AccountId: 011433970860
ContactId: e41b2ae0-4af4-4a13-b581-7f49fc2781aa
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 643570 ms
Total Talk Time (AGENT): 331663 ms
Total Talk Time (CUSTOMER): 295802 ms
Interruptions: 7
Overall Sentiment: AGENT=0.9, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/e41b2ae0-4af4-4a13-b581-7f49fc2781aa_20250103T20:01_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][POSITIVE] Yeah I know Miss [PII] and happy New [PII]'s to.
[AGENT][POSITIVE] Happy [PII] to you. How can I help you today?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]. I was calling.
[CUSTOMER][NEUTRAL] I had uh my my policy number is 764299.
[CUSTOMER][NEUTRAL] I had put in a claim.
[CUSTOMER][NEUTRAL] Um, a couple of weeks ago, I guess about a month ago, and they wouldn't, I was, I was seeing that I had to write paperwork for it or they just didn't pay anything for that particular claim, um, you know.
[CUSTOMER][NEUTRAL] Particular procedure.
[AGENT][NEUTRAL] OK, Mr. [PII], so you your policy you had filed a claim with us, is that correct? And you're just wanting to check the status on it?
[CUSTOMER][NEGATIVE] Well, I y'all, y'all y'all, y'all send it back to me and I got the paperwork in the mail saying it wasn't. I was just trying to see y'all don't y'all didn't pay anything to your uh uh like y'all y'all don't pay anything for CAT scans and that, uh, MRRs.
[AGENT][NEUTRAL] OK, so Mr. [PII], I'll have to pull, I can help you. I can take a look at what we received, but I will have to pull up your information for verify some things with you for security and also any information that I provide for you today would be a verification of benefits and not a guarantee of payment, OK? So what is a good call back number for you in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Say that again, please.
[CUSTOMER][NEUTRAL] You need a post office box.
[AGENT][NEUTRAL] Uh, I'm not there yet. Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. I don't, the reason I was saying I don't had these policies in about 20 years and I have been through this a bunch of times, so I already know procedures what what you gonna be asking.
[AGENT][NEUTRAL] Yes, but I have to let the computer get to the screen before I can verify the information you, you're providing for me, OK? So, thank you for the phone number and you gave me the policy number. So first off, if you'll verify your date of birth.
[CUSTOMER][NEUTRAL] Yeah.
[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 on file for you is the same as the one that you gave me. So again, just to re-verify that that is the number we should have for you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The only one I got.
[AGENT][NEUTRAL] OK, and lastly your email address please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. So on your policy, what is the claim number that you have a question about? You said that you had received some information.
[CUSTOMER][NEUTRAL] It, it's the last one I, I, the last one I don't, um, I don't have it in front of me. It's been a, it's been about a month ago and I just got a chance to call today cause I've been on the weather.
[AGENT][NEUTRAL] From us in the mail?
[AGENT][NEUTRAL] OK. So the last time that I can see that we reviewed on this policy was back in November. I do see that um this is for Memorial University. Give me just a moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] This is for data service back in September.
[AGENT][NEUTRAL] OK, and this was, we, it states that we were in need, it states to please provide a diagnosis code for the state of service. This information may be obtained from your provider of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So that's what I, that's why you said diagnosis code. I thought I, I, I, I was thinking that's what it needed cause I thought I had got paid for CET scans before and I had an MRI since then so that'll be good. I can I send both of them, but I need diagnosis code for both of them everything. Anything I said I need diagnosis code for.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] You could
[AGENT][NEUTRAL] Always, you would always need to, yes, sir, we always will have to have a diagnosis code with any claims submitted, but I can see that you're set up on the online service center, so you can log in to your portal and you can see that remark on this last claim that we reviewed, and then you can upload, once you get that information, you can upload it as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, I, I just, I, I, I knew I needed something. I forgot. I had forgot what y'all call that diagnosis code I'm writing it down right now. I knew it was something. But I said I know I said I've been paid for it. I said I know I've been uh.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, yes, sir.
[CUSTOMER][NEUTRAL] Pay for a CT scan before and and then I just had an MRI done on.
[CUSTOMER][NEUTRAL] Do some of the field, so it should be ready.
[AGENT][NEUTRAL] You say yes, sir, wait, you haven't filed that one yet, but yes, sir, and um.
[CUSTOMER][NEUTRAL] So I get all that.
[CUSTOMER][NEUTRAL] Oh no, I ain't no I ain't no I ain't thought of yet.
[AGENT][NEUTRAL] OK, OK, yeah, because the last one that I see in the system that we processed was that when we just went over for your data service back in September looks like it was on [PII] of this year.
[CUSTOMER][NEUTRAL] That's the, that's the CAT scan.
[AGENT][NEUTRAL] And that's the one that states we needed the diagnosis code for.
[CUSTOMER][NEUTRAL] OK, just kidding. OK. Alright, well I found both of them this I I I I I I knew it was something I, I knew it was some kind of cold, but I couldn't remember that name and I and I've been under the weather pretty bad so I but I get I'm writing it down that that.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] There's a lot of stuff going around.
[CUSTOMER][NEUTRAL] Yeah, yeah, it's.
[CUSTOMER][NEUTRAL] It's, you know, it's COVID around. I'm in Savannah and COVID kinda picking up a living and flu and pneumonia and all kinds of stuff going on.
[AGENT][POSITIVE] Mm. Yes, there's a lot, got lots and lots going around. There certainly is.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] And uh can I, I need to ask you something too.
[CUSTOMER][NEUTRAL] How do I do I need to send um the guy that signed me up. Me, me and [PII] is divorced, so I need to take off. Uh, who I can I get? I need to take off my insurance.
[AGENT][NEUTRAL] OK, so you would have to contact to make any changes to your coverage. You would have to contact um
[AGENT][NEUTRAL] The Universal Trucking Benefits Association, UTBA. I'm not sure of all the agents over there, but I can give you their phone number and if you need, I can also connect you with them if you would like. But just so that you can have the number.
[CUSTOMER][NEUTRAL] Mr. [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, you can
[CUSTOMER][POSITIVE] Oh, you can connect me. I'll get the number. I, I, I can, I can look. I always look at the number. You can go ahead and connect while I'm on the phone, but I appreciate it though. I didn't have need to get that code, you know, cause me and [PII] came finally last month.
[AGENT][NEUTRAL] OK. So yes, sir, because it is still showing that she is um still on this policy.
[CUSTOMER][NEUTRAL] Uh, in
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I got, I got the uh divorce decree and everything, you know, they needed, you know, uh, that last one, no, I think the middle of November. I just hadn't had a chance to send it in.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK. Yes, sir, they would, they'll tell you because I'm sure they will have to have a copy of that to have it changed over, but yes, I'll be happy to connect you with one of their representatives.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, no problem. I appreciate it.
[AGENT][POSITIVE] All right. Well, you're very welcome, Mr. [PII]. So again, is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh no, ma'am. I'll be getting them, them two. I'll be filing them too in September and last last month, you know, 2, the CT scan and.
[CUSTOMER][POSITIVE] I'll be filing it soon and uh I appreciate it.
[AGENT][NEUTRAL] OK. And then you're welcome, and anytime you're filing one of the claims, um, there's a claim form out on our main website, Mr. [PII], for this type of policy for the hospital indemnity plan. And on the first page of that claim form, it gives all of the instructions.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] As to what the documents are that we need when you file a claim, if that would make, you know, might make it easier, you just go out there to [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And at the top you'll
[CUSTOMER][NEUTRAL] OK, well, see, the thing is.
[CUSTOMER][NEUTRAL] The thing is, ma'am, I, the thing I should have checked it. These people at Memorial.
[CUSTOMER][NEUTRAL] Every time she I had to, I had to call and it takes like 7 days to get this stuff when like can I can go right there and pick it up. But then I always, they don't, they always know what I need because like when I call them I need them diagnosis code. They always send me the wrong thing every time they never, they I think they just do that on purpose unless you ask for it because they never send a camera I go in there, everything be spot on.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I've just picked up some stuff from them today, but Memorial, they never do it and it takes 7 to 10 days, then you got to reorder and then take another 7 to 10 days. I think they just do that to hold people up. I honestly I do.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So, but I got, I got the word now I'm gonna make sure I.
[AGENT][NEUTRAL] Well, I certainly hope that's not the case, but
[CUSTOMER][NEUTRAL] I, I think it is cause every time cause I don't, I don't have to read stuff, send stuff all the time. They say never they write code on it. Then when I call them back, oh you didn't ask for the diagnosis code. Well, come on, ma'am, I can talk to y'all all the time. Y'all know what I want, know what you know what I need.
[AGENT][NEUTRAL] I certainly hope that's not the case.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Well, yes, sir, I could.
[CUSTOMER][NEUTRAL] Put it in put it in a file or something.
[AGENT][NEUTRAL] Yeah, for the, for this policy, for sure. I mean, you know, for other things, maybe not, but yes, sir, for this, for this type of policy, every time we review a claim, we're gonna have to have that, that diagnosis code, not.
[CUSTOMER][NEUTRAL] You know, so.
[AGENT][NEUTRAL] Not just the procedure code. You know, what they did, we need to know the why and the diagnosis code tells us the why they're doing it, so.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] And I got you. I understand that. You know, all the me. I, I, I understand. I appreciate that.
[AGENT][NEUTRAL] All right then.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you're very welcome, Mr. [PII]. So it was nice speaking to you. I hope you have a very nice and safe weekend, and if you will give me just one moment, I will, um, get you connected with one of the representatives at the Universal Trucking Benefits Association.
[CUSTOMER][POSITIVE] Yes ma'am, I appreciate you.
[AGENT][NEUTRAL] All right. One moment.
[AGENT][NEUTRAL] Well, I'm having some technical, oh.
[CUSTOMER][NEUTRAL] UTVA
[AGENT][NEUTRAL] Hey [PII], it's [PII].
[CUSTOMER][NEUTRAL] Hey how are you?
[AGENT][POSITIVE] I'm all right. How are you?
[CUSTOMER][POSITIVE] I'm good.
[AGENT][POSITIVE] Good. I have a Mr. um [PII] on the line who is with Lumber Transport.
[AGENT][NEUTRAL] And his coverage is currently couple, but he says he's recently divorced and so he's needing to find out about having her removed.
[AGENT][NEUTRAL] From the coverage.
[CUSTOMER][NEUTRAL] OK, you can go ahead and send him over.
[AGENT][POSITIVE] Thank you so much. Have a good weekend.
[CUSTOMER][POSITIVE] Thank you. You too.
[AGENT][POSITIVE] All right, thank you. Bye-bye.