AccountId: 011433970860
ContactId: 12a656b7-85c9-45ce-83b0-51746a011055
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 388779 ms
Total Talk Time (AGENT): 107905 ms
Total Talk Time (CUSTOMER): 135957 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/12a656b7-85c9-45ce-83b0-51746a011055_20250127T20:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yes, [PII]. I was wondering, could you explain to me, um, how, um,
[CUSTOMER][NEUTRAL] The preexisting condition or or the exclusion period how that works for new members.
[AGENT][NEUTRAL] Yeah, absolutely. I would just need to look at your policy. Uh, do you have a policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, I, my, uh,
[CUSTOMER][NEUTRAL] The people in my benefits, they gave me a group number.
[AGENT][NEUTRAL] Alright, let's take a look at that. What's the group number?
[CUSTOMER][NEUTRAL] OK, it's 18296.
[AGENT][NEUTRAL] OK, is it something that you're just thinking about signing up for?
[CUSTOMER][NEUTRAL] No, I just recently signed up for it and I um.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I just was trying to get more information.
[AGENT][NEUTRAL] I got you. OK, give me just a sec, let me put this in. What is your first and last name?
[CUSTOMER][NEUTRAL] Um, it's [PII] and the last name is [PII]
[AGENT][NEUTRAL] OK, thank you, [PII]. Let me see.
[AGENT][NEUTRAL] I'm just looking for your policy, sorry for the hold here.
[CUSTOMER][NEUTRAL] No, you're fine.
[AGENT][NEUTRAL] All right. I got your policy here, [PII]. Can I just have your date of birth, please, and then address that we would have on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, date of birth is, uh, [PII], and the address is uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you so much. And let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, let me.
[AGENT][NEUTRAL] Uh, limitations and exclusions on this. Let me see what we got.
[AGENT][NEUTRAL] OK, so it looks like there is a preexisting condition, um, which is, it looks like the exclusion period is 12 months.
[AGENT][NEUTRAL] So, they define that as a specified disease, heart attack, or stroke, or internal cancer for which medical advice or treatment was recommended or received by the member. So if any of that was applicable within the last 12 months, then that would be considered pre-existing and wouldn't be covered under the plan. Does that make sense?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It does. So I guess let me just tell you the situation. Um, my, uh, my, I had a primary care visit, uh, last, uh, like in December, um, and she said that my white blood count level was high and so she referred me to, um,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She said it's a hepatologist, but it's at an oncology doctor. So,
[AGENT][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Um, I haven't had that appointment yet, but she's suggesting that I
[CUSTOMER][NEUTRAL] That I go there for that appointment and so.
[CUSTOMER][NEUTRAL] Um, there's not been any diagnosis of any kind or treatment thought or anything like that up until now.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] And they might not even say, I mean, I'm, I could, hopefully I'm completely.
[CUSTOMER][NEUTRAL] Just jumping the gun, but um
[CUSTOMER][NEUTRAL] I, I guess I'm just trying to find out is, you know, if I go to this appointment.
[CUSTOMER][NEUTRAL] And they do say that there is some kind of cancer.
[CUSTOMER][NEUTRAL] Is that like covered or you have to pay for it for 12 months before you ever even qualify?
[AGENT][NEUTRAL] Yeah, you would have to have the plan for 12 months before you even like qualify.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, that's what I.
[AGENT][NEUTRAL] Did you need me to check on anything else for you, [PII]?
[CUSTOMER][NEUTRAL] Um, no, I don't think so.
[AGENT][POSITIVE] All right. Well, if you have any other questions or concerns, feel free to call us. We're always happy to help.
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] You're welcome. Take care.
[CUSTOMER][NEUTRAL] Uh bye bye.