AccountId: 011433970860
ContactId: 00ea28e2-7544-4588-97ae-a4378407f2d2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1134869 ms
Total Talk Time (AGENT): 186128 ms
Total Talk Time (CUSTOMER): 330769 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/00ea28e2-7544-4588-97ae-a4378407f2d2_20250408T20:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, [PII], my name is [PII], and I was calling because I had, um, filed a claim uh for critical illness for cancer for my husband, um, probably about 3 weeks ago now, but they requested additional information, so I sent that in, and I was just trying to see if there's an update on it sometimes y'all can see things before I can and um.
[CUSTOMER][NEUTRAL] I don't, I don't know. It's just.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, of course. Um, I will look that claim for you and I can let you know. Uh, do you have the policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, hold on a second, I'll give it to you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 141.
[CUSTOMER][NEUTRAL] 5882
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and then what's a good callback number in case our call gets dropped on accident?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] No. [PII] You're kicking me in my stomach and stuff.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEGATIVE] Don't get me in.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, and then your first and last name?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And then you're calling in regards to your husband, right?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK. And his date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And your mailing address and email on file, please?
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] It's [PII] and it's [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mm. Mhm.
[AGENT][NEUTRAL] OK. Give me just one moment and I will look that claim up for you.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK. Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh that luggage is.
[AGENT][NEUTRAL] And then do you have the data service?
[CUSTOMER][NEUTRAL] You don't
[CUSTOMER][NEUTRAL] Um, yeah, let me look at the claim. The day he was diagnosed with cancer, you mean?
[AGENT][NEUTRAL] OK. Or the claim
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Or the data service for the claim?
[AGENT][NEUTRAL] Yes, the, the date of service for the claim or if you have the claim number that would be best.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, I'll get it for you. Hold on one second.
[AGENT][POSITIVE] OK. Thank you.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] OK, the claim number was um 357-717-4.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It was filed under that claim number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] It doesn't do what I can't carry.
[CUSTOMER][NEUTRAL] 6 months.
[CUSTOMER][NEUTRAL] Yeah, 6 months.
[CUSTOMER][NEGATIVE] You don't do.
[CUSTOMER][POSITIVE] Enjoy my freedom.
[CUSTOMER][NEUTRAL] For my go.
[CUSTOMER][NEUTRAL] Mama, go
[CUSTOMER][NEGATIVE] What youla before? You gonna be crying.
[CUSTOMER][POSITIVE] One my go.
[CUSTOMER][NEUTRAL] yeah
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I really
[CUSTOMER][NEUTRAL] You know my phone.
[CUSTOMER][NEUTRAL] Ah, boo boo boo.
[CUSTOMER][NEGATIVE] Oh, stop.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] OK, so it says for this claim number that the calendar year maximum for this benefit has been exhausted with the payment of this claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, that's for the wellness.
[CUSTOMER][NEUTRAL] That because I sent in claims for wellness too, so that was for wellness checks.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] So up under that one it says something about um they needed the physician statement so I sent that in.
[CUSTOMER][NEUTRAL] I, when I filed that claim, I sent in the pathology report.
[CUSTOMER][NEUTRAL] Along with the wellness stuff too. I found it all together when I filed it, and they put it all up under one claim number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. Give me just one second. Can I put you on a brief hold while I look further into this?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] [PII], can I put you on a brief hold just a second?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you. Yeah. No, you're OK.
[CUSTOMER][NEUTRAL] Yeah, sure, sorry.
[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] Hi, thank you for holding. So, are you verifying if we received the pathology report or the attending physician statement?
[CUSTOMER][NEUTRAL] Mm, yes.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] No, I'm, I'm trying to find out if they've done anything with the claims.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean they should have all the, they had the pathology report when I first sent it.
[CUSTOMER][NEUTRAL] And then I had to send in the physician statement.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] They should have both of those.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so they have the pathology report and then you sent in.
[AGENT][NEUTRAL] The physician statement.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So when I first filed the claim, it only requested the pathology report along with the claim, so that's what I said.
[CUSTOMER][NEUTRAL] And then I got a letter in the mail saying they needed a physician statement filled out, so I got that filled out and I sent that I uploaded that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Learn
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] In.
[CUSTOMER][NEUTRAL] I usually take.
[CUSTOMER][NEUTRAL] And it was
[CUSTOMER][POSITIVE] I do yeah.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Take it out.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] They control like your doctor.
[AGENT][NEUTRAL] Sorry, there's a lot of claims to go through on this one, just a second.
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] No, you're OK.
[CUSTOMER][NEUTRAL] So when I last looked on my photo when I send in a position statement, it doesn't have a claim number to it, so I don't know if they, you know, know to tie that into the other one.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Like, I know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, yeah, sometimes it can have a totally different claim number.
[CUSTOMER][NEUTRAL] Free instructions
[AGENT][NEUTRAL] Is there
[CUSTOMER][NEGATIVE] No, it don't have anything, no claim number, nothing changed.
[CUSTOMER][NEUTRAL] On my end from what I see.
[AGENT][NEUTRAL] OK. Does it have your husband's name on it or yours?
[CUSTOMER][NEUTRAL] My husband.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That like
[CUSTOMER][NEGATIVE] Proper.
[CUSTOMER][NEUTRAL] Video
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] are backed up there's a lot of the stuff.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEGATIVE] So what I'm afraid of is that the paperwork I sent in to go with that claim, the physician statement, is just gonna sit there and no one's gonna know what what it's for.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We don't
[CUSTOMER][NEUTRAL] The.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hey, can I just put you on a brief hold? Um, I'm so sorry. Uh, I'm gonna ask a colleague for just a second set of eyes on this one.
[CUSTOMER][NEUTRAL] be.
[CUSTOMER][NEUTRAL] That's OK. Yeah.
[CUSTOMER][NEUTRAL] OK. Thank you. You are on hold.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What, honey? I'm working. I literally have a client on the phone. I cannot right now.
[AGENT][NEGATIVE] You want me to get fired? Cause I can't. I just can't right now.
[AGENT][NEUTRAL] You're gonna have to figure it out.
[AGENT][NEUTRAL] What?
[AGENT][NEUTRAL] Wait until I'm on break, OK? I can't do it right now.
[AGENT][NEUTRAL] Get out, please. I can't. You, you can explain to me when we're done.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] I know what you want me to do?
[AGENT][NEUTRAL] 882.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Hey, I'm so sorry about that wait. Um,
[CUSTOMER][NEUTRAL] Hey, it's OK.
[AGENT][NEUTRAL] So it looks like we have the APS and it's in line for review right now.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so, so, um, so does that, that, what does that mean? Like they hadn't looked at it yet is that.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh, so we have the attending physician.
[AGENT][NEUTRAL] STMT and it's in line for review so um we.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It takes about 7 to 10 days for processing.
[CUSTOMER][NEUTRAL] Mhm. All right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Yeah, is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK. Thanks for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] You too. Thanks, bye.