AccountId: 011433970860
ContactId: e2f82cf9-510f-46b1-bcba-585f5512bcf0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 499720 ms
Total Talk Time (AGENT): 190518 ms
Total Talk Time (CUSTOMER): 187147 ms
Interruptions: 2
Overall Sentiment: AGENT=0.2, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/e2f82cf9-510f-46b1-bcba-585f5512bcf0_20250326T21:28_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. Birthday [PII]. I'm calling for my husband, [PII]. Birth date is [PII].
[CUSTOMER][NEUTRAL] And I'm calling about a claim that we have submitted.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I need an update on it.
[AGENT][POSITIVE] OK, well, I can definitely help you with the claim status. May I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And may I have your policy number?
[CUSTOMER][NEUTRAL] 243-561-5
[AGENT][NEUTRAL] 243-561-5
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And is the claim for you or your husband?
[CUSTOMER][NEUTRAL] It's for my husband.
[AGENT][NEUTRAL] Alright, and I'm in the policy, I just need you to verify your date of birth and the mailing address. Well, you already gave me your date of birth, just the mailing address on file.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment, and this is for your accident policy or the hospital indemnity policy.
[CUSTOMER][NEUTRAL] The accident.
[AGENT][NEUTRAL] All right, and let me see which one.
[CUSTOMER][NEUTRAL] He had surgery back in December and the claim was denied, but we submitted all information that was required, that they were asking for.
[AGENT][NEUTRAL] OK, let me
[CUSTOMER][NEUTRAL] Uh, it was sent in February.
[CUSTOMER][NEUTRAL] But it was sent to America Fidelity.
[CUSTOMER][NEUTRAL] America Fidelity said that they have already uploaded all the files for you to look at, and I had called last week to American public, and she was gonna make a notation, so I need an update on it.
[AGENT][NEUTRAL] I understand. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] for claim. OK, so this is what I'm gonna do. Let me go ahead and reach out to the claim support so that they can check their files and see if the documents have been received. Um, let me see if I can see it on my end first. Hold on one moment.
[CUSTOMER][NEUTRAL] But like
[CUSTOMER][NEUTRAL] Like I said, I had sent it certified mail so I can make sure that it went through, but not knowing they were gonna require a signature. I didn't need a signature. I just need a verification that it was delivered.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] But they, the post office sent it to American Fidelity for a signature, and there is a signature it was received, and I spoke to somebody at American Fidelity, and they told me they have uploaded the files, and it was there for you to look at.
[AGENT][NEUTRAL] OK, um, because I'm not seeing it here, um, but I can definitely reach out to claims so that they can look into it for you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, please.
[AGENT][NEUTRAL] Sure, and before
[CUSTOMER][NEUTRAL] Cause I had called last week and I talked to somebody about it also.
[AGENT][NEUTRAL] Mhm. I see when you called on the [PII] to let us know that the paperwork has been sent in, but I just don't see the paperwork, so I'm gonna reach out the claim so that because it's claim so that they can check their files.
[AGENT][NEUTRAL] Um, but before I reach out to claims, was there anything else that I can assist you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, that was it.
[AGENT][POSITIVE] OK. Well, thank you so much for calling APL and hold on one moment, I'm gonna get a representative for you, OK?
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Ferring
[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 doing good. I need to transfer this call to you. Um, the member, it sounds like, so she said she sent the claim to American Fidelity. She's spoken to American Fidelity and they said they've uploaded everything, but I don't see anything since January.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] I mean if she sent it to American Fidelity and they've uploaded it, it's gonna be on their system it's not gonna be on ours.
[AGENT][NEUTRAL] But it's an APL policy.
[CUSTOMER][NEUTRAL] We don't share a system.
[AGENT][NEGATIVE] She sent it to the wrong, the post office sent it to the wrong place.
[CUSTOMER][NEGATIVE] Weird.
[CUSTOMER][NEUTRAL] That is weird. Um.
[AGENT][NEGATIVE] Very, very weird.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, hang on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What is that policy number?
[AGENT][NEUTRAL] So it's 243-561-5.
[CUSTOMER][NEUTRAL] one
[AGENT][NEUTRAL] Yes, ma'am, part one.
[CUSTOMER][POSITIVE] OK, thanks for.
[CUSTOMER][NEUTRAL] She doesn't have any other policies.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Well, I mean, she has a few.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] They all laughed.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Do we know if the date of service was before her last day or his last day?
[AGENT][NEUTRAL] Um, no, we don't know if the data services before the. Wait, hold on. I do know that. She said that he had, he had surgery in December. This is them resubmitting because they, the first initial claim was denied.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, very, very, very, OK, um.
[AGENT][NEUTRAL] But she said she spoke with American Fidelity and they said that they uploaded everything and I'm like,
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] See, and that doesn't make any sense because.
[CUSTOMER][NEGATIVE] They don't have access to our system.
[CUSTOMER][NEUTRAL] They would have had to have sent it to us through like email or something.
[AGENT][NEUTRAL] So then I don't
[AGENT][NEUTRAL] I'm not sure. That's all she told me.
[AGENT][NEGATIVE] But just I'm, I'm confused.
[CUSTOMER][NEUTRAL] OK. Um,
[AGENT][NEGATIVE] That one threw me for a loop.
[CUSTOMER][NEUTRAL] Is there any way that you can let them know that because I mean we don't have anything, you know we don't have anything, is there any way that you can let them know that we need to reach out to American Fidelity and um kind of verify and we can give them a call back.
[AGENT][NEUTRAL] Yes, um,
[AGENT][NEUTRAL] I'm, let me do this because [PII] has instructed me to go ahead and transfer the call. So can you take this call for me, please, but I'll note the policy because I just don't want any issues.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] No yeah I understand OK.
[AGENT][NEUTRAL] Um, but I'll go ahead and note the policy, everything she said, and yeah, I, I don't see anything.
[CUSTOMER][NEUTRAL] OK, is it like uh the spouse or something for part one?
[AGENT][NEUTRAL] Yeah, it's part two calling, um, his wife.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] They're together, but we're talking to her.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, got you, OK.
[AGENT][NEUTRAL] All right, [PII], um, hold on one moment, let me get her.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Hello, Mrs. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Thank you so much for holding. I have [PII] on claims on the line with us and she'll be assisting you further, OK?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEUTRAL] Hey this is [PII], how are you?