AccountId: 011433970860
ContactId: 0f01ba1f-e2eb-4ce0-a668-5b9fa52e50e3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 622380 ms
Total Talk Time (AGENT): 321699 ms
Total Talk Time (CUSTOMER): 285787 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/12/0f01ba1f-e2eb-4ce0-a668-5b9fa52e50e3_20250612T16:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, [PII]
[CUSTOMER][NEGATIVE] Uh, uh, hi, my name is [PII], and I need some info on our family plan with you guys. Um, I need to know what we got and what can we use it for because it's this big booklet just not helping me.
[AGENT][NEUTRAL] Oh sure, OK, so we just need help identifying what kind of policy this is and then those covered benefits.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, sure, yeah I can take a look at that um first if you don't mind, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, my number is [PII] and my name is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] I'll give you my name [PII]. mhm.
[AGENT][NEUTRAL] OK, yes, thank you. And then do you have that policy number?
[CUSTOMER][NEUTRAL] Uh, let's see, 01.
[CUSTOMER][NEUTRAL] 223689
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Alright, and then, uh, let's see, [PII], can I get a, uh, um, excuse me, I'm just gonna verify some information really quick. Uh, can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And this is in [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address we've got on file for you. uh, looks like it is a [PII] account.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] OK, thank you so much for verifying all of that. OK, so this policy is a cancer policy. Um, so let me get that policy pulled up. Most everything that you see, you did say you have a copy of the policy, correct?
[CUSTOMER][NEUTRAL] Yeah, I have a copy, but it's so thick. I just can't break it down.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I understand, yes, there's quite a bit in there. So, um, in short, most everything that would be covered is going to be in response to a positive diagnosis of cancer. Um, however, I'm going to get that policy pulled up because sometimes there are other coverages in these policies as well. So give me just a moment, let me take a look.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, most of the policy is going to be um like definitions and such however let's see on page.
[AGENT][NEUTRAL] Oh goodness, are you looking at a uh physical copy or are you looking at an electronic copy?
[CUSTOMER][NEUTRAL] I'm looking at a physical copy.
[AGENT][NEUTRAL] Physical, OK, so I believe that would be page 23, although it won't say that on the bottom, um it was a page that says schedule of benefits um so closer to about the middle or the back.
[CUSTOMER][NEUTRAL] Hold on.
[CUSTOMER][NEUTRAL] Hold on 2.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 18, where they stop having page numbers.
[AGENT][NEUTRAL] I think it's right after the 19th um but it's the 23rd page OK you see where it says yes OK so those pages that's going to be your best friend that's it just um.
[CUSTOMER][POSITIVE] OK, I got it schedule benefits.
[AGENT][NEUTRAL] Simple, clear cut and dry, the benefit name dollar amount, and then the frequencies. The rest of the policy again is going to be more definition. So if you're like, you know, what about the anesthesia benefit you could go back and reference that more in depth. Um, so all of this again is going to be regarding a positive diagnosis of cancer. The only thing, and this is what I'm looking for. OK, so on the, I believe that's the 3rd page of this, it's letter Z.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and that's the diagnostic and prevention benefit. So that benefit does not have to have, of course, a positive diagnosis of cancer. It's going to be like, um, mammograms, colonoscopies, um, Pap smears, things like that. Uh, one calendar or one per calendar year, uh, that's a $45 benefit if you get those.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then if it requires a follow up, um, and that's a separate benefit as well. So everything else under this policy, I don't see anything additional. So yeah, everything else is going to be in regard to uh cancer treatment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, what if, um.
[CUSTOMER][NEUTRAL] Well, this is a family uh policy. If they don't know, they think it might be and we have to go through all these steps, nothing will can be applied to any of that.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Correct. Until there is a positive diagnosis. Yes. So if a um biopsy is performed or if they get a positive diagnosis of cancer, right from that point, you would send that information to us, um, and then you can begin to file claims from that point.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, uh, OK, uh, this is not the policy if you're off work because of going back and forth, they don't pay you for each day that you're off from work, right? or having surgery.
[AGENT][NEUTRAL] No, no, you mean like a disability policy?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] No this isn't anything like that and I did look just for good measure uh and this is the only policy you have with us so if you have anything like that I would get with your um employer uh to see if um.
[AGENT][NEUTRAL] There was anything else offered by maybe a different company.
[CUSTOMER][NEUTRAL] OK, so all I have with y'all is the dental and the uh critical illness, and uh that's it.
[AGENT][NEUTRAL] No, ma'am. So the, this is the only policy you have with us is this cancer policy.
[CUSTOMER][NEUTRAL] OK, I'm showing dental too, so I need to call and find out about that.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, you did y'all have cards with this?
[AGENT][NEUTRAL] I'm sorry, what was that?
[CUSTOMER][NEUTRAL] No, no ID card. No ID cards so.
[AGENT][NEGATIVE] Oh no, not, no ma'am, not for this kind of policy.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][POSITIVE] Alrighty, uh, yeah, mhm.
[CUSTOMER][NEUTRAL] Alright, I was just trying to clarify.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] Mhm. What's going on here and uh what can I use in case?
[CUSTOMER][POSITIVE] But I will keep your number if anything pop up we'll be calling you back.
[AGENT][POSITIVE] Oh absolutely.
[AGENT][NEUTRAL] Definitely yes if you have any questions or need help with anything, did you have any other questions for me at the moment? I know it's pretty confusing.
[CUSTOMER][NEUTRAL] Now, uh, you, you, you said if I go back diagnostic, uh, like mammograms and stuff like that, y'all cover $45 per year.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] That's correct, um, and there is no timely filing limit, so I'm showing this policy has been active since [PII], so anything from that point, uh, if you've not filed, you are absolutely more than welcome to get those filed and we'll honor those claims.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Really? Oh, well, I've been several times for mammograms and pap smears and stuff, so I would have to get my physician to get a record and send it to y'all. Um, now, I have uh another insurance.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Sure, yeah.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And when I worked and I don't know if you raise one or the other. I don't know how you do that.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] No, no, no, no, you're fine. Uh, so this policy will pay those set dollar amounts that you see on those pages regardless of any other insurance that you have.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh, so if, what if the other insurance, you know, it's something extra.
[AGENT][POSITIVE] If it's paid in full, that's perfectly fine, that is perfectly fine we'll still pay this amount.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Like who who on me and you? Uh-huh. So this is, this is your policy with uh if something happened to you with a pay, take care, pay, pay me out for you. Oh no, this is different this is different. OK uh well that's what I wanted to know uh too if I had another policy uh and they would pay out for my going to see the doctor, yours would pay out too, right? It's all depending on the other policies she don't know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] For going to see the doctor, um, it would be those diagnostic and prevention benefits are the only ones that would be covered, um, outside of a positive diagnosis of cancer. So again, if you were to go to get any sort of those, uh, diagnostic tests, um, then that's what this would pay.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, you got something else. This is just a, a cancel plan. Uh-huh. OK. You said it come out of your no, this, yeah, it comes out, but it's through your company. Quantic. Do you know, uh, what company it is coming through? Is this, um.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] I am showing that you are the policy holder for this account and it was through um I think Concordia Parish Schools.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Oh really? Oh, I didn't know, I didn't know this came through the school system. I thought it was, uh, with my husband and stuff. See that's why I need to call. I don't know where my insurance coming from.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, no, you're perfectly fine. Yeah, it's a lot to keep up with.
[CUSTOMER][NEUTRAL] OK, is my husband on this? That's what I need to know.
[AGENT][NEUTRAL] Yes, ma'am, um, [PII], yes.
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, it's not just for me. He can, he, if he has a treatment, OK, uh, uh, we could take care of him.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Yes, he's eligible for these benefits as well, yes, and any, um, same with the diagnostic and prevention. So if we were to get any tests like a colonoscopy or anything, uh, you can file those claims for him as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK then, um, alright, um.
[CUSTOMER][NEUTRAL] That's what I need to know. Anything else, Mr. [PII]? All right, thank you so much. I need to call and check on the other, other thing. OK, bye bye.
[AGENT][POSITIVE] You are very welcome.
[AGENT][POSITIVE] Absolutely, yes, have a great rest of your day bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.