AccountId: 011433970860
ContactId: 01ec5f79-d3ae-40b0-a2f1-de129626f9ce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 749900 ms
Total Talk Time (AGENT): 172719 ms
Total Talk Time (CUSTOMER): 549537 ms
Interruptions: 4
Overall Sentiment: AGENT=1.4, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/01ec5f79-d3ae-40b0-a2f1-de129626f9ce_20250304T15:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm with TRS Blue Cross Blue Shield. This is a recorded call on the line with us. It's a beneficiary for the, uh,
[CUSTOMER][NEUTRAL] The person I'm calling in about.
[CUSTOMER][NEUTRAL] And her name is Ms. [PII] and and so she had a question for you.
[CUSTOMER][NEUTRAL] This [PII], are you with this?
[CUSTOMER][POSITIVE] Oh, let me come for show you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Miss [PII]. Yes. OK, I'm on the line with American Public Life. What was your name again, ma'am? My name, my name is [PII]. The, the lady at the insurance company. Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't hear her.
[CUSTOMER][NEUTRAL] What was your name again?
[AGENT][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] Yeah, can you hear us?
[AGENT][NEUTRAL] My name is [PII]. Yes, I can hear you both.
[CUSTOMER][NEUTRAL] [PII], OK, [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hi.
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I believe your name sounds familiar. So I think I'm, I spoke to you before last week sometime. Maybe I could be wrong regarding, um, uh.
[CUSTOMER][NEUTRAL] Uh, filing a claim for my brother's cancer insurance. I have, uh, faxed that over with a copy of, I've actually sent a copy of a death certificate right away after I spoke to someone there last week, and then the following day I completed the cancer claim and I attached also, um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, uh, the death certificate as well. I've had issues with your insurance since day one. I'm not trying to be a complainer or anything. I just want you to understand I filed my original claim since back in [PII]. You guys said you never got it.
[CUSTOMER][NEUTRAL] So I'm doing all this all over again, and again I'm hearing the same thing. And just last week I filed a claim form for the insurance again like I said with uh a copy of the death certificate and prior to that, the day before I had already sent a copy of the death certificate. So I don't understand, um.
[CUSTOMER][NEUTRAL] Does it take some time then for your people to upload um what comes in through a fax cause I sent everything through a fax.
[AGENT][NEUTRAL] Uh, yes, ma'am. It does take 7 to 10 business days.
[CUSTOMER][NEUTRAL] And I sent it to that
[CUSTOMER][NEUTRAL] Oh, OK, so if I just did this last week, and then they're probably not uploaded yet then. OK, that's probably what's going on. That's the only thing I can fax number.
[AGENT][POSITIVE] Correct. Um.
[CUSTOMER][NEUTRAL] Yeah, I want to verify the fax number. Yes, yes, I will verify that. And it's, it's on the claim form, so, um, I know I'm, I'm sending it to the right place and I also have a copy of the original claim form that I sent already one time before, you know, back in June, um, the fax is 877.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] 3659423. I also have receipts to show from when I faxed it originally. I have receipts. I keep receipts from, you know, where I go and I do this at. I keep receipts of every.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEUTRAL] So, um, also I do need to ask you another question though because based on what Ms. [PII] just told me, you guys are looking like for, um, um, um, everybody tells us different things.
[CUSTOMER][NEUTRAL] The pathology report when he, when he was originally diagnosed.
[CUSTOMER][NEUTRAL] And then all chemo treatments?
[CUSTOMER][NEGATIVE] Right, just chemo or what about surgeries and everything else? I was told that the insurance didn't cover any of the surgeries.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, so first what I'm going to need to get from you, Miss [PII] is the policy number so I can pull up the policy and even see what policy it is.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me look, hold on, there's 2 policy numbers. Yeah.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] The first one is 207-842-2.
[CUSTOMER][NEUTRAL] Yeah, I I have so.
[CUSTOMER][POSITIVE] I believe I gave you both, uh, policy numbers as well, Miss [PII]. Yes ma'am, and the you want both at the same time.
[CUSTOMER][NEUTRAL] Sorry.
[AGENT][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] OK, did you get the 1st 1 207-8422?
[AGENT][NEUTRAL] 207, yes.
[CUSTOMER][NEUTRAL] OK, the second one is 242-6917.
[AGENT][NEUTRAL] Thank you so much. And then just for security reasons, um, Ms. [PII], can you please verify the address phone number?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] And email address that's on the policy?
[AGENT][NEUTRAL] For [PII].
[CUSTOMER][NEUTRAL] Yes, um, oh, for [PII], um, let me see, hold on.
[CUSTOMER][NEUTRAL] His phone number would have been [PII], that's his telephone number was [PII].
[AGENT][NEUTRAL] OK, thank you. And then his um.
[CUSTOMER][NEUTRAL] And the policy number would have been
[CUSTOMER][NEUTRAL] Email address.
[AGENT][NEUTRAL] And do you have a physical address?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um, I do, but I don't want anything sent to that address because he's no longer there. Um, it's [PII].
[AGENT][NEUTRAL] OK, I understand, but we're just right now we're just verifying, yes.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK. It was [PII].
[CUSTOMER][NEUTRAL] Zip code [PII].
[AGENT][POSITIVE] OK, yes ma'am, thank you. I appreciate you verifying the policy. OK, so what I'm going to need to do is.
[CUSTOMER][NEUTRAL] And that's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Checking the information um and you sending in.
[CUSTOMER][NEUTRAL] Check what information.
[AGENT][NEUTRAL] The claim information that you have sent in I'm going to need to um.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Check that.
[AGENT][NEUTRAL] Get a claims examiner to call you back and I want a good phone number that they can call you back on and I'm gonna send a request while we're on the phone together so that you can um discuss the claim with them that way an examiner's looking at what you've sent in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you guys will be able to talk about the claim, is that OK?
[CUSTOMER][NEUTRAL] Right, right, and but the thing is I'm not the one. I don't even know what any of that stuff looks like that you're requesting, so I mean, and, and, and, and I was, I, I'm his beneficiary and I was his power of attorney. However, now my brother is deceased, so if I call, he was a patient of Texas oncology in [PII], and then he was a patient that I had him at MD Anderson as well.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] So, um, we did back in June when I filed my original claim.
[CUSTOMER][NEUTRAL] Um, we went there personally to Texas oncology and
[CUSTOMER][NEGATIVE] took in the form that he needed to sign to release all of his medical information to you guys. Apparently nothing was sent.
[CUSTOMER][NEUTRAL] So everything I have done has been out the window ever since.
[CUSTOMER][NEGATIVE] And I'm just, I, I'm so confused and I've never been so confused and lost in my life. So I mean, and like I was explaining to my brother was already dying when all this was going on. We were trying to beat the clock and take care of business, and I'm very disappointed that it didn't, none of it got done other than, I mean thank God at least, um, my name is there as a beneficiary, otherwise I wouldn't even be able to be doing this.
[AGENT][NEGATIVE] Oh no.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So, um,
[AGENT][NEUTRAL] Right, I understand.
[CUSTOMER][NEUTRAL] I, I, I mean, I, I, I was told that you guys needed all those medical records from both places from MD and from Texas Oncology, OK, so I, I went to MD as well personally cause I took him one last time before he passed away.
[CUSTOMER][NEGATIVE] And I signed all the paperwork there as well, and I asked them to send you guys all the medical records. I don't know what else to do other than you guys request them personally. I mean, your insurance company. I would think that's why, why you guys are there, right? That's what you do. I mean, in situations like this, I'm not.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] I'm not, uh, my, the patient is deceased. I'm the beneficiary. They're not gonna give me any medical records.
[CUSTOMER][NEUTRAL] So, um,
[AGENT][NEUTRAL] I do have um I'm looking at the notes on the policy where you've called for.
[AGENT][POSITIVE] And I do have a phone number that I'm going to transfer you to um there's a note in here that um if you call and you need assistance that she's available to help.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So, um, I'm going to transfer you on over to [PII].
[CUSTOMER][NEUTRAL] And who is, who is that?
[AGENT][NEUTRAL] Her name is [PII].
[CUSTOMER][NEUTRAL] OK, yeah, that's the one I, well, I spoke to [PII] before, but she's with, um, Blue Cross Blue Shield, isn't she?
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Or is she with, um, you see that see that's how confused I am. So then she's with um with um.
[CUSTOMER][NEUTRAL] What's the name of your insurance to, not TRS.
[AGENT][NEUTRAL] APL.
[CUSTOMER][NEUTRAL] APL. She's with um
[CUSTOMER][NEUTRAL] American Family Insurance. OK, she's with you guys then.
[AGENT][POSITIVE] American Public, yes, yes ma'am, and I'm gonna go ahead and transfer you over to [PII] um because she does have notes in here and then she'll be able to help you better than I can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. OK. Well, I will.
[CUSTOMER][NEUTRAL] OK, but ma'am.
[CUSTOMER][NEUTRAL] Yeah, ma'am, I've already spoke to [PII]. We went through all of this already, which is why we're, which is, yeah, which is why we're speaking to [PII].
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So I can give you [PII] [PII]'s telephone number, um, because I've already spoke to her and she told me exactly what what we needed so we're we're going in circles again. OK, so do you want to just hang up and let her transfer me to [PII] cause I'm gonna tell you we're not gonna be able to find EOBs from [PII] to the date of, you know, to [PII].
[CUSTOMER][NEUTRAL] Yeah, well, I think [PII] mentioned, if I remember well, [PII] mentioned [PII], and I don't know, I don't know the difference in the dates or why the dates are changing. All I know is that he did have insurance and he was diagnosed since [PII]. So, um, that's all I know. So, um, I'll have to.
[CUSTOMER][NEUTRAL] Yeah, let me get, I, I have [PII]. Well, she can give you the number. I have it somewhere right now. I, I, I've got too many going on.
[CUSTOMER][NEUTRAL] Yeah, well I can get it back from [PII], but please, yeah, let her transfer me to [PII].
[CUSTOMER][NEUTRAL] Yeah, yeah, I'm not getting anywhere. Not for [PII]. OK. OK.
[AGENT][NEUTRAL] OK. All right.
[AGENT][NEUTRAL] It's gonna
[AGENT][NEUTRAL] It's gonna be a brief hold while I transfer you over so and can help you further from here um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] So I'm gonna put you on a quick hold while I transfer you and I appreciate you guys calling APL and I hope that everything goes smoothly for you from here on out.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, so, so, so Ms. [PII], then I'm gonna hang up and I'll wake you up for a call because I'm still on the clock here myself, alright, thank you so much and um and I do have [PII]'s direct line number as well so if you lose her by any chance, call me back any time. Thank you bye bye. Bye bye.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK, yes ma'am, sir, you can transfer me to [PII].
[AGENT][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] Thank you. Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Hi, you've reached [PII]. Sorry, I missed your call. Please.