AccountId: 011433970860
ContactId: 0ee6b495-aaf4-46de-bfa8-dd2e55b50d87
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 679799 ms
Total Talk Time (AGENT): 410655 ms
Total Talk Time (CUSTOMER): 255822 ms
Interruptions: 5
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/0ee6b495-aaf4-46de-bfa8-dd2e55b50d87_20250205T15:52_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, uh, I was calling about a claim form I got from y'all.
[AGENT][NEUTRAL] OK, you received a claim form from APO and you have a question regarding it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes ma'am, uh, you need my number, my policy number?
[AGENT][NEUTRAL] Yes, well, I can help you with this. First off, who am I speaking with, please?
[CUSTOMER][POSITIVE] Above it's perfect.
[AGENT][NEUTRAL] I'm so sorry. What was the name again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, thank you. Mr. [PII], what is your good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And your policy number?
[CUSTOMER][NEUTRAL] 256-5030
[AGENT][NEUTRAL] 256-6030. Is that correct?
[CUSTOMER][NEUTRAL] Mhm. Yes, ma'am.
[AGENT][NEUTRAL] OK, thank you. So one moment while I get your information pulled up, Mr. [PII]. Once I do.
[AGENT][NEUTRAL] I will have to verify several things with you first for security and also any information that is provided would be a verification of benefits and not a guarantee of payment. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Your phone number on file is the same as the one you gave me, so that is the best number that we should have, is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, thank you. And what is your email address because I do need to add that, Mr. [PII].
[CUSTOMER][NEUTRAL] Uh, it's the [PII].
[AGENT][NEUTRAL] I'm so sorry. I didn't understand that. Can you say that again?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so it was, uh-huh, and then your last name. Mhm.
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mm [PII]
[CUSTOMER][NEUTRAL] That [PII]. I mean, let's do it again, it's [PII], then [PII] last [PII] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And what's after [PII]?
[CUSTOMER][NEUTRAL] talk about [PII]. [PII] [PII] [PII].
[AGENT][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so I have got that added, OK.
[AGENT][NEUTRAL] Alright, so now the reason I added your email, uh, Mr. [PII], it said that you'll have the ability now to be able to set up your profile in our online service center portal.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] And that will give you access to all of your policy information. You can actually upload claims information directly into the portal from a computer. Now I will email you the user guide on how to set up your profile and uh then if you have any questions, you know, when you go to do that, excuse me, you could call us back and we'll be more than happy to help you. So how can I help you today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now
[CUSTOMER][NEUTRAL] I'm filling out my claim form now. What do I need to send in with it.
[AGENT][NEUTRAL] This is a cancer claim form?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, on page one of the claim form.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] It should have all of the instructions for completing the form, Mr. [PII], as well as all of, you know, the documentation that you would need to also submit.
[CUSTOMER][NEUTRAL] Yeah, I see it.
[CUSTOMER][NEUTRAL] OK. I don't know what the what the therapy, let's see, uh, medical bill. OK, I got that. Uh.
[CUSTOMER][NEGATIVE] I don't have ways nothing like that. Travel and login expenses. Now what page would be the travel and login expenses be on?
[AGENT][NEUTRAL] Let me pull up that claim form so I can look at it with you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Cause I got 44, 20 4.
[CUSTOMER][NEUTRAL] That's all I see.
[CUSTOMER][NEUTRAL] And 104 and 404 and.
[CUSTOMER][NEUTRAL] 2 or 4, trying to find 3.
[CUSTOMER][NEUTRAL] I don't see 3, where?
[AGENT][NEGATIVE] Page 3 is, it says cancer claim form and it starts with section D and it's a lot of wording.
[CUSTOMER][NEUTRAL] So I got it over here.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] It's just a lot of
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you say that?
[AGENT][NEUTRAL] So section D claim form fraud statements.
[CUSTOMER][NEUTRAL] I'm looking for claim.
[CUSTOMER][NEUTRAL] I don't see that one I just see I got uh 2 or 4 when I printed it out 4 or 4 and 10 4.
[CUSTOMER][NEUTRAL] I don't see 3 nowhere.
[AGENT][NEUTRAL] OK, and did
[AGENT][NEUTRAL] Did you, OK, and did you print that form from our website at [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. I'm probably left it at home.
[CUSTOMER][NEUTRAL] Well, I'll get back on it.
[AGENT][NEUTRAL] Yes, so it, OK, so it should have, yes, sir. I mean if you downloaded it and printed it from our website, it should have printed that page 3 of 3, I mean excuse me, 3 of 4.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, I don't think it did.
[CUSTOMER][NEUTRAL] Let me see, hold up.
[CUSTOMER][NEUTRAL] Probably daily so I can't find it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, what all does it cover?
[CUSTOMER][NEUTRAL] Hold up, let me see what this is. No, that's not it.
[CUSTOMER][NEUTRAL] The all does this cover, man.
[AGENT][NEUTRAL] OK. Have you been, OK. Has there been a positive, are you following for a cancer diagnosis?
[CUSTOMER][NEUTRAL] You already did that. Everything is done.
[AGENT][NEUTRAL] And that that's what you're going to be submitting your claim for is my question.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so just one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Now, once you set up your portal to, um, just so you're aware, Mr. [PII], you will also have a copy of all your policy information online. There's a full copy in your portal of your policy for you to review, um.
[CUSTOMER][NEUTRAL] do
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So give me just one moment.
[AGENT][NEUTRAL] And any information again that I do provide would be a verification of benefits and not a guarantee of payment. Excuse me, so you have multiple different types of benefits on this policy?
[AGENT][NEUTRAL] And they are listed under your schedule of benefits, which is several pages in length.
[AGENT][NEUTRAL] So you do have, mhm, go ahead.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Uh, so I got to go back home and finish print those out, I guess, OK.
[AGENT][POSITIVE] Yes, sir. I mean, I'll be happy to go over any specific questions you have. There's just a whole lot, there's a lot of benefits on your cancer policy depending on the service.
[CUSTOMER][NEUTRAL] So how does it work? That's all I kind of wanna know how does all that work.
[AGENT][NEUTRAL] OK, so once you have received a positive diagnosis of cancer, you would file your claims with us for the different services that are covered under your policy. In that portal, you can add in direct deposit information so that if we are able to pay benefits to you, Mr. [PII], they could be electronically deposited to you instead of a paper check having to be mailed.
[CUSTOMER][NEUTRAL] To the
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So you don't know how much it's gonna be?
[CUSTOMER][NEUTRAL] Offhand.
[AGENT][NEUTRAL] Well, you have a lump sum.
[AGENT][NEUTRAL] Internal, you have an internal cancer first occurrence lump sum benefit of $5000 which is a maximum of 1 per covered person per lifetime.
[AGENT][NEUTRAL] Now, are you having to receive
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Radiation, chemotherapy.
[CUSTOMER][NEUTRAL] Yeah, but radiation probably.
[AGENT][NEUTRAL] OK, so on your radiation therapy, chemotherapy, and immunotherapy, the maximum per covered person for a 12-month period is $20,000.
[CUSTOMER][NEUTRAL] yeah.
[CUSTOMER][NEUTRAL] How
[AGENT][NEUTRAL] That is the maximum that we would pay in a twelve-month period.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] So basically if I go for 9 weeks, how much would that be?
[AGENT][NEUTRAL] Well, I can't say that. We, we can't pay claims over the phone.
[CUSTOMER][NEUTRAL] OK then.
[AGENT][NEUTRAL] We would have to, we would just have to receive all of the required documentation for review, but that would be the.
[CUSTOMER][NEUTRAL] OK, what all documentation would you need?
[AGENT][NEUTRAL] Everything that's listed on that first page of that claim form.
[CUSTOMER][NEUTRAL] OK, I got all that.
[AGENT][NEUTRAL] Mhm. So again that can we cannot accept claims information, Mr. [PII] via email. So the most efficient way is to upload it to your portal once you set that up. You can also fax it to that secured fax line that's on the bottom of page one or mail it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, I saw that.
[CUSTOMER][NEUTRAL] And this is an APAO right? APO right.
[AGENT][POSITIVE] APL. Yes, so that is correct. Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, when I go back on my finish it then uh you said you gonna email me, what did you say you're gonna email me?
[AGENT][NEUTRAL] I'm gonna email you the user guide for the portal that so you can set up your profile. Now when you do upload your information, Mr. [PII], you will have to upload that uh from a computer. The portal does not currently support, you know, mobile uploads, but um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah, I got that uh.
[CUSTOMER][NEUTRAL] No, that's so, uh, is all my information that I have from my doctor may be uploaded and sent straight to y'all directly.
[AGENT][POSITIVE] Yes sir and this user guide that I'm gonna send you will tell you like the maximum size of the files that can be uploaded so you if it's a whole lot of information and exceeds that you would just do multiple uploads and you will instantly get a confirmation letting you know that we received it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And would be in line for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now, what about like when I went to see this.
[CUSTOMER][NEGATIVE] I had to pay $500 down and then have to pay $102 a month in payment plans because when I went near my box, it was $2000.
[AGENT][NEUTRAL] OK, I'm sorry, I didn't unders.
[CUSTOMER][NEUTRAL] I got that information receipt.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, when I went to do my biopsy, it was $2000 so I pay $500 down, then they got me paying $102 a month for till August. Do I need to send that in with it too?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can go ahead and send anything that you have as far as what the, you will just make sure that you have your itemized bills for your data to service that you're submitting for. Again, the easiest way instead of you trying to write a lot of things down is to just use that first page to check, you know, to check off what we're needing and as you gather your information.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] OK then.
[CUSTOMER][POSITIVE] Alright then appreciate you ma'am. I'll get that out to you uh tonight when I get out of work.
[AGENT][NEUTRAL] OK. Well.
[AGENT][NEUTRAL] All right. OK, and, um, the email just so that you're aware of who it's coming from and recognize it as not being junk or spam mail. That email is gonna come from [PII]. Uh-huh, and I will put APL in your subject line for you.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Caine good, OK.
[CUSTOMER][POSITIVE] Alright thank you ma'am.
[AGENT][POSITIVE] Well, you're certainly very welcome. So if that's all I can help you with at the moment, Mr. [PII], thank you again for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] Uh, so this is ERP AP cancer insurance, right? OK, thank you.
[AGENT][NEUTRAL] [PII], yes sir.
[CUSTOMER][POSITIVE] [PII]. OK, thank you.
[AGENT][POSITIVE] Uh-huh. You're welcome.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] OK.