AccountId: 011433970860
ContactId: fc2787d0-d0c1-44a0-92c8-094beaf693e5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1170939 ms
Total Talk Time (AGENT): 306232 ms
Total Talk Time (CUSTOMER): 390727 ms
Interruptions: 13
Overall Sentiment: AGENT=0.3, CUSTOMER=-1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/fc2787d0-d0c1-44a0-92c8-094beaf693e5_20250218T16:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. With whom am I speaking? How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you?
[AGENT][POSITIVE] I'm good and you?
[CUSTOMER][NEUTRAL] Doing alright thank you um I've got someone who's needing to speak with y'all uh he had filed a disability claim I guess he had already had uh benefits prior but um it had come back as an abscess and it did state that the benefit maximum had been met, but he wants to talk to y'all because he he doesn't think that that's accurate as it's different.
[AGENT][NEUTRAL] What's the policy number?
[CUSTOMER][NEUTRAL] It is 01171049.
[AGENT][NEUTRAL] OK, and what is his name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and we have a callback number for him?
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, you can go ahead and send him over. Thank you.
[CUSTOMER][POSITIVE] All right thank you bye bye.
[AGENT][NEUTRAL] Bye.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. Is this Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, this is [PII].
[AGENT][NEUTRAL] OK, and I understand your name, date of birth, physical address and email has been verified, is that correct?
[CUSTOMER][POSITIVE] Yes, ma'am, that's right.
[AGENT][NEUTRAL] OK, and you're calling because your claim, uh, your, your disability claim has been denied stating the benefit maximum has been paid, is that what you're calling regarding?
[CUSTOMER][NEGATIVE] Yeah, yeah, this is altogether different than uh what I was dealing with. I, the foot that I've had this problem with, they released me on it. And on the [PII], I went into the doctor's house and they noticed a spot on this foot that I've had surgery on. And on [PII], I had surgery again on this same foot.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, but, but on our
[CUSTOMER][NEUTRAL] So this is uh this is all together a new deal.
[AGENT][NEUTRAL] Well, you've not filed a new claim for a new foot, OK? So the, the, the, what we've been.
[CUSTOMER][NEUTRAL] Well, that's what we just, that's what we were supposed to be doing, that they faxed to my doctor's office.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, let's take a look.
[CUSTOMER][NEUTRAL] In the doctor's office, lady spent an hour following out here a couple of weeks ago.
[AGENT][NEUTRAL] OK, let me place you on a brief hold.
[CUSTOMER][NEUTRAL] That was supposed to be, yeah, that was supposed to be uh on the claim.
[AGENT][NEUTRAL] OK. I'm gonna put you on a brief hold to, to double check to see uh what exactly was going on. One moment, OK? Thank you. Uh-huh. OK, thank you. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, you betcha. You betcha.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 13.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for patiently waiting for me, uh, Mr. [PII] so I'm gonna have to have someone return a call to you, uh, to explain to you what is going on and if you need to file a claim for the new one because from what I'm looking at, I don't see a new claim was filed, a new disability claim, if it's separate, it should have been filed, but I'm not, I'm not seeing one, OK? So, um.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, that's what I.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that's what I requested when I uh talked to them. They said that what they were sending was a new claim, because I told them, I said, this is nothing to do with my old deal. I said, this is a whole new deal. I said, heck, this, I, I went into the doctor on the [PII].
[CUSTOMER][NEGATIVE] And had a spot that didn't look good. And uh by the [PII], they took me into surgery, and I uh had a week's stay in the hospital since then, and uh now I'm on these PICC line IVs trying to get the infection cleared up.
[AGENT][NEUTRAL] OK. So,
[AGENT][NEUTRAL] So do you have a claim form? Our claim forms are online. You need to get your, the claim form filled out by the doctor for the new side.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEGATIVE] Well, we had to have you all fax that, cause they never could download it. The uh lady I dealt with sent a deal to the uh head uh over the doctor's office, and she could never get it to download, so we had to have y'all fax it to us.
[AGENT][NEUTRAL] Mm.
[AGENT][NEGATIVE] Well, they never sent it in we haven't received a new claim and you know.
[CUSTOMER][NEUTRAL] Well, that deal that was faxed back to you is what they sent to us.
[AGENT][NEUTRAL] Mm, we haven't received a new claim for a new disability, so if you got a different disability.
[AGENT][NEGATIVE] We have not received that.
[CUSTOMER][NEUTRAL] So the paperwork you all yet sent back that was dated the uh notice of this starting on [PII], that's not the claim form that we were supposed to fill out.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] There should be some do documents there on this.
[AGENT][NEUTRAL] OK, well, let me just do this because I'm not sure what's going on with your file. Someone that process the individual that process this claim will have to return a call to you and she's not available right now. What's a good call back number for you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, it'd be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. All right. So, um, um, I think she's gone for the rest of the day, so you can look to hear from her possibly tomorrow, OK?
[CUSTOMER][NEGATIVE] OK, OK. Yeah, that'd be funny. Yeah, I just need to get something going cause I'm gonna get evicted from my house if we don't get something going here, so.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK. Yes, sir. Yes, sir. So she'll call you back, OK? And is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, if you would tell her, are y'all in [PII] or y'all down in [PII]?
[AGENT][NEUTRAL] We're all over, but we no we no longer have an office where you can walk into in [PII] so we all work all over.
[CUSTOMER][NEUTRAL] And my truck.
[CUSTOMER][NEUTRAL] No, no, I just was I just was wondering because of the time frame on what time she might call back. I was gonna give you, I've got a doctor's appointment in the morning, so I was gonna have her try to call me if she would around uh [PII] Central Standard Time tomorrow.
[AGENT][NEUTRAL] I can tell her to do that. I can tell her, I could put that in there at [PII] so she does reside in [PII], so [PII] Central Standard Time. I'll let her know that, OK? And let me check one other thing. Let me make sure, let me make sure that uh she's gonna be in tomorrow because I know she left early today cause that way we'll um be on the same page.
[CUSTOMER][NEUTRAL] If he could have her call me.
[CUSTOMER][NEUTRAL] Central time, yeah. OK, yes, she'd be on the same time as I am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, this calendar, I see.
[CUSTOMER][NEUTRAL] What's her extension number and I'll save it here.
[AGENT][NEUTRAL] Unfortunately, we, we don't, we're not allowed to give out extensions. You just have to call back the [PII] number and they'll get you to who you need to speak to. So it looks like she's off tomorrow, so it may be Thursday when she calls you.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, there ain't anybody else I can deal with on it then, huh?
[AGENT][NEUTRAL] Um, I will reach out to someone to see, but more than likely this will have to go through the examiner that processed the claim because she, she knows what she received and and why she denied it and why she's saying this maxed out, and I, unfortunately, I can't make heads or tails on what's going on with it. I don't see a new claim form. So it's, it's better, it's better that we get with the person that knows. Mhm. Yes. OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] Sure, sure. Yeah, I'm, I'm with you. I'm with you. They, they must have sent me, yeah.
[CUSTOMER][POSITIVE] You bet. I agree with you totally on that. I, I understand where you're coming from because like I said, I told everybody when I, I talked to different people trying to get this stuff emailed and nobody at the doctor's office or my lady friend or anybody could open any of it up.
[CUSTOMER][NEUTRAL] So, uh, I finally just called back and I told him I said I'm trying to file this new claim. I said the lady at the doctor's office and the assistants, neither one could open the email to download it. Would you just fax me whatever I need and they faxed it and uh, we filled it all out and sent it back. I think it would have been, uh, not this past Monday but the Monday before is when I was sent back.
[AGENT][NEUTRAL] OK, OK, alright, well I'm gonna get this message to her and when she comes in on Thursday, I know she will return your call right away because she normally is good about doing that the same day, OK, but she won't be here tomorrow and she's already left for the day, OK? Alright, I'm sorry I couldn't help you, Mr. [PII], but we're on the same team.
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][NEUTRAL] That'll work.
[CUSTOMER][NEUTRAL] Sure, sure.
[CUSTOMER][POSITIVE] Hey, I appreciate.
[AGENT][NEUTRAL] And I can help you with general questions. Yeah, I can help you with the general questions about disability, but when it gets this deep like yours, unfortunately, uh, my hands are, I've gone as far as I can go. So, um, I'm gonna make sure thirsty.
[CUSTOMER][POSITIVE] You bet you. I appreciate, I appreciate you.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah. Oh, you're fine. Hey, I appreciate, I appreciate you explaining it all to me, and apparently, what's happened is they must have sent us their own paperwork to fill out because we uh dotted every I and crossed every T uh that morning before they sent it back, so.
[AGENT][NEUTRAL] Yes, sir. Yes, sir.
[AGENT][POSITIVE] Yes, sir. Yes sir.
[CUSTOMER][NEUTRAL] And we spent almost a week trying to get the paperwork, so.
[AGENT][NEUTRAL] Yes, and when was that you was trying to get that paperwork? Was that this year or last year?
[CUSTOMER][NEGATIVE] That's uh been since I was in the hospital. I didn't even uh contact you until I got out of the hospital. I had the surgery on the [PII].
[AGENT][NEUTRAL] So when was that? This year or last year?
[AGENT][NEUTRAL] Of this month?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] [PII]. OK, alright, yes, sir, because I'm not seeing anything. I'm not seeing anything new that has come in. So yes, sir, just look to hear a call, get a return call from her and she'll be able to further assist you, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, over [PII].
[CUSTOMER][POSITIVE] Hey, I appreciate you and thank you so much.
[AGENT][POSITIVE] And her, OK. You're welcome. Thank you for calling APO Mr. [PII].
[CUSTOMER][NEUTRAL] What is that? What is, what is that lady's name that I'll be taking?
[AGENT][NEUTRAL] Her name is [PII]. Her name is [PII].
[CUSTOMER][NEUTRAL] Oh, Ms. [PII]? Well, that's who I dealt with before. I got her extension. It's 3 it's 3488, her extension. I know her well. I, I talked to her, I talk to her every month.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Well, you always keep her name. OK.
[AGENT][NEUTRAL] OK, I'm not sure. Yeah, so that's, yes, sir. So that's who's gonna call you back. Uh-huh.
[CUSTOMER][NEUTRAL] OK, yeah, I talked to her every month while I was on this deal from June [PII], but the, uh, yeah, I know the, I know that claim ended in uh December, but this is totally a whole new deal here we're dealing with.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] OK, alright, OK then, well, alright, well just back from her, OK, uh huh.
[CUSTOMER][POSITIVE] Well, thank you, ma'am.
[CUSTOMER][POSITIVE] Hey, thank you so much. You have a great day.
[AGENT][POSITIVE] You're welcome. You have an awesome rest of your day too, Mr. [PII]. Thanks for calling APO.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Thank you, ma'am. Bye now.
[AGENT][NEUTRAL] Uh huh bye bye.