AccountId: 011433970860
ContactId: f902a083-c08d-4ca2-9706-47ee12fe0030
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 297250 ms
Total Talk Time (AGENT): 123436 ms
Total Talk Time (CUSTOMER): 181126 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/f902a083-c08d-4ca2-9706-47ee12fe0030_20250602T19:48_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] in group billing. Um, I got a call.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] I got an insured on the phone who's calling about a claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And his policy number is 2356292. It's [PII] and uh a good call back number for him is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And he, he said that um
[CUSTOMER][NEUTRAL] The doctor said that he was supposed to be on leave until December, but we got him coming back earlier. There's, I don't know anything about all that, but
[AGENT][NEUTRAL] Oh boy.
[CUSTOMER][NEUTRAL] That's, that's not my expertise, so um.
[AGENT][POSITIVE] I got you, I got you.
[AGENT][NEUTRAL] Not quite what you work on day to day, is it?
[CUSTOMER][NEUTRAL] But yeah.
[CUSTOMER][NEUTRAL] No, it's not, but if you can, but I have verified everything, um, his email, his address, his date of birth.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Social, everything, so he is fully verified.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Is there a particular claim that he called about so I can look at that and then kinda go from there?
[CUSTOMER][NEUTRAL] I think it says disability.
[AGENT][NEUTRAL] Right, but like is there a particular claim number that he mentioned?
[CUSTOMER][NEUTRAL] Uh, he did not, he did not give me a claim number. I had to look for his policy number by his social, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, that's OK. Let me see if it's the most recent because it.
[CUSTOMER][NEUTRAL] I do apologize.
[AGENT][NEUTRAL] No, that's OK. Uh, let's see, return to work per information according to the information received, we've allowed benefits through the return to work. OK, so that's probably what he's calling about because we've denied him additional benefits.
[CUSTOMER][NEUTRAL] Uh, I think that's that sounds, mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, he said that it was something about an extra $600 or something. That's like I said, I don't know.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] claims is not my expertise.
[AGENT][NEUTRAL] No, that's fine. I completely understand.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, uh, yeah, I have it pulled up so I can give it a look and I discuss it with him and see where we can go from here.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][POSITIVE] All right, [PII], well thank you for your help and you have a good day.
[AGENT][POSITIVE] You're welcome. Yes, ma'am. You too.
[CUSTOMER][NEUTRAL] All right. All right, bye bye.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am. Hang on, let me get a better place where you can hear me. Hey, um, I think I've already been verified and everything. Uh, well, listen, OK, my, uh, my benefits stopped because, uh, y'all said that the my doctor released me, uh, sometime in the middle of April this year.
[AGENT][NEUTRAL] Hey.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, so I got a letter saying I was, um, uh, that, that that was it and everything, and, and, uh, I think my payment, uh, it was supposed to be 3 and it was like 24, uh, that's when I got cut off, but, uh, my doctor said that I'm, I'm still off work till December of this year.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] OK, have they, yeah, I'm gonna see if they sent in any type of updated form that gave an uh like a a later return to work.
[CUSTOMER][NEUTRAL] I was wondering if y'all could look into that.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] OK, so the last attending physician statement we have.
[AGENT][NEUTRAL] Anticipated return to work is dated [PII], so if that has been extended we need them to fill out a new physician statement and send that in that you're going to need additional time.
[AGENT][POSITIVE] So that we can we we'll we'll backdate it to where we last paid you and um and we'll continue to pay you benefits through either the maximum allowed for your policy or your return to work whichever one comes sooner.
[CUSTOMER][NEUTRAL] OK, yeah, uh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now they sent me the form they told me my doctor told me that um they sent it the new updated one but y'all didn't get it but they emailed it to me. Can I just upload the one that emailed to me?
[AGENT][NEUTRAL] Yeah, through the portal.
[CUSTOMER][NEUTRAL] Because trying to get
[CUSTOMER][NEUTRAL] Yeah, because I have the, the one they said that, yeah, and it says on it [PII].
[AGENT][NEUTRAL] Yeah, um,
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] And it's signed and everything by them?
[CUSTOMER][POSITIVE] OK, I'll just upload it. Oh yes ma'am, yes ma'am. Phone numbers on there to the doctor and everything it's signed by the doctor. So, OK, cool man. I'll just do that and uh and and then I appreciate you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Absolutely.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] No problem at all if you need anything else, you give us a call OK?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Uh, well, you guys have always been great. Thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're so welcome. Have a good day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye.