AccountId: 011433970860
ContactId: 089bd865-7a8f-4938-adbc-97404b68f1e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 320290 ms
Total Talk Time (AGENT): 189201 ms
Total Talk Time (CUSTOMER): 122180 ms
Interruptions: 3
Overall Sentiment: AGENT=1.3, CUSTOMER=2.4
Redaction Types: PII
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] with the care team. How are you doing today?
[AGENT][POSITIVE] I'm just fine, thank you.
[CUSTOMER][POSITIVE] Good. I'm glad to hear that. Hey, I have a quick question about a cancer policy. Um, if you could help me out with that?
[AGENT][NEUTRAL] I sure can. Do you have a policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, policy number is 1300961.
[AGENT][NEUTRAL] I'm sorry, what was that number again?
[CUSTOMER][NEUTRAL] Oh, I'm so sorry, 1300961.
[AGENT][NEUTRAL] OK, give me one minute and let me look that up for you.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] On [PII]
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me get that policy pulled up.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] OK, I have it pulled up. And what is your question?
[CUSTOMER][NEUTRAL] Um, as far as her chemo benefits, it restarts not on the calendar year but from the cycle date of when it was first started, um, and I was wondering, I, I'm wondering, besides going through every single claim and looking for the first one because I've been doing that for a little bit now and I'm not getting anywhere, um, is there a quicker way to see when that started last year so she knows when it resets for [PII]?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh yes. OK. When you go to CLA HQ.
[CUSTOMER][NEUTRAL] See, oh my gosh, I use that with dental all the time, but I never use it for any of the other policies.
[AGENT][POSITIVE] Yeah, you can use it for this here.
[AGENT][NEUTRAL] And one way you can go, you find it under CLAHQ and you would, now, it's chemo, radiation and immunotherapy. So it's all three of those combined. They're not gonna be separate.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Does it, is it all under the benefit name chemo 12M? Is it like the benefit?
[AGENT][NEUTRAL] No, some of them would be, um, it could be under radiation or it could be under chemo. So the easiest way for you to do.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] is you can either go through all of them and see if there's any other radiation benefits paid out because the policy will pay a maximum amount per um period of with the, which is radiation chemo immuntherapy benefit.
[AGENT][NEUTRAL] You know, they're not gonna be separate benefits. So, if they had radiation, that benefit is going to be called a uh I think it's R A D I A T and we have a number underneath it. So, that's one way you can look, but you'll have to go through every one of them to see if they had chemo radiation. Um but another way you can do is, you see where they had that last chemo benefit paid?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, which on which one are you on the CLA HQ again?
[AGENT][NEUTRAL] 2, C L A H Q.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And that policy number.
[CUSTOMER][NEUTRAL] So I see that last one from 1724.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you see, um, they're on that first page.
[AGENT][NEUTRAL] You have a data service [PII], and you have chemo 12M.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Take that, go to, and then go to your other screen, another line, type in EOBI.
[AGENT][NEUTRAL] Oh, I'm sorry, EOB and Type in E O B N T in the action field.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And take that claim number where that last chemo benefit either was denied or paid.
[CUSTOMER][POSITIVE] Oh my gosh, and it's right in the notes.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, it's supposed to be, not always, so you might want to go look at the one, you know, there, you know, there may be another claim number that [PII] was, but they're supposed to put under EOBNT to let the insured know that benefit period.
[CUSTOMER][POSITIVE] OK, thank you. That helped me so, so much because I was literally opening every claim on the M track and hitting all the lines and trying to check all the dates and I was like there's gotta be a fast way.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] And you always I use that CLA HQ a lot and then you could find the claim number and then go to your you know EOBOI pull the claim number or whatever, you know, that real this CLA HQ really helps a lot but now on this one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, it will start over on [PII], I mean [PII].
[CUSTOMER][POSITIVE] OK perfect so I will let her know because she wants to know when it restarts and um perfect I.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] I see that here and I really appreciate it. I, that's gonna save me so much time in my whole future.
[AGENT][POSITIVE] Oh, my pleasure.
[AGENT][POSITIVE] Yes, it does.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][POSITIVE] Glad you called in it.
[CUSTOMER][POSITIVE] Me too, it was getting really gruesome, so thank you so much.
[AGENT][NEUTRAL] Yeah it was, I know.
[AGENT][NEUTRAL] Anything else I can help you with, [PII]?
[CUSTOMER][POSITIVE] No, that's all I need today. Thank you so much. You're a lifesaver.
[AGENT][POSITIVE] OK. You're welcome, [PII]. Thank you. You have a good day. Goodbye.
[CUSTOMER][POSITIVE] Take care.
[CUSTOMER][NEUTRAL] You too. Bye.