AccountId: 011433970860
ContactId: 03c58803-ab42-40af-98da-e02c42a3145a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 613739 ms
Total Talk Time (AGENT): 263729 ms
Total Talk Time (CUSTOMER): 344391 ms
Interruptions: 7
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/29/03c58803-ab42-40af-98da-e02c42a3145a_20250129T20:01_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah this is [PII] and I have a question um about my plan benefits, and I'm a bit confused.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, OK, so I can help you spell your name for me.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And what's your policy number?
[CUSTOMER][NEUTRAL] Last name is [PII]. Uh, my policy number is, let me get that for you. It is 18296.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Do you have your ID card?
[CUSTOMER][NEUTRAL] Um, I don't recall ever getting an ID card from you guys because I did open enrollment back in September. I mean, it became accepted in September, but I'm, I'm in my account right now, and if you need something that I can get off my account, I could probably get it for you.
[AGENT][NEUTRAL] Um, are you on the online service center?
[CUSTOMER][NEUTRAL] Yes, I'm, I'm, I'm on, yes, I'm logged in.
[AGENT][NEUTRAL] OK, can you see your policy? Or actually, the ID card is on the out on the site.
[CUSTOMER][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] Under
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Do you know what it's under?
[AGENT][NEUTRAL] I think it's under the policy dashboard.
[CUSTOMER][NEUTRAL] OK, say policy mm.
[AGENT][NEUTRAL] And you could just or your policy certificate and uh.
[CUSTOMER][NEUTRAL] Policy contact information.
[AGENT][NEUTRAL] Um, and, uh, so it's PDF documents, your PDF for your policy and.
[CUSTOMER][NEUTRAL] OK, hold on, notification.
[CUSTOMER][NEUTRAL] Yeah, OK, I'm looking at the PDF document. Yes, I got it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So do you need group information or is there anything you need off of it?
[AGENT][NEUTRAL] And I see it. Yeah, the policy number is, is it 2541314 on that card or the policy? OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, certificate number, yes, OK, so, oh, it has a policy number then it has a certificate number, so the certificate number was 02541314, and the policy number has 18296.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, it's the first one you gave me.
[CUSTOMER][NEUTRAL] So maybe it's the way.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I wonder why does it do that?
[AGENT][NEUTRAL] So it's it is a 254.
[CUSTOMER][NEUTRAL] OK, 2541314.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's the that's what you give us when you call us, that's the number you give us when you call us.
[CUSTOMER][NEUTRAL] OK, sorry, I'll make a note of that. OK.
[AGENT][NEUTRAL] OK. And then what is your date of birth and mailing address?
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII]. Mailing address is [PII].
[AGENT][NEUTRAL] What's the city?
[CUSTOMER][NEUTRAL] [PII]. It might be listed as [PII], but sometimes it should be [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we have [PII]. OK.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Sometimes it pops up, it's the same.
[AGENT][NEUTRAL] OK. All right. And then what's your email address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you for that.
[AGENT][NEUTRAL] Right, so you have a cancer policy.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And you wanted to go over the benefits or what's covered under this policy?
[CUSTOMER][NEUTRAL] Yeah, I was covered because I, I, I, I'm a bit concerned because I had surgery, but I was referred to, uh, my doctor referred me to an oncologist back in August, right when, when I was, had gotten this plan. The plan was affected [PII], but it wasn't until I was in surgery that they staged me with stage one ovarian cancer, so I don't know what I'm covered for.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] And I don't know what's what's the.
[CUSTOMER][NEUTRAL] I'm just, I just so happened to be an open enrollment and did not realize this would come up so I wasn't sure.
[AGENT][NEUTRAL] Right. OK. All right, so.
[AGENT][NEUTRAL] So you, you've, you've um.
[AGENT][NEUTRAL] Been diagnosed with that. And so under your cancer policy.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, you know, there's a radiation chemo immunotherapy benefit under here.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, I'm not having to do any of that, um, at this time because they did a, uh, just when I doing a total hysterectomy and so I will have to go back next month just for follow up. He has me on his care for the next couple of years he said I have to come back to him, but right now he said that wasn't needed, so but I wanna know what was I covered for being that I have medical bills or stuff like that, so I wasn't sure if any of this covered anything.
[AGENT][POSITIVE] Oh, good.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah, he said that your hysterectomy wasn't needed.
[CUSTOMER][POSITIVE] He gave me, he did that, he performed a hysterectomy and he said chemo or anything that wasn't needed. Yes, I did that it was done on septic. Great, wonderful.
[AGENT][NEUTRAL] Oh, you've already had that done. OK. OK. How do you feel?
[AGENT][NEUTRAL] You do? Can you tell the difference?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][MIXED] Well, I, I never had any children. It was a bit bittersweet because I didn't have any children and so, but I told, he told me when they were in surgery, I did sign and agree. I said if there's cancer found, go ahead and do that because I don't wanna battle this. This is something that I've just lost a cousin to cancer and I said that's something I wouldn't want to go through.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Right, exactly.
[CUSTOMER][POSITIVE] But it feels OK. I feel OK.
[AGENT][NEUTRAL] OK, good. Did you have it, uh, the old way or the robotic way? They're doing it so many different ways.
[CUSTOMER][NEUTRAL] Uh, they had, he had to go through the abdominal, total, had to go through and open up because they had to make sure that there was nothing had spread it, was it contained and all that. So he, he wasn't sure until he actually did the surgery. He said, I don't know if there's cancer in there or not. I don't know. But it's when they did the surgery and they found out that it was, he stages at stage 1A, so.
[AGENT][POSITIVE] Got it. Yeah. Got it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK. All right. Well, I'm glad that you're feeling good.
[AGENT][NEUTRAL] Um, so under, under your policy.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] There is an ovarian cervical cancer screening benefit under here.
[AGENT][NEUTRAL] Um, and I think
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And they would have to, did they do like a screening? I'm thinking they, I know they.
[CUSTOMER][POSITIVE] Well, he did well.
[CUSTOMER][NEUTRAL] He did all of that. What they did, they, they tested everything when I was in surgery. That's how he knew. He, he wouldn't have known until he opened my abdominal area up and checked my ovaries. It was in my right ovary. And so it was on that time when he tested it. He said he'll have to test and see and send it to a pathology lab in the mid middle of surgery, and that's when he found it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. And so, since it was a positive diagnosis, those itemized bills can be reviewed.
[AGENT][NEUTRAL] Like the surgeon's bill, um, the hospital bill.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's so, yeah. OK. OK, I have a, I have that, yeah, I have a whole bunch of those.
[AGENT][NEUTRAL] Mhm. The anesthesiologist bill.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, I can download them from my account and upload them. I just wasn't sure. I'm like, I don't even know and I didn't realize I had this until I was going over my business. I said, well, at least I did have this as a part of my benefits when I returned back to work. I was going through all of my stuff, so I wasn't sure. That's why I said let me just call and just see because I had been off work.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Exactly, right.
[AGENT][NEUTRAL] Right now, um, because you're gonna be sending, sending that documentation in yourself, I'm gonna email you a cancer claim form and it's just basically capturing your demographic information, your name, your mailing address and all of that. And then, um, on page one, it will tell you, uh, based on what type of service was provided, what documents we, we need, and I pretty much told you that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK. OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We will need the the pathology report when they first or the uh the initial diagnosis.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you can get, OK. And then page one, as you go through it, you'll see it'll tell you dependent upon what, what you had done. So for instance, like a surgery, it'll tell you what documents we need, um, and then you would just send all of it in together.
[CUSTOMER][NEUTRAL] OK, I have all of that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] And so let me email you the claim form because I wanna make sure that you do get it.
[AGENT][NEUTRAL] And I'm gonna send it to the email that you verified.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] I'm gonna go ahead and download it from my chart.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I think it is a lot of paper and so much stuff.
[AGENT][NEUTRAL] What's your, what's your policy? You can download your email too. I mean your uh policy.
[CUSTOMER][POSITIVE] Yeah, I got, I got the policy. Yeah, I got a copy I'm gonna download and and put it in my stuff for my benefits stuff, but I'm logging into my medical account and downloading all that information. Yeah, they, they do a good thing, good thing, uh, UT Southwestern has a, a good portal where you all your stuff is available.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah. And.
[AGENT][NEUTRAL] Oh OK, got you.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] So, I'm gonna download everything and have it where I can just upload it quickly.
[AGENT][NEUTRAL] Right? And so I'm sending this to [PII], right?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. I just emailed that over to you.
[CUSTOMER][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] And then make sure you put your claim number, it's gonna ask for it I think when you sign it at the bottom of one of the pages, it'll ask you to put your policy number somewhere down there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect, got it. OK, I got it.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, well, I will work on getting this filled out and uh upload it and go from there.
[AGENT][NEUTRAL] All right, [PII], did you have any other questions?
[CUSTOMER][POSITIVE] No, you really helped me and that's what I needed. I said let me call because I'm online and I'm just confused as I can be.
[AGENT][POSITIVE] All right. So if you don't have any other questions, thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. You too. Thank you. Bye-bye.
[AGENT][NEUTRAL] Uh, bye-bye.