?
[CUSTOMER][NEUTRAL] So now that I now I know what's going.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Then you would still need to submit your portion of the claim form each month leading up to that date.
[AGENT][NEUTRAL] For benefits to be paid, but if for in.
[CUSTOMER][POSITIVE] She only my form, yes, OK, yes, got you.
[AGENT][NEUTRAL] Correct. But if you were to not go to work, back to work, uh, [PII], you know, and it was extended for, then at that point, you, yes, just like this time, they would need to complete each of their sections, your doctor and you, your employer.
[CUSTOMER][NEUTRAL] The employer.
[AGENT][NEUTRAL] As well as you. Uh-huh.
[CUSTOMER][NEUTRAL] OK, OK, got it. OK, alright, OK, now I, yes, I got you now, yes, yes, OK, hoof.
[AGENT][NEUTRAL] That makes sense?
[AGENT][NEUTRAL] OK. And then all disability benefits, um, Mr. [PII], are processed on or right about the [PII] of each month. So you would just need to get your claimant's statement into us each month, you know, before the [PII].
[CUSTOMER][NEUTRAL] OK, OK, so I need to get this next one in by the [PII].
[AGENT][NEUTRAL] Mhm, yes, because that's when all disability benefits are processed is on or this, you know, very close to the [PII]. Again, depending if it what day of the week that falls on if it's on a weekend, you know, it could be.
[CUSTOMER][NEUTRAL] On or before.
[CUSTOMER][NEUTRAL] Right, right.
[AGENT][NEUTRAL] Before or after the [PII], but yes, that's, that's how disability claims are processed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK dear, I appreciate your time now that I know what's going on I'll get that all taken care of as soon as possible.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Well, well, you're welcome. So again, is there anything else I can help you with, Mr. [PII]?
[CUSTOMER][POSITIVE] And no, you, you've helped a lot. I appreciate it and I'm sorry for being a little short. I think I was.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Oh, you were not. That's OK. Not at all. So.
[CUSTOMER][NEGATIVE] I it's, it's just overwhelming, dear. I'm sorry.
[AGENT][POSITIVE] I understand. Well, thank you for calling APL and I hope you have a great day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you ma'am.
[AGENT][NEUTRAL] Mm. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.