AccountId: 011433970860
ContactId: 14c4d7fe-8bca-48d9-856d-59e86ef111ed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 772059 ms
Total Talk Time (AGENT): 289361 ms
Total Talk Time (CUSTOMER): 418684 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/14c4d7fe-8bca-48d9-856d-59e86ef111ed_20250123T18:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Hi, [PII]. This is [PII], and I have lost my book. I have lost everything.
[CUSTOMER][NEUTRAL] Uh, I have a policy that is so old. It's, are y'all still with American Public Cancer Insurance?
[AGENT][POSITIVE] Yeah, so if you've had a policy with like American public life, yeah, I mean it should still, yeah, absolutely.
[CUSTOMER][NEUTRAL] Yeah, OK, now you said your name was what?
[AGENT][NEUTRAL] My name is [PII]. That's OK. My name is [PII]. Uh-huh.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK. I'm just trying to write everything down. OK. I need some help with this. I have had uh lung dermatology put in two different requests for a claim.
[CUSTOMER][NEGATIVE] And I don't know if they sent it to the right place. They said they've heard nothing back from it.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So I need to see if you still have me, you know, I, it's still taking money out of my checking account of $82 and something a month.
[CUSTOMER][POSITIVE] But I wanna make sure that we're all on the same page here.
[AGENT][POSITIVE] Yeah, absolutely. Do you by chance have your policy number?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEGATIVE] I don't have anything. I cannot find the book. I cannot find the paperwork that I even took to the dermatologist.
[CUSTOMER][NEUTRAL] Um, I don't know how we can start looking something up except for you to go by my name.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Yeah we can do a search by name or social so if you wanna give me your uh first and last name.
[CUSTOMER][NEUTRAL] OK, let's do the social. Let's do the social [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you so much. Let me just uh put this in here, do a search, one moment.
[CUSTOMER][NEUTRAL] I hope you're working from home, or do you have snow where you are?
[AGENT][NEUTRAL] Um, you know what, I'm in [PII]. We don't have any snow right now. It's just cold, so.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Well, we had, how many inches did we inches, [PII]?
[CUSTOMER][NEUTRAL] No, we had more than that. Oh, he's, oh, OK. My family lives in [PII], and they had almost 8 inches of snow, but we're in, yeah, we're in [PII], and he says we had 2.5 inches.
[AGENT][NEUTRAL] Oh yeah, that was.
[AGENT][NEUTRAL] Yeah, no, that floor.
[CUSTOMER][NEUTRAL] But the roads are so, you know, nobody knows how to drive in this weather and everybody.
[CUSTOMER][NEUTRAL] bumping into each other and everything else.
[CUSTOMER][NEUTRAL] So we're staying in.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah. All right, [PII], let me just verify your date of birth and then address, please.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm old.
[AGENT][NEUTRAL] Thank, no, thank you. And then let me just get the uh address we should have on file for you.
[CUSTOMER][NEUTRAL] My address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So let me take a look under claims and see what I see here. One second.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I do see a claim on here.
[AGENT][NEUTRAL] It was, it's submitted it looks like back in November.
[AGENT][NEUTRAL] Um, and it is actually from Lane dermatology.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] So we had requested.
[AGENT][NEUTRAL] That we needed an explanation of benefits from our primary.
[AGENT][NEUTRAL] And so,
[CUSTOMER][NEUTRAL] Now why would you need an explanation of benefits from a primary?
[AGENT][NEUTRAL] Well it looks like on a couple of these things that were billed they were requesting that to see what the primary had paid.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] So we did get the claim, I mean.
[CUSTOMER][NEUTRAL] Now, wouldn't the prim, are you talking the, the primary would be the dermatologist or my primary doctor?
[AGENT][NEUTRAL] Your primary insurance.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Oh, I understand now you wanted to see if my regular.
[CUSTOMER][NEUTRAL] UnitedHealthcare or whatever paid anything on it.
[AGENT][NEUTRAL] Mhm. So.
[CUSTOMER][NEUTRAL] I don't, I don't think I did any, oh, so.
[CUSTOMER][NEUTRAL] Uh, lane dermatologist should have that information.
[CUSTOMER][NEUTRAL] Not me.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah, well, so what I was gonna say was there should have been some communication sent to them.
[AGENT][NEUTRAL] In regards to that, requesting the information. So,
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] Because there was a claim submitted. I'm not sure why they're saying they haven't heard anything from us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Maybe because they didn't want to look it up because they're too lazy.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So really, it's not denied or, I mean, it's just, you know, at this point, like kind of in
[CUSTOMER][NEUTRAL] It's just sitting there.
[AGENT][NEUTRAL] Pretty much. I mean, for lack of better words, yeah, um, cause it just needs some additional information. Um, they're of course more than welcome to contact us and we can of course relay that information and give them whatever they need in regards to the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so you have that information of how much my regular insurance paid?
[AGENT][NEGATIVE] No, we do not. Mm mm, no.
[CUSTOMER][NEUTRAL] On the claim?
[CUSTOMER][NEUTRAL] OK, so if that's what they need.
[CUSTOMER][NEUTRAL] How do I get that information?
[AGENT][NEUTRAL] Well, you should be able to go to United Healthcare if that's who your primary insurance is, and just um either uh request the explanation of benefits from that date of service, and they can give that to you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I should be able to do that online. I should be able to.
[AGENT][NEUTRAL] You should be able to too. I just, yeah, I didn't know if some people don't, you know, really mess with that online stuff so but yeah if you have like an online portal that'll have all that information in there too.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] OK, through lane, it should be something through lane dermatology.
[CUSTOMER][NEUTRAL] No, it would be through United Healthcare.
[AGENT][NEUTRAL] It would be the United Healthcare explanation of benefits.
[CUSTOMER][NEUTRAL] OK, that's who I should go to online.
[AGENT][NEUTRAL] 4 lane dirt.
[AGENT][NEUTRAL] Right, 4 lane.
[CUSTOMER][NEUTRAL] For 4 lane, OK.
[AGENT][NEUTRAL] Lane, yeah.
[CUSTOMER][NEUTRAL] All right, then I would need to take that to lane and say, here, this is what you need.
[CUSTOMER][NEUTRAL] To complete.
[AGENT][NEUTRAL] Or you
[AGENT][NEUTRAL] Yeah, or it could just be submitted to us because we have the claim just don't have all the information to finalize processing the claim.
[CUSTOMER][NEUTRAL] OK. Well, if you had an hour, I'd get on this computer and see what I can do. But
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Or I could call you back, which is impossible. [PII], I found it, I found it.
[AGENT][NEUTRAL] Yeah, I mean, honestly, the easiest way is just to, it would be honestly to contact my dermatology. I can give you the claim number and tell them, hey, my secondary insurance, American Public Life, they have this claim on file, they need this information, and they should be able to submit it on your behalf also, but I get if you want to just go ahead and take care of it yourself.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK, is there.
[CUSTOMER][NEUTRAL] I in an American public or whatever number that's my number that you could give me to put down in my little red book. So I since I've lost, I don't know where it is. [PII] said, Well, who could find it in here, but I've got everything in 3 piles now and that book, it's, I have an insurance box that has all of our policies and it is not in there.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And you know, it's like the dog came in here and ate it and we don't have a dog.
[CUSTOMER][NEGATIVE] So I don't know. It's just so confusing and upsetting when something like this happens. All right. Is there a number, my number that you can give me so I can put it in my little red book.
[AGENT][POSITIVE] Yeah, absolutely. Let me know when you're ready.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK, so your policy number is 880.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 044.
[CUSTOMER][POSITIVE] Oh, that's so easy.
[AGENT][NEUTRAL] It is, you've had a
[CUSTOMER][NEUTRAL] I thought it's gonna be 10 numbers long.
[AGENT][NEUTRAL] No, you've had it a while, so it's pretty short.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh yeah, I've paid you thousands of dollars.
[AGENT][NEUTRAL] Oh, yep, that was, that's all.
[CUSTOMER][NEGATIVE] And my only regret, I have a regret. This was done when I was very young and innocent.
[CUSTOMER][NEUTRAL] And in fact, I had not even been teaching probably 6 years and I retired and when did I retire in [PII]. So, you know, again, you already know how old I am, but
[CUSTOMER][POSITIVE] I've had, I changed over from an American family life. The girl was so good.
[CUSTOMER][POSITIVE] That when she came to talk to us at school, she was a fabulous sales lady, and she talked a bunch of us into going with your company.
[CUSTOMER][NEGATIVE] And I lost out on the best insurance policy I could have ever had.
[AGENT][NEUTRAL] Um, I'm sorry.
[CUSTOMER][NEGATIVE] And it's very sad.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] But once you drop that American, I mean, um American family life policy, too bad, it's gone.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] And I couldn't go back and redo it. So instead of $20 a month, all these years, I'm paying $87 a month or whatever it is. Isn't that awful that I did that? I'm just so depressed within myself that I was so stupid.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm sorry. Yeah.
[AGENT][NEUTRAL] Should have would have could have, right?
[CUSTOMER][POSITIVE] Yeah, yeah, but y'all have paid off a couple of times for me, so.
[CUSTOMER][NEUTRAL] Even for cancer. So, anyway.
[AGENT][POSITIVE] Well, I'm glad glad to hear that. Did you have any other questions or concerns?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] No, [PII], I know you've got another bunch of whiny people to talk to.
[CUSTOMER][NEUTRAL] So thank you for my policy number and I have this correct phone number so I will see what I, I'm going to see them tomorrow roads permitting so that's why I'm doing this today is to try to get something straightened out in person tomorrow.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Right, right. OK.
[CUSTOMER][POSITIVE] So thank you for this information. I just really appreciate you being there.
[AGENT][POSITIVE] Not a problem.
[AGENT][POSITIVE] My pleasure. You have a blessed day.
[CUSTOMER][POSITIVE] You too. Take care, dear. All right, bye bye.
[AGENT][NEUTRAL] Uh, uh-huh. Bye-bye.