AccountId: 011433970860
ContactId: ff7b7b32-9ff2-46b2-9893-70374547f47a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 359730 ms
Total Talk Time (AGENT): 171801 ms
Total Talk Time (CUSTOMER): 82809 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/ff7b7b32-9ff2-46b2-9893-70374547f47a_20250226T15:39_UTC.wav
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[AGENT][POSITIVE] Thank you for calling APL. You're speaking with [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Uh, hi, I'm [PII], um.
[CUSTOMER][NEUTRAL] And I filed a claim for a short term disability and it says.
[CUSTOMER][NEUTRAL] Status process and I just wondered what that meant.
[AGENT][NEUTRAL] OK, let me see, can I help you first? Give me your name.
[CUSTOMER][NEUTRAL] Uh, name is [PII].
[AGENT][NEUTRAL] OK, [PII], what's your phone number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right. Do you have your policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] 250-0346
[AGENT][POSITIVE] All right, thank you for that information. Now, give it to me again, Ms. [PII].
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Give me, give it to me again.
[CUSTOMER][NEUTRAL] 25
[CUSTOMER][NEUTRAL] 00346
[AGENT][NEUTRAL] Both seats. OK.
[AGENT][NEUTRAL] All right, Ms. [PII], I have you verify your date of birth and your mailing address for verification.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Date of birth [PII].
[CUSTOMER][NEUTRAL] And mailing address is [PII].
[AGENT][NEUTRAL] All right, what about your email address on file?
[CUSTOMER][NEUTRAL] That [PII].
[AGENT][NEUTRAL] All right, thank you for that information. All right, yes, ma'am, your claim was processed on [PII]. You should be receiving your explanation of benefit stating that your policy, your, your claim that you submitted was a pre-existing medical condition, meaning that you had treated for this particular medical condition before you took out our policy.
[AGENT][NEUTRAL] So it was considered preexisting. So and if you don't agree, you can do an appeal once you receive the claim explanation of benefit and you don't agree with the decision made on your claim, you can do an appeal telling why you don't agree with that the decision that was made.
[CUSTOMER][NEUTRAL] How do you do an appeal?
[AGENT][NEUTRAL] OK, you're gonna just write out what you're appealing, while you're appealing it, the reason why you're appealing it and just put attention appeal department and you can fax it or mail it to our our office.
[CUSTOMER][NEUTRAL] To your office.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] How do I find that information?
[AGENT][NEUTRAL] OK, uh, fax number is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Uh, one sec, I'm trying to get to a spot to.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] You ready?
[CUSTOMER][NEUTRAL] 877.
[AGENT][NEUTRAL] Uh-huh. 365.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] 942 3.
[AGENT][NEUTRAL] And put attention appeal department and make sure you have your policy number on there.
[CUSTOMER][NEUTRAL] A you.
[CUSTOMER][NEUTRAL] Department.
[AGENT][NEUTRAL] Mhm. And the claim number that you can reference is 355-7107.
[CUSTOMER][NEUTRAL] Um, claim number.
[CUSTOMER][NEUTRAL] It's 355.
[AGENT][NEUTRAL] 7107.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And it should be a letter stating
[AGENT][NEUTRAL] Why you disagree with the decision that was made on your client.
[AGENT][NEUTRAL] And if you have medical documentation that can back you up, you can submit whatever you want with it to for your, the reason why you say this was not a pre-existing medical condition that you had not treated for this before you took out this policy on [PII].
[CUSTOMER][NEUTRAL] Let her say it I just decision.
[CUSTOMER][NEUTRAL] And then add medical documentation.
[AGENT][NEUTRAL] Anything that you wanna add that you know, to show that you had not treated for this particular medical condition before you took out this policy.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Yeah, whatever you, whatever you want to add with it to show to to verify that you had not treated for this medical condition before you took out this policy on [PII]. That's all you have to do. Uh-huh. Whatever you, whatever you want to put in your appeal and show with your appeal while you appealing it, why you disagree that this is not a pre-existing medical condition.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] All right. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] That was it.
[AGENT][POSITIVE] All right. Well, thank you for calling American Public Life, and you have a wonderful day. Bye-bye.
[CUSTOMER][POSITIVE] Alright thanks.