AccountId: 011433970860
ContactId: 0840fe1e-0e14-4cd3-a940-1959f6da03ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 514820 ms
Total Talk Time (AGENT): 136373 ms
Total Talk Time (CUSTOMER): 257985 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/0840fe1e-0e14-4cd3-a940-1959f6da03ba_20250610T16:48_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] I just wanted to get an update on uh a claim I filed. I don't know if it's gonna not pay anything or what, uh, so I just wanted to check that. What information do you need?
[AGENT][NEUTRAL] Uh, what is your name and the policy number, please?
[CUSTOMER][NEUTRAL] The policy number is 1591914 and my name is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] It was a wellness claim is what it was.
[CUSTOMER][NEUTRAL] But all of this says amount paid 0 so I don't know if it's just not.
[CUSTOMER][NEUTRAL] Eligible or what?
[AGENT][NEUTRAL] OK, and Ms. [PII], verify your date of birth, mailing address and email address for me, please.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][POSITIVE] OK, ma'am, thank you so much. Do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Pardon me?
[AGENT][NEUTRAL] Do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes [PII].
[AGENT][POSITIVE] OK, Ms. [PII], thank you so much. Hold on one moment for me.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But this for data service in [PII]?
[CUSTOMER][NEUTRAL] Some of them, I just, um, I had asked and I got an email back that it said there was no time frame because I had not filed any of this since [PII] on my wellness, like, on that wellness form, you could check um your physical and your bone density test and things like that.
[CUSTOMER][NEUTRAL] On the claim form.
[CUSTOMER][NEUTRAL] It's not anything to do with my cancer claim that I had in.
[CUSTOMER][NEUTRAL] Breast cancer.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I thought maybe I missed them and they told me there was no right time frame on file and so I went back and put the dates that
[CUSTOMER][NEUTRAL] Some of them that I could find.
[AGENT][NEUTRAL] Oh, let me see.
[AGENT][NEUTRAL] Let's
[AGENT][NEUTRAL] OK, because that policy number you gave me it didn't become effective until [PII], but you had a previous policy.
[AGENT][NEUTRAL] But um,
[CUSTOMER][POSITIVE] It was effective. It's just that I retired and I ported this from school.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So it was effective and it paid my cancer policy. I'm not questioning that one. This one was just a, a wellness claim form for it's got a place you could check bone density screening, uh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Um, metabolic lipid panels and routine physicals. I've had some more stuff done like, uh,
[CUSTOMER][NEUTRAL] Different stuff, but I just didn't go back and hunt all of it up.
[AGENT][NEUTRAL] Because it looks like some came in today. Were these the ones you submitted today through the online service center?
[CUSTOMER][NEUTRAL] I don't have to have a
[AGENT][NEUTRAL] Oh no it wasn't today, it was in May.
[CUSTOMER][NEUTRAL] No, yeah, I, I did this in at the end of May and that's why the girl had told me it would be 5 to 7 days. And so I thought I'd check on it.
[AGENT][NEUTRAL] Uh, looks like um.
[CUSTOMER][NEUTRAL] I mailed, I mailed the form on [PII], [PII], but I went in and added some more when she told me I did them online and I put in some more and some more dates when uh
[CUSTOMER][NEGATIVE] She told me that there was no time frame. And I, I had told her that I posted one like a biopsy of my breast and I'm not sure I shouldn't have put that one on there cause I'm not sure I didn't collect that one. And I said, will that be a problem? She said, no, they'll just deny it. So,
[AGENT][NEUTRAL] Yeah, cause it looks like the claims that came through, uh, there were some that came in on the [PII], they were processed today as not covered, non-covered uh cancer screenings.
[AGENT][NEUTRAL] Like a limping panel that's covered screening, cancer screening.
[CUSTOMER][NEUTRAL] OK, well, why?
[CUSTOMER][NEUTRAL] OK. Well, why on these, uh, wellness claim forms does it show bone density if that's not a cancer screening?
[AGENT][NEUTRAL] Because there are some other policies like some of our accident policies or health policies may have um those covered under our cancer policy, there is a specific screenings that are covered to detect cancer or internal cancer.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, this claim, this claim form is not very.
[CUSTOMER][NEGATIVE] Uh, it's not very playing for somebody.
[CUSTOMER][NEGATIVE] You know, that don't really know what we're doing here.
[CUSTOMER][NEUTRAL] But, uh,
[CUSTOMER][NEUTRAL] I just remembered that we got uh
[CUSTOMER][NEUTRAL] Pa, you know, when we did a mammogram and different stuff and the one of my insurance is the one that mentioned this to me that I ought to file it. But I guess he thought I.
[CUSTOMER][NEGATIVE] had something else too, I don't know. But I really don't appreciate them not letting me know what uh
[CUSTOMER][NEUTRAL] That it wasn't gonna pay or whatever. I've just sat here and wondered about it.
[AGENT][NEUTRAL] Well, they were just processed today, um.
[CUSTOMER][NEUTRAL] So,
[AGENT][NEUTRAL] So those explanation of benefits will go out tomorrow, but have you set up on our online service center. They do have it to where you can view your claim status. Um, I don't know if you recently did it, but our, uh, online service center has been updated, so you're more likely, if you just recently did it like within this week or.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] It should be fine, but if not,
[CUSTOMER][NEUTRAL] I did.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] OK, it says uh.
[CUSTOMER][NEUTRAL] They completed [PII]. Is that [PII]'s completion date or mine?
[AGENT][NEUTRAL] Uh, that's the date we processed today.
[CUSTOMER][NEUTRAL] Not
[CUSTOMER][NEUTRAL] OK, mine, mine all say [PII].
[CUSTOMER][NEUTRAL] They received [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so, so in other words, since they're all been processed and now paid, none of them are gonna pay anything, right?
[AGENT][NEUTRAL] And they were processed today.
[AGENT][NEUTRAL] No, ma'am. Uh, it looks like they were process is not covered cancer screenings.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][POSITIVE] Thank you very much for the help.
[AGENT][POSITIVE] Uh, yes, ma'am. Thank you for calling APL. Have a great rest of your day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Bye.