AccountId: 011433970860
ContactId: e539d92a-e222-4448-8346-8ded4ac6f5f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2642340 ms
Total Talk Time (AGENT): 883460 ms
Total Talk Time (CUSTOMER): 1236184 ms
Interruptions: 12
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/24/e539d92a-e222-4448-8346-8ded4ac6f5f8_20250324T16:44_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] Yes ma'am, my name is [PII], and I'm trying to make sure that all the paperwork has been pro is being processed correctly and is of, you know, all the paperwork that is submitted correctly for, you know, proper dis dispensation.
[AGENT][NEUTRAL] I can help you with that, Mr. [PII]. What is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have your policy number available?
[CUSTOMER][NEUTRAL] No, ma'am, not offhand.
[AGENT][NEUTRAL] I can look it up by your social would that be OK?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And what is that number?
[CUSTOMER][NEUTRAL] 435113645
[AGENT][NEUTRAL] Thank you, Mr. [PII]. Is this on your disability policy?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Can you verify your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] All right, thank you. And I think I spoke to you the other day. Let's see what we've got.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] It'll be my pleasure to assist you with that claim information. Let's see.
[AGENT][NEUTRAL] Bear with me just one second.
[AGENT][NEUTRAL] And we were waiting on that fax, weren't we, from the doctor?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEGATIVE] So we didn't receive it.
[AGENT][NEUTRAL] See, I know you called on Thursday to see if we'd received it.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And we had night.
[AGENT][NEUTRAL] And I'm not showing that we've received it yet. Did they do you know if they refaxed it?
[CUSTOMER][NEUTRAL] Yes, ma'am, they said they did.
[AGENT][NEUTRAL] Do you know what day they did?
[CUSTOMER][NEUTRAL] Cause I talked to the, I've said Wednesday.
[AGENT][NEUTRAL] Wednesday.
[CUSTOMER][NEUTRAL] When I physically talk to the lady.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] She told me she faxed it.
[AGENT][NEUTRAL] Did you happen to verify the fax number that you sent that to?
[CUSTOMER][NEUTRAL] Yes ma'am, because it was we used the original paperwork and the phone number was on the back of the fax.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That's right. OK.
[AGENT][NEUTRAL] I am checking, let's see.
[AGENT][NEUTRAL] I'm still not showing it. Let me see if it came in possibly the next day or something. Maybe they sent it late that afternoon.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I remember checking the faxes last um.
[AGENT][NEUTRAL] Thursday when you called in.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I just don't have anything from Thursday or Friday or Friday or today.
[CUSTOMER][NEGATIVE] Fuck.
[AGENT][NEUTRAL] Did, did you, did they say that they might fax it again?
[CUSTOMER][NEUTRAL] They said they faxed it when I talked to them Wednesday morning.
[AGENT][NEUTRAL] Have you got a phone number or something that we can contact them?
[CUSTOMER][NEUTRAL] Oh, it's Ossner Hospital in [PII]. That's all I, I, I hang on, let me see if I can dig it up.
[AGENT][NEUTRAL] OK, so I was just thinking we might do a three-way call.
[CUSTOMER][NEUTRAL] Give me a sec.
[AGENT][POSITIVE] All right. Thank you, Mr. [PII].
[CUSTOMER][NEGATIVE] Everything is hard with my visions, you know, messed up like it is.
[AGENT][NEUTRAL] Yeah, I remember that.
[AGENT][NEUTRAL] Let me, I'm gonna see if I can find it too.
[AGENT][NEUTRAL] Let's see if I can find it on this claim.
[CUSTOMER][NEUTRAL] G
[AGENT][NEUTRAL] Cause it seemed like, now I'm going from memory here, so it may not be correct, but it seemed like there was a portion on the physician's statement that was not completed.
[CUSTOMER][NEUTRAL] Right, the date of completion.
[AGENT][POSITIVE] Got you.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] Let me see if there's a phone number on this real quick.
[AGENT][NEUTRAL] I've got a phone number for, uh, that was for Doctor [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'll tell you what, have you got a minute and let's do a 3 way call to them and see if they can fax that back over to us, OK? Alright, hang on just a second that way you don't have to worry about trying to see the numbers. Let me see if I can get.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Because I'm not to be, not to be a jerk, but I need that money because if I don't pay my rent, I lose my house.
[AGENT][NEUTRAL] That is not being a jerk. I understand. I have been there and I know how stressful that is.
[AGENT][NEUTRAL] So you
[CUSTOMER][NEUTRAL] And so I need to get it, you know, I need to know what's going on with it and I'm not trying to be forceful or anything, but I still need, I need to know.
[AGENT][NEGATIVE] You're not.
[AGENT][POSITIVE] Absolutely. And I'm gonna see if we can get them on the line. If you'll hold just a minute, let's see what we can get done for you, OK? All right, thank you. And I understand I've been where you are and I didn't have a disability policy. So I understand the stress. So you'll be well.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Well, I was where you are with a different reason, but I understand. Let me see if I can get them on the line real quick, OK?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Thank you for calling Oxner Ophthalmology. This call may be recorded for quality and training purposes. Please tell us about your experience by staying on the line for a brief survey.
[CUSTOMER][NEUTRAL] To best help you, please tell us in a few words what you are calling about. You can say something like schedule an appointment or get medical advice.
[AGENT][NEUTRAL] Need to speak to medical records.
[CUSTOMER][NEUTRAL] To best help you
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Thank you, your call is being transferred to a representative.
[CUSTOMER][NEUTRAL] Thank you for calling Saint Bernard Hospital release of information department. Our hours of operation are [PII] Monday through Friday. If you need to send in a fax, please fax your request to [PII]. If you would like to speak to a member of our staff, hold the line and we will be with you shortly. Record your message at the tone when you are finished. Hang up or press pound for more options.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's the number on the plane.
[AGENT][NEUTRAL] That's the number on the claim form for Doctor [PII].
[CUSTOMER][NEUTRAL] Yeah, but, uh.
[CUSTOMER][NEUTRAL] Like I said, I got the paperwork from Oshna Hospital, not.
[CUSTOMER][NEUTRAL] Saint Bernard Hospital.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] Maybe that
[CUSTOMER][NEUTRAL] Let me see something.
[AGENT][NEUTRAL] Is that where the disconnect is, I wonder? Let's see, because on the claim form.
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] Doctor [PII] is the one who completed the claim form.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And that's the physician's office contact number was who I called.
[CUSTOMER][NEUTRAL] Yeah, well, maybe he works out of, uh, [PII]. I don't know.
[AGENT][NEUTRAL] I'm just checking one more thing.
[AGENT][NEUTRAL] This is Ashner Health System patient disability FMLA cover sheet.
[AGENT][NEUTRAL] And I'm seeing if there's any.
[AGENT][NEUTRAL] Maybe a callback number for them looks like they've got your information listed.
[CUSTOMER][NEUTRAL] I've got a
[CUSTOMER][NEUTRAL] Local phone number of [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, let's try that number, OK? I'll try anything to help you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Well, let's see if we can get someone there and see if we can get this taken care of.
[CUSTOMER][NEUTRAL] Now that's probably just the general hospital phone number so we'd have to go through all the mess of, you know which department they transferred to.
[AGENT][NEUTRAL] Department
[AGENT][POSITIVE] OK, let me see what I can do. If you don't, if you've got time, I'll continue to try.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] All right thank you one moment.
[CUSTOMER][NEUTRAL] Thank you for calling Oxner Health System. This call may be recorded for quality and training purposes.
[CUSTOMER][NEUTRAL] Thank you for calling Oxner Health. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII]. This is [PII] with APL. Have you got a department? Um, I've got one of your patients on the line and we're needing a physician statement for a disability claim. Who would I, is that medical records or who do I need to speak with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, we have a disability department that is with medical records um hold on please.
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEUTRAL] Come on.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] I can give you the phone number if you'd like before I transfer.
[AGENT][NEUTRAL] Yes, please, in case we get disconnected.
[CUSTOMER][NEUTRAL] Do
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I can give you the medical records number too if you'd like.
[AGENT][NEUTRAL] OK, what's that number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright thank you [PII]. I really appreciate you transferring the call.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] Not a problem have a good day.
[AGENT][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] You have reached the Health information department. If you need a copy or are checking for the status of your medical records, please press 1. If you submitted an insurance or FMLA form to be completed for your provider at the [PII] location, please press 2.
[CUSTOMER][NEUTRAL] If you submitted an insurance or FMLA form to be completed for your provider at the [PII] location, please press 3. For all other calls, please press 0 to speak with the operator.
[CUSTOMER][NEUTRAL] Wait while I transfer your call.
[CUSTOMER][NEUTRAL] Thank you for calling Oxner Health System. This call may be recorded for quality and training purposes.
[CUSTOMER][NEUTRAL] How may I help you?
[AGENT][NEUTRAL] Yes, um, my name is [PII]. I'm with American Public Life Insurance Company calling with one of your patients. We are trying to get some information so that we can.
[CUSTOMER][NEUTRAL] company.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, information fax us so that we can process a disability claim. Can you help us with that?
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You have reached the Health information department. If you need a copy or are checking for the status of your medical records, please press 1. If you submitted an insurance or FMLA form to be completed for your provider at the [PII] location, please press 2.
[CUSTOMER][NEUTRAL] If you submitted an insurance or FMLA form to be completed for your provider at the [PII] location, please press [PII]. For all other calls, please press [PII] to speak with the operator. Thank you.
[AGENT][NEUTRAL] You know what
[CUSTOMER][NEUTRAL] You have reached the Health information department. If you need a copy or are
[CUSTOMER][NEUTRAL] Wait while I transfer your call.
[CUSTOMER][NEUTRAL] Thank you for calling Auctioner Health System. This call may be recorded for quality and training purposes.
[CUSTOMER][NEUTRAL] [PII] how may I help you?
[AGENT][NEUTRAL] Yes, we were trying to get some help um getting the document faxed for one of your patients to APL.
[CUSTOMER][NEUTRAL] What type of
[CUSTOMER][NEUTRAL] What department do you need?
[AGENT][NEUTRAL] Um, it's gonna be the Ashner.
[AGENT][NEUTRAL] Mr. [PII], can you help?
[AGENT][NEUTRAL] It's uh I.
[CUSTOMER][NEUTRAL] Yeah, uh, it's gonna probably be the, uh, disability uh records department.
[CUSTOMER][NEUTRAL] One moment.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] If you are a patient or calling from a physician and would like to fax a medical records request, please send your fax to [PII]. If you are an attorney's office, insurance company, or disability company and would like to check the status of your medical records request, please press [PII].
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] If you are a patient or calling from a physician's office and would like to speak with a representative about a medical records request, please press 2.
[CUSTOMER][NEUTRAL] If you would like to check the status of points to be completed by a provider.
[CUSTOMER][NEUTRAL] Medical records, this is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII]. I'm hoping you can assist us today. Um, this is [PII] with American Public Life Insurance Company. I have one of your patients, [PII] on the line with us. He is trying to file for his disability, um, benefits.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We received a fax from for his disability claim form from, and the doctor's name was [PII]. However, there was a portion that was not completed. Mister [PII] has called back to check on that and someone stated that it was faxed to us on Wednesday. However, we never received that fax with the completed form. Can you help us, please?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I'm gonna have to um send you to the disability desk and when I transfer you over just press press option 3.
[AGENT][POSITIVE] Option 3. Thank you so much.
[CUSTOMER][POSITIVE] No problem, hold on one.
[AGENT][NEUTRAL] I thought that's where we were going.
[CUSTOMER][NEUTRAL] It takes 2. Yeah, well, is our top priority at auction, which is
[AGENT][NEUTRAL] That's OK, we'll get there.
[CUSTOMER][NEUTRAL] You have reached the Health information department. If you need a copy or are checking for the status of your medical records, please press 1. If you submitted an insurance or FMLA form to be completed for your provider at the [PII] location, please press 2.
[CUSTOMER][NEUTRAL] If you submitted an insurance or FMLA.
[AGENT][NEUTRAL] She said 3.
[CUSTOMER][NEUTRAL] Wait while I transfer your call.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I don't know if they're gonna answer.
[CUSTOMER][NEUTRAL] No, I don't think so.
[AGENT][NEUTRAL] Did you write down the
[AGENT][NEUTRAL] Oh, I thought so. Did you happen to write down that disability phone number?
[CUSTOMER][NEUTRAL] No, I didn't. I can't see anything to write down.
[AGENT][NEUTRAL] I didn't know if you could ride it big.
[AGENT][NEUTRAL] Well, I'm putting it in the notes.
[CUSTOMER][NEGATIVE] No, I can't.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I put it in the notes on your um.
[AGENT][NEUTRAL] And I'll put option 3.
[AGENT][NEGATIVE] But no answer.
[AGENT][NEUTRAL] What I would suggest, Mr. [PII], is
[AGENT][NEGATIVE] I don't think they're gonna answer.
[CUSTOMER][NEUTRAL] I don't think so either. It's lunchtime.
[AGENT][NEUTRAL] OK, I'm gonna disconnect that call, hang on.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So what I was, let's see, hang on just a second.
[AGENT][NEUTRAL] I'm writing all this down.
[AGENT][NEUTRAL] And your, your good callback number is [PII]?
[CUSTOMER][NEUTRAL] [PII] yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] So what I'm going to do a special for you, OK?
[AGENT][NEUTRAL] As I am going to, when I get back from lunch.
[AGENT][NEUTRAL] I'm gonna try to contact them one more time.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'll call you back and let you know if I did get to speak to someone.
[AGENT][NEUTRAL] And if they stated that that they're going to refax it, if not, I would suggest.
[CUSTOMER][POSITIVE] I'd appreciate it.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Uh, you know, I'm putting everything in the notes. If I can't get to them, I would just suggest you call back maybe tomorrow and just whomever answers, ask them to please call the number that was notated with you to see if y'all can get that refax back in or in the meantime if you can contact them and just tell them you know that we did not receive it if they would please refax it.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEGATIVE] Yeah, because like I said, and please put it in a note that I'm coming close to losing my house because I don't have any pay coming in and I'm depending on this money coming in.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Sure. I understand. It is so stressful. Well, first of all, you're dealing with issues, you know, with your health, and then you're worried about your bills because your bills don't stop. And I do understand that.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEGATIVE] They don't and they don't understand.
[CUSTOMER][NEUTRAL] And that's another, you know.
[AGENT][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] Yeah, well, like I said, you, you know.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's why, you know,
[AGENT][NEUTRAL] I understand.
[CUSTOMER][NEUTRAL] I mean,
[CUSTOMER][NEUTRAL] The, the, whoever makes the decision whoever makes the decision on, you know, releasing the funds.
[CUSTOMER][NEGATIVE] You know, somebody needs to put a, needs to tell him, hey, you know, he's trying and you know, he's about to lose his house and if it's only a date.
[CUSTOMER][NEUTRAL] On a piece of paper, I mean, you know, I don't see the logic in holding everything up because of a simple little date.
[AGENT][NEUTRAL] Well, it's because of insurance compliance, you know, I mean, we have to have the documentation from your physician completed.
[CUSTOMER][POSITIVE] I mean, I'm working on it as much as I can and I will continue to work on it.
[AGENT][NEUTRAL] Yes, you are.
[AGENT][POSITIVE] Yes, you are, and I know that, and I know you are, and I'm gonna try to help you. We're gonna see if we can't get it.
[CUSTOMER][NEUTRAL] So, I mean, you know.
[CUSTOMER][NEUTRAL] I mean, you know, if we can, you know.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] There's gotta be some sort of, you know, I understand you got your rules and regulations, but I mean there's some, isn't there some way we can meet in the middle?
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] That's, you know, let's see if we can get this. If we have problems getting this, then, um,
[AGENT][NEUTRAL] You know, I can transfer you to our disability department to speak with them and I can do that right now if you would like to.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, please, because, you know.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And you know, I'm.
[CUSTOMER][NEUTRAL] I'm trying to get everything done.
[CUSTOMER][NEGATIVE] Short of going over there and I can't go over there cause I can't get over there because I can't see.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] OK. So let me get you to our disability department and you can discuss it with them.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] And again, like I said, I'm gonna try once I get back from lunch to see if I can reach someone in [PII] as well for you, OK?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] All right. And give me just a minute cause I'm gonna kinda let them know what's going on to explain, so you don't have to go through all that again, OK?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] All right. Thank you, [PII]. One moment, please.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][POSITIVE] OK, thank you, thank you for calling APL. This is [PII]. How can I help you?
[AGENT][POSITIVE] Well, happy Monday, [PII]. It's [PII].
[CUSTOMER][POSITIVE] Happy Monday. How are you, ma'am?
[AGENT][NEUTRAL] I'm doing all right, but I have tried to help this gentleman, he's just panicking, bless his heart. Um, let me give you a policy number, you know, with disability when it's not paid, you know, the bills don't stop and he says he's about to lose his house.
[CUSTOMER][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh gosh.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It's policy number 2361828.
[AGENT][NEUTRAL] For [PII], he's called and called and called and called.
[AGENT][NEUTRAL] Um, I spoke with him last Thursday, so the issue I believe is
[AGENT][NEUTRAL] On that claim number 3576423.
[AGENT][NEUTRAL] There is a portion on the physician statement that they did not put when the disability began or the anticipated return to work day.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm, yeah, let's see.
[AGENT][NEUTRAL] So I, I did give him that um information.
[AGENT][NEUTRAL] Last week, and he said he called the provider back and they still say that they faxed it last Wednesday.
[AGENT][NEUTRAL] Which of course we don't have that on file.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEGATIVE] And he is having vision problems. That's um why he can't work.
[AGENT][NEUTRAL] Um, just now we tried to call Ashner Clinic together to the disability department to see if we could get that re-faxed. We did not have any luck con connecting with the disability department.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm putting it in the notes, the phone number and all that.
[CUSTOMER][NEUTRAL] Yeah it looks like we.
[AGENT][NEUTRAL] But he
[CUSTOMER][NEUTRAL] OK, it looks like we also don't have the employee statement which is.
[AGENT][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] Oh [PII], I didn't. Are you sure? Because I think.
[AGENT][NEUTRAL] That might be, well, let me see.
[CUSTOMER][NEUTRAL] Well, that one, the DL 37, it says it's incomplete, so the, the remark code says the claim form submitted was incomplete in order for additional consideration be given, please complete the statement of insured, which is the employee's portion.
[AGENT][NEUTRAL] I think
[CUSTOMER][NEUTRAL] So we have a tenant physician which that's the part that they.
[CUSTOMER][NEUTRAL] Did not um put the.
[AGENT][NEUTRAL] We need to make sure because I thought I checked on that.
[CUSTOMER][NEUTRAL] OK, yea[PII], I'm double checking the documents now.
[AGENT][NEUTRAL] I might have missed it.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEGATIVE] I mean, he's so panicky and, you know.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And I get it because I was on, I mean, I.
[CUSTOMER][NEUTRAL] Ok my email just.
[AGENT][POSITIVE] I've been out of work before and didn't even have a disability policy and I worried about my home and, you know, yeah, I get it.
[CUSTOMER][NEUTRAL] Yeah, yeah, same.
[AGENT][POSITIVE] But the good [PII] gave me what I needed when I needed it.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hey man, sister.
[AGENT][NEUTRAL] Got the authorization form policy holder statement.
[AGENT][NEUTRAL] That's on page 2.
[AGENT][NEUTRAL] So we do have that.
[CUSTOMER][NEUTRAL] That that's, that's his employer we need his portion.
[AGENT][NEUTRAL] Oh, I got you, got you. Hang on. State statement of insured.
[CUSTOMER][NEUTRAL] We don't have the insured statement.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] Oh well, I'll be ding ding dong it. I'm sorry.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEGATIVE] Are you kidding me?
[CUSTOMER][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] OK, I see statement of insured though.
[AGENT][NEUTRAL] I really thought we had
[AGENT][NEUTRAL] Yeah, I thought we had.
[CUSTOMER][NEUTRAL] On page 3.
[AGENT][NEUTRAL] I thought the only thing that I could find was the
[CUSTOMER][NEUTRAL] Oh, I think it's 2 pages though.
[CUSTOMER][NEUTRAL] Let me, let me just pull up this form because I need sometimes it helps to like see the whole thing because.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You know what I mean? Like sometimes I just truly, I'm just like I don't know. I don't know what's missing. Let me just see.
[AGENT][NEUTRAL] Got it.
[AGENT][NEUTRAL] Yeah, I know.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, let's see, OK.
[CUSTOMER][NEUTRAL] Um.
[AGENT][NEUTRAL] I'm trying to get, we were trying to get that form.
[AGENT][NEGATIVE] Faxed over with the physician's completed portion, but uh we, we're not having any luck.
[AGENT][NEUTRAL] And he has been trying, you can see in the notes.
[CUSTOMER][NEUTRAL] What number did you call for um that.
[AGENT][NEUTRAL] So we at first we started with the number on the claim form for Doctor [PII] or whatever his name was, and then he said, no, it's from Ashner Hospital. So then I looked where this was faxed from.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And we called there and they transferred us to the disability department and that phone number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII] option 3.
[CUSTOMER][NEUTRAL] OK, it says option 2 on the form that they submitted, but OK.
[AGENT][NEUTRAL] And then the lady gave me the medical records phone number as well. We did not go there.
[CUSTOMER][NEUTRAL] OK, so statement of insured we're missing page 2. We have page 1 which goes through asking like section F where it asked about like the initial.
[CUSTOMER][NEUTRAL] Dot uh disability details and then page 2 goes into like their physician information continuing disability details and a signature so we don't have page 2. I'm gonna see if there's an EOB note as well on this claim.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] He just, he's like, can I just talk to somebody and let them know I'm trying or is there any way if it's just a date can we, you know.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, so we're missing page two of his form and we do not have, let me see what that was again, DM 326.
[CUSTOMER][NEUTRAL] The verified disability from the.
[CUSTOMER][NEUTRAL] Position
[CUSTOMER][NEUTRAL] Which was on this I believe.
[AGENT][NEUTRAL] I wonder why she told me to hit option 3 instead of 2.
[CUSTOMER][NEUTRAL] I don't know because like like I said on that form that was faxed over from [PII] um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let's see, pending position statement they put codes and then they like I said they didn't put the date it began or his anticipated return to work, um.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Let me see what all we have here.
[CUSTOMER][NEUTRAL] They first treated they put that but that doesn't necessarily mean.
[CUSTOMER][NEUTRAL] That's when
[CUSTOMER][NEUTRAL] And then they have um.
[CUSTOMER][NEUTRAL] Disability FMLA cover sheet. So on the bottom of that it says this form is to be used for FMLA or disability forms only disability desk phone and it gets that number but it says option 2.
[AGENT][NEGATIVE] And see he can't make calls because he can't see.
[CUSTOMER][POSITIVE] God bless him.
[AGENT][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Would he be willing to let me try and get in touch with them um and contact like I know he's panicked and he wants to talk to someone there's not anything I can do for him um I mean I can talk to him if he really really needs it but if I can call him back, I'm going to try and reach out to them using that option too.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And actually I'm going to.
[CUSTOMER][NEUTRAL] When did they say they sent the other fax?
[AGENT][NEGATIVE] [PII] and see I have access to the faxes and we have nothing.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That's not, I mean, everything, no, it's just the [PII] today.
[CUSTOMER][NEUTRAL] There's nothing out there for the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] And there's nothing in the disability queue.
[AGENT][POSITIVE] Did not see anything in the queue.
[CUSTOMER][NEUTRAL] That you're aware of
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Yeah, I don't see anything there. I'm gonna check.
[CUSTOMER][NEUTRAL] The pending for [PII] too because just in case it's there and not I mean I don't see any new documents or whatever under his name but I just wanna like double check and make sure we don't have it hidden somewhere.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, yeah, I don't see that anywhere, um.
[CUSTOMER][NEUTRAL] And like I said I don't see that any new documents have come through and we normally would if it's been out there so.
[AGENT][NEUTRAL] And he hung up
[CUSTOMER][NEUTRAL] Let me, oh, OK.
[CUSTOMER][NEUTRAL] What I'm gonna do if he calls back let him know that you've spoken to someone in claims you can give him my name if you want to um I'm actually about to go to lunch but um.
[AGENT][NEUTRAL] Me too. I was supposed to at [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, I'm going to try and contact them as soon as I get back and I'm going to use that option too that's on there and if I can't get through I'm going to send an email because they provided an email also um.
[CUSTOMER][NEUTRAL] And I'm going to see if I can get them to refax.
[CUSTOMER][NEUTRAL] And let them know that we.
[CUSTOMER][NEUTRAL] Did not have any additional information that we're, you know, we've been informed that it was sent on the [PII], however, we do not have that. I may, I mean my email or the care team email because I can send it through the care team um.
[CUSTOMER][NEUTRAL] If I'm not able to contact them, you know, I can use that. What is it that template or whatever that comes from the care team instead of your personal information.
[AGENT][NEUTRAL] Mhm. Right.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Just encourage them to try and resend it somehow even I, I know we're not supposed to encourage email, but at this point this poor guy and his panic if the fax was successfully sent on their end and some reason we didn't get it or it's been misplaced, I would prefer email at this point.
[CUSTOMER][NEUTRAL] Um, so I don't know, I'll just have to see if I can reach them, um, and if not, like I said, I'll email them. Does he have an email on file?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] He does, but he's got vision problems, so he can't read it.
[CUSTOMER][NEUTRAL] He does. I may.
[CUSTOMER][NEUTRAL] That's right, so he can't really read it. I was gonna say like I can copy him on it that way he knows that we've been in contact with him through email, but I don't know how how much good.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] I would, yeah, I would go ahead and copy them.
[AGENT][POSITIVE] And at least he has it, yeah.
[CUSTOMER][NEUTRAL] Just so he has it because he can always get like a family member or someone to be like yeah this is you know they're reaching out on your behalf or whatever OK uh.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Let us both go. I will.
[AGENT][NEUTRAL] I'm just gonna call him back real quick and just let him know that you're gonna continue to try to contact them and you he should hear back from you this afternoon. How about that?
[CUSTOMER][NEUTRAL] Make a note after.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, yes, um, because if I can't reach them I will still contact him and let him know like this is the steps we've taken we are reaching out, um, when you call him back let him know that we don't have that second page of his statement that has his signature and date like the date he signed it.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh [PII]
[AGENT][NEGATIVE] He's gonna panic
[CUSTOMER][POSITIVE] So that will need to be, it's uh I mean I know he's panicked but that's literally all we need we need to get in contact with them and we just need him to send his form so I mean I know you're really good at reassuring people but just just reassure him like it's gonna be OK we're gonna help you we're gonna we're gonna get this done you send this part, let us try to reach them and we'll go from there. I will contact him this afternoon directly with whatever I was able to do whether that's.
[CUSTOMER][NEUTRAL] Call them and actually speak with someone or whether that's having to send an email and waiting on them to contact me back.
[AGENT][POSITIVE] I mean look at the way he signed his authorization form bless his heart.
[CUSTOMER][NEGATIVE] Yeah, you probably can't even see like the lines and stuff if he's having that severe.
[AGENT][NEUTRAL] Mm mm, he can't.
[CUSTOMER][NEGATIVE] I mean because the doctor said that like it's so bad that he's having to.
[AGENT][NEUTRAL] How is he gonna send that form?
[CUSTOMER][NEUTRAL] I mean his wife signed on his behalf.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] On the
[CUSTOMER][NEUTRAL] On the first page, what was that page?
[CUSTOMER][NEUTRAL] Was that his? Oh yeah, that's the authorization. So that's her signature because of his eye issues I'm assuming.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And then he did sign like he didn't even yeah he did he did sign but like like we said he can't really see the box so it you know what it reminds me of and this is awful but it truly reminds me almost like a stroke victim.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] That goes off to one side or someone that has like weakness on one side, whether they're left or right-handed, they're weak and so it kind of goes off, but his is just more not being able to see the line where it needs to be.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It does.
[AGENT][NEUTRAL] OK. Tell me what because now I'm, now I'm, uh, now, yeah, wait a minute.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEGATIVE] Now I'm, I feel like I've been going, and now I'm dizzy. Which page was it?
[CUSTOMER][NEUTRAL] We need page 2.
[CUSTOMER][NEUTRAL] Um, of the insured.
[AGENT][NEUTRAL] And was it even completed at all?
[CUSTOMER][NEGATIVE] No, we do not have it at all.
[AGENT][NEUTRAL] OK, so let me get to those claims and forms, you know.
[CUSTOMER][NEUTRAL] So it's page 3 of the 8 page document but as far as his part it's gonna be the second part where his signature is at, um.
[AGENT][NEUTRAL] I wanna get that pulled up and just I'm gonna go ahead and email it to him and so maybe his wife can.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] See, he last worked the [PII].
[CUSTOMER][NEUTRAL] The employer verified that he last worked the [PII] and then the physician said if I'm not mistaken, he was seen the [PII].
[AGENT][NEUTRAL] Is it the um physician's names, last name, first name?
[AGENT][NEUTRAL] Is that the portion he needs, the page he needs to complete?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It is and that's really like.
[CUSTOMER][NEUTRAL] I mean if he has his physician's name and contact numbers, you know, great get someone to fill that out for him um he does not have to do the continuing disability details because this is not this is his initial it's not continuing disability so he doesn't have to do that part we just need at least one physician and contact number.
[CUSTOMER][NEUTRAL] I know and I'm sure he has it because he provided that with you because you said you tried to reach out that Doctor [PII] or something.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And they said that he was saying.
[CUSTOMER][NEUTRAL] Date symptoms first appeared accident occurred was [PII].
[AGENT][NEUTRAL] Wonder if I can email just this page.
[CUSTOMER][NEGATIVE] But they didn't do the day.
[CUSTOMER][NEUTRAL] Uh, you should be able to.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Oh, he was first treated on the [PII], so he was working the [PII]. They said that it first occurred on the [PII], and they got him into the office on the [PII].
[CUSTOMER][NEUTRAL] So it's really just filling out that part where it says disability began.
[AGENT][NEGATIVE] I can't do just that page.
[CUSTOMER][NEUTRAL] I mean, which is crazy, but.
[AGENT][NEGATIVE] I could fax just this page, but I can't email just this page. Why? Why, why, why?
[CUSTOMER][NEUTRAL] Um, you should be able when you have it pulled up, do print.
[CUSTOMER][NEUTRAL] If you're looking at it just to print that page or just put in page 3 and it should say just that page like to uh uh an Adobe Acrobat or something like that.
[AGENT][NEUTRAL] No, it doesn't cause print is just.
[AGENT][NEUTRAL] Let's see, hang on, save this PDF file.
[CUSTOMER][NEUTRAL] Pages.
[CUSTOMER][NEUTRAL] Custom
[AGENT][NEUTRAL] OK. What page was it?
[CUSTOMER][NEUTRAL] Page 3, page 3.
[AGENT][NEUTRAL] 3.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Did it did it did it did it.
[AGENT][NEUTRAL] Maybe, maybe
[AGENT][POSITIVE] Hot ding ding dong.
[CUSTOMER][NEUTRAL] OK, so I.
[AGENT][NEUTRAL] I'm, I'm just gonna go ahead and email this to him and see if his wife or someone can.
[AGENT][NEUTRAL] Help him with that.
[CUSTOMER][NEUTRAL] OK, oh, I see Doctor [PII]. OK, ophthalmology, and you said you already tried to contact them?
[AGENT][NEGATIVE] Yeah, but he said that's not the right place to call because we needed to call.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well that's who filled out the form though.
[AGENT][NEUTRAL] I know, but he said it came from [PII]. That's why I was confused too.
[CUSTOMER][NEUTRAL] I'll I'll call both of them.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And see if I can figure something out like we have a disability claim form on file you know and just kind of go over the situation and just be like you know we're missing some information here is there any way that it can be it looks like it was filled out by your office and signed.
[CUSTOMER][NEUTRAL] Can you
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] Refill out this particular portion and send it back to us and then if they're like well you know whatever the case may be then um then I'll call [PII] because if they're the ones that filled it out they're the ones that we need the information from because it was they were referred from this Doctor [PII] to Doctor [PII] and it looks like he's the one that filled it out so yeah I'll reach out to them first.
[AGENT][NEUTRAL] Yeah, I know.
[CUSTOMER][NEUTRAL] But either way I'm gonna call I'll email, I'll do what I have to do um I may actually because I think Doctor [PII]'s fax number was provided.
[CUSTOMER][NEUTRAL] Yes, what I might do is I may send that portion of the form back to them and ask them to please.
[AGENT][POSITIVE] Complete it.
[CUSTOMER][POSITIVE] Yeah, complete this portion because we have everything else we need this portion completed and see if they will get that filled out.
[CUSTOMER][NEUTRAL] And I'll put it as urgent.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let me give him a quick call back.
[CUSTOMER][NEUTRAL] But yeah, I'm gonna call fax all the things.
[AGENT][NEUTRAL] And I'll let him know and then I'll tell him that you're gonna call him. I've emailed him that page through of that claim form so when you call him if you'll just check and.
[CUSTOMER][NEUTRAL] And I
[AGENT][NEUTRAL] Tell him, reiterate to have his wife or someone help him complete that portion and get it back to us.
[AGENT][POSITIVE] And hopefully we can get him taken care of.
[CUSTOMER][NEUTRAL] OK, I will, I will.
[CUSTOMER][NEUTRAL] Yes, because as soon as we get that we have everything it's just a matter of getting it pulled and processed, so.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, OK, I will do everything I can. You're welcome.
[AGENT][POSITIVE] beans. All right. Thank you, [PII].
[AGENT][POSITIVE] I appreciate you. You're awesome.
[CUSTOMER][POSITIVE] Alright, no problem.
[AGENT][POSITIVE] Thanks.
[CUSTOMER][POSITIVE] You're awesome.
[AGENT][POSITIVE] Uh, you're awesome. You're awesomer.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] Thanks, [PII]. Take care.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] You're welcome. OK, you too.
[AGENT][NEUTRAL] Bye-bye. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.