AccountId: 011433970860
ContactId: 15ad7e53-33d6-48db-9074-ea9d726d8fbf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1769489 ms
Total Talk Time (AGENT): 695820 ms
Total Talk Time (CUSTOMER): 874544 ms
Interruptions: 12
Overall Sentiment: AGENT=0.6, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/15ad7e53-33d6-48db-9074-ea9d726d8fbf_20250623T12:21_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Hey, [PII]. I have a cancer policy with you guys and I've been trying to file some claims, and I have just not, it hasn't worked out very well, OK? I tried to send the specific papers you need to get the uh lump sum initial cancer. And anyway, it just has not worked out. Let me tell you what I did get back. I got back a check for $443.46.
[CUSTOMER][NEUTRAL] And hold on, hold on, I have a reference number on that and of course a policy number and that's good and fine but.
[CUSTOMER][NEGATIVE] I still can't get the payment for the first initial cancer diagnosis and I know there's a lump sum payment.
[AGENT][NEUTRAL] OK, so you're the insured and you're just wanting to check on the information that we've received, essentially claim status to see why you haven't received the first occurrence benefit.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, ma'am. And, and I know.
[CUSTOMER][NEGATIVE] Yeah, and I know you have all the information because I got a little frustrated and I sent you it from the, from the day.
[CUSTOMER][NEUTRAL] That they suspected what it was. Up until the, after my mastectomy surgery, I sent you 70 something pages of information from the hospital. So I know you have the, the initial diagnosis cause they're the ones who did the initial diagnosis.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so what I need to do is I need to first pull up your policy information and verify some things with you and yes ma'am, I'll be happy to take a look at what we have and then we can go from there, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so first off, who am I speaking with?
[CUSTOMER][NEUTRAL] Alright, policy number?
[CUSTOMER][NEUTRAL] Oh, [PII]
[AGENT][POSITIVE] Thank you. And Miss [PII], what is a good callback number for you please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And then, yes, ma'am, now your policy number.
[CUSTOMER][NEUTRAL] 633189
[AGENT][POSITIVE] OK, thank you. Give me a couple of moments please to get your information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, Ms. [PII]. So first off, I'll need to verify several things with you for, for security and also any information that is provided would be a verification of benefits and not a guarantee of payment. So if you could first please verify your date of birth.
[CUSTOMER][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you, also your home mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that is on file for you, Ms. [PII] is different than the one you gave me. What is another number that we could have?
[CUSTOMER][NEUTRAL] Well, I can give you my husband's number, but he's he never answers his phone, but it's a good number. He just never answers the phone uh number I gave the number I gave you.
[AGENT][NEUTRAL] OK, I
[AGENT][NEUTRAL] I don't know if maybe this had been a landline.
[CUSTOMER][NEUTRAL] It could have was it a [PII] number maybe?
[AGENT][NEUTRAL] Yes, ma'am. What's that phone number?
[CUSTOMER][NEUTRAL] OK. That was the phone number we had for a year. My daughter is [PII] old and we got that number when she was in kindergarten, so she could remember it really well.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah, uh, yes, ma'am. What was that full number?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] I don't know it was a [PII], probably [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, [PII] that was the the old number, but now my uh the the number that all the business.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In my household is done on is the number we're talking on, which is the [PII].
[AGENT][NEUTRAL] OK, the [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] [PII], that's right. And now I can give you his number if you need it, you know.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] No, I don't, no, I don't need his. Uh, what is your email address, Ms. [PII]? Because I see we do not have an email on file for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, all lowercase [PII].
[AGENT][NEUTRAL] Alright, so just a moment, I'm just gonna repeat that back to you to make sure I heard you correctly. That's [PII].
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I've gotten your your phone number updated Ms. [PII] to [PII] and added your email address, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so let me look. I can see that we have, OK, so that claim that was recently processed in which you referred to that check, let me look at the comments I'll note on that one.
[AGENT][NEUTRAL] OK, so on [PII], Ms. [PII], and well, one last thing before I get into that, do you use the internet very much because we have a, I'm asking you that.
[CUSTOMER][NEUTRAL] Not a lot.
[AGENT][NEGATIVE] Not at all.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Not a lot.
[AGENT][POSITIVE] Oh, not a lot because we have a portal, Miss [PII] now that I would be happy to email you the user guide for how to set that up and use it because that would give you access.
[CUSTOMER][NEUTRAL] Uh, I'll be honest with you.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] I, I get all of that and I understand all that. And my husband has been disabled for 15 years and now I, now I need a knee replacement. I have cancer. He's in worse shape than ever before, all of that. And I say all that to say this, every single doctor has a portal.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And every single insurance company has a portal.
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEGATIVE] And I just can't cope with all of it.
[AGENT][NEUTRAL] I understand.
[CUSTOMER][NEUTRAL] OK, I'll just be, I'm just being totally honest. I have my cancer treatment people. I've done their portal, OK?
[CUSTOMER][NEGATIVE] But I just can't deal with all of these pools.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] I, I totally understand, Ms. [PII]. I really do. And, and I just wanted to make you aware that we have that, so that if you wanted to set it up that way you could log in and see your claim status before you receive your explanation of benefits in the mail. Um, you know, it would just give you access a little sooner to what the decisions have been or, you know, if we're missing information.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I got you. I, I understand.
[CUSTOMER][NEUTRAL] And I really do appreciate it and my daughter made fun of me this past weekend because I had an email account and I told her to shut up. I, I've had an email account almost as long as she's been alive.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I said we may not be totally into the 21st century, but we are well, you know, we all have inched on in there to securely in the 21st century anyway.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Right. So where are you gonna get by anyway? I get, I get that too. I, I totally do. OK, so you did receive an explanation of benefits along with your payment. Is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, and yes, ma'am, and I really, I, I really don't have an issue with this. Transportation costs and all that kind of thing is not uh it is not gonna come into play much until we get into the expenses for chemo, right? And I figured what I was gonna do and this is my, because I don't actually need, need the money in order to do chemo, OK? I'm gonna wait till the chemo is finished.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And then I'm gonna get all my EOBs and my hotel bills and all that and send it all in at once.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, not try to do it like.
[CUSTOMER][NEUTRAL] But do it in sections through mastectomy, chemo, yeah, go ahead.
[AGENT][NEUTRAL] So let me look.
[AGENT][NEUTRAL] Right, right. All right. So what I'm doing, OK, I'm looking at the claim that was, that was processed prior to this one and which payment was issued, which you should have already received an EOB.
[AGENT][NEUTRAL] You know, back at the end of April or very first part of May.
[CUSTOMER][NEUTRAL] I got, well,
[AGENT][NEUTRAL] And that had a lot to do with.
[CUSTOMER][NEGATIVE] Yeah, I got, I got one where they turned down everything. I got nothing. So, uh.
[AGENT][NEUTRAL] OK. Do you happen to have that EOB in front of you showing the claim number?
[CUSTOMER][NEUTRAL] No, ma'am, I do not, but I can.
[CUSTOMER][NEUTRAL] It, it would normally be.
[CUSTOMER][NEUTRAL] Right here I'm bad to if I need to save it I put it in a particular pile and then later on go through it and sort it into what it belongs with or it's time to throw it out one of the two, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am, I.
[CUSTOMER][NEUTRAL] And so,
[CUSTOMER][NEUTRAL] Uh, hold on.
[AGENT][NEUTRAL] OK. So I was just, well, I was just looking at that one and that one was stating that we were still in need of a pathology report.
[AGENT][NEUTRAL] Miss [PII]
[CUSTOMER][NEUTRAL] Yeah, I, I get that, and that would be that pathology report would be in the paperwork you got for the one that we're looking at right now because you got 72 pages of what came from the hospital and the breast clinic and the diagnostic and the biopsy and the actual the test after the surgery, uh, all of that y'all have.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] And I'm still looking for that other.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And I get that I was not sending you what you wanted and I, I do understand that, uh.
[CUSTOMER][NEUTRAL] That's why I sent everything.
[AGENT][NEUTRAL] Now, what I can do, uh, if you would like, Ms. [PII], I can send a request.
[AGENT][NEUTRAL] To have this information reviewed.
[AGENT][NEUTRAL] Uh, to see if they can locate the pathology report and all of that information that you submitted most recently.
[CUSTOMER][NEUTRAL] I cannot find, I cannot find that, OK, but.
[AGENT][NEUTRAL] That's OK. That's OK. You did receive it though. So based on what you were stating,
[CUSTOMER][NEUTRAL] Oh, hold on, hold on, hold on.
[CUSTOMER][NEUTRAL] I may, I may have laid my hands on it just here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh. OK. All right.
[CUSTOMER][NEUTRAL] Yes, in order to give consideration to this da da da, surgical benefit is, oh no, that's not the one you're looking for.
[CUSTOMER][NEUTRAL] You're looking for the other one.
[CUSTOMER][NEUTRAL] I actually do have it here. It just takes me a minute.
[AGENT][NEUTRAL] You're fine.
[CUSTOMER][NEUTRAL] OK, I have one that says they turned down the surgical benefit, OK, but there's, if I'm not mistaken, I thought there was another one.
[AGENT][NEUTRAL] Yes, ma'am. There would have been one. It ends, the claim number on that explanation of benefits ends in 888. That was the one we were, we were asking for the pathology report.
[CUSTOMER][NEUTRAL] I could be wrong.
[CUSTOMER][NEUTRAL] OK, I'm looking at it.
[CUSTOMER][NEUTRAL] OK, that the pathology report is going to be in, hold on, I can probably.
[CUSTOMER][NEUTRAL] Hold on, let me.
[CUSTOMER][NEUTRAL] Again, it takes a second.
[AGENT][NEUTRAL] Oh, you're fine.
[CUSTOMER][POSITIVE] I'm working off a desk that I used when I was in junior high because it fits in my little house better than anything. Well, it fits in my house better than anything else and it's, it's great for fitting, but
[AGENT][POSITIVE] Well, that works.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Well, sometimes when you start doing stuff like this, not so much.
[AGENT][NEUTRAL] You don't have a lot of desk space, that's true. That's true.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, hold on.
[CUSTOMER][NEUTRAL] OK, and you're looking for the initial one.
[AGENT][NEUTRAL] The one ending in, yes ma'am, that claim number would end.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, no, no, I mean the
[CUSTOMER][NEUTRAL] It's no, I'm talking about the, the information.
[AGENT][NEUTRAL] And 888.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, I mean, I mean, I, I've got that page but it really doesn't tell you anything other than you didn't send us what we wanted.
[AGENT][NEUTRAL] Well, the second page is.
[AGENT][NEUTRAL] Yeah, the 2nd page is where those remarks are that I was referring to.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, but it basically, it basically said, hey, we need some different information.
[AGENT][NEUTRAL] So let's
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, OK. Abnormal, abnormal.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, don't know, that's all the initial.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, I'm getting close.
[AGENT][NEUTRAL] Oh, you're fine.
[CUSTOMER][NEUTRAL] There's all the information about the mammography and ultrasound and all that stuff before.
[CUSTOMER][NEUTRAL] They did.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Biopsy? OK.
[CUSTOMER][POSITIVE] Good grief.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Here's the order for the biopsy.
[CUSTOMER][NEUTRAL] There's the, where the biopsy was physically done.
[CUSTOMER][NEUTRAL] With a note that it is, the report is pending.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm looking at a page that stated 2425 within the paperwork that I sent to you guys where it point blank says uh hold on let me find the.
[CUSTOMER][NEUTRAL] Oh crap. I had it in my.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And this is, this is the report on the biopsy.
[CUSTOMER][NEUTRAL] Spinal pathological diagnosis is invasive carcinoma ductal grade 2. No lymph lymphovascular invasion or pito component demonstrated. So that is in the paperwork that I sent to you guys.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so give me just a moment. Uh-huh, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] And it's they
[CUSTOMER][NEUTRAL] Yeah, well, it's dated 22-425. Now there's several pages dated 2-4-25, but
[AGENT][NEUTRAL] 2420 is the pa.
[AGENT][NEUTRAL] Uh, let's see. OK, give me just a moment, I'm making some notes.
[CUSTOMER][NEUTRAL] Yeah, there's like, I'm looking at I have different pages that are.
[CUSTOMER][NEGATIVE] No, not 5, but several pages that are have that same heading in that same day.
[AGENT][NEUTRAL] Excuse me.
[CUSTOMER][NEUTRAL] All right, darling.
[CUSTOMER][NEUTRAL] I have this thing about sneezing and if you'll just go ahead and let me sneeze 5 or 6 times and get it out it's over with.
[AGENT][NEUTRAL] Uh, you'll be OK. Uh, I've just, I've had some terrible something going on in the last couple of days. I think it's just the change in the weather, going from mild and a lot of rain to now very hot over the last couple of days. I'm hoping that's what it is anyway, Ms. [PII].
[CUSTOMER][NEUTRAL] You know?
[CUSTOMER][NEUTRAL] I heard that it's.
[CUSTOMER][NEUTRAL] I've been very fortunate in my later years. Earlier in my life, I, I would end up with pneumonia and all this stuff, but it all started from, from uh allergies and hay fever and all. It would all start from that. And I, and I, I ended up changing to my husband's doctor and he gave me something. He says, you're bad enough, take this 12 months out of the year. Take it all the time, he says, and we won't have all that trouble, you know, and we have it.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Well, well, I personally started taking Zyrtec daily and a few years ago and, you know, just, sometimes it's, sometimes there's just something in the air that doesn't care anything about that.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] It doesn't cure that I take that.
[CUSTOMER][POSITIVE] Thank you. I, I
[CUSTOMER][NEUTRAL] I do, I do get that, but he also gave me some kind of prescription nose spray.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And when when the other gets the best on me that will break up the stuff that that gets stuck in my sinuses.
[AGENT][NEUTRAL] You use that.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] And once I, the sinuses are clear, I'm in good shape, you know.
[AGENT][POSITIVE] Well, that's good that it works for you like that.
[CUSTOMER][NEUTRAL] No joke. I don't think I can tolerate it nowadays. I got too many other things going on.
[AGENT][POSITIVE] That, I'm sure. Yes, ma'am. It sounds like you certainly do. Um.
[AGENT][NEUTRAL] Alright, so I have submitted a ticket for you, Ms. [PII], to our claims department to have them review the information and I documented in there about the path report being dated to 4 and just ask for it to be re-reviewed and to have someone reach out to you.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, that's wonderful.
[AGENT][NEUTRAL] So that may take, you know, I mean,
[CUSTOMER][NEUTRAL] Alright, now let me
[AGENT][NEUTRAL] Go ahead. I'm sorry.
[CUSTOMER][NEUTRAL] I'm not really in a hurry, so I just know after a certain period of time I face it because things have a tendency to just get forgotten. I mean, it, it's just the way of life. It's not anybody's intent, it's not my intent. It's just the way jump happens, you know. Uh, let me ask you this, is my theory about spending in stuff.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] It does.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Isn't that simpler than trying to send in every tiny little thing? Like I said, I sent in from when they diagnosed through the, the mammogram, OK, I'm not the, the surgery, OK? And then I'm in the mean, I'm in the middle of chemo and I figured when I finish the chemo and I collect everything for the chemo, I'll submit it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then after that I'm gonna have another surgery and I figure after that's complete I'll submit it just in a, in a piece that's kind of connected to each other, you know, as opposed to a bunch of a little thing.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am, and I tell you.
[AGENT][NEUTRAL] Right. And this hormone, I don't know because I can't see all of your documentation that you submitted. But do you have the cancer claim form itself because it has all of your instructions on it of what needs to be submitted.
[CUSTOMER][NEGATIVE] No, ma'am, the only thing, the only thing they sent me was some stupid little form. I'm sorry, I hate to make that comment, but some stupid little form and it says that it's a cancer claim form, but it's, it's just.
[CUSTOMER][NEGATIVE] Almost ridiculous.
[CUSTOMER][NEUTRAL] And the fact that it doesn't really.
[CUSTOMER][NEUTRAL] Uh, do much. You can send me something new and let me see if it's any better than what I've got and maybe it will be and, and initially I wasn't looking for, I'll be honest with you, I wasn't even looking for the uh.
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] Well, I don't
[CUSTOMER][NEUTRAL] Transportation and all that kind of stuff initially. I was just initially looking to get hooked up and get the
[CUSTOMER][NEUTRAL] Initial diagnosis taken care of and then start doing this in sections. Well, I didn't make it with the initial diagnosis somehow I'm trying to do that I got to the travel and some of that stuff done, you know, through the surgery so send me a new one just in case the one I've got is not the one, you know, uh, and I will.
[AGENT][NEUTRAL] Is
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh-huh, uh-huh.
[AGENT][NEUTRAL] OK, it should be if they've just recently sent it to you. Now let me ask you this, is there a way if I email it to you, um, Ms. [PII], that you could print it out because that's gonna be a whole lot quicker than getting it in the mail.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Well, uh, you can try it. It's, uh,
[CUSTOMER][POSITIVE] It may or may not happen. Our wonderful because we have this wonderful computer with a brand new uh printer and all, and sometimes we can get it to cooperate with us and sometimes we can't.
[AGENT][NEUTRAL] OK. Uh, so, OK.
[CUSTOMER][NEUTRAL] So feel free to send.
[AGENT][POSITIVE] All right. Well, give me just a second and let me, um, because again, I always recommend to kind of use that.
[CUSTOMER][NEUTRAL] Feel free to send it.
[AGENT][NEUTRAL] Um, as a checklist. And then as far as what we review, like you said you weren't trying to get the transportation really and all that, but we're gonna review any information that's submitted because a lot of people don't even realize what they're trying to, you know.
[CUSTOMER][POSITIVE] Oh, I get it. I totally get it.
[CUSTOMER][NEUTRAL] Are you not
[AGENT][NEUTRAL] Everything that they're
[CUSTOMER][NEUTRAL] Oh, I, hey, I'm in that group.
[AGENT][NEUTRAL] You know, so.
[CUSTOMER][NEUTRAL] I'm in that group. I've had this policy for so many years till.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I mean, we're talking about serious. I had this policy during most of the years I was working and I've been retired for 11 years. So,
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK. Yeah, I can see that you've had it since, actually, this one became effective in [PII]. So, yeah, you've had it almost 20 years.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] So, uh, and now I did use the, I have the ICU one several times, but of course I've never used this one.
[AGENT][NEUTRAL] But I did.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So I've gone ahead also and ordered for like 3 claim forms to be sent to you. So maybe, you know, if you have a way that you can make copies of them or whatever, but um
[CUSTOMER][POSITIVE] Oh, I definitely can make copies. That one I'm good on.
[AGENT][NEUTRAL] OK. OK. Well, again, in that first page, it does, it, you can just use it as a checklist. The entire first page has bullet points and it's titled Instructions for the insured or patient. So, you know, that, that will make it a lot easier as far as how you want to submit your claims. It's, it's really just whatever is easier for you, Ms. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Some people submit it as they go along. Some people wait, um, and it, it just kind of depends on what's gonna be easier for you. Different people find it easier to do it different ways, um, as far as keeping up with it, you know, instead of it being so overwhelming and trying to get everything together and think about everything that's been done, it's easier for them to do it as they go. And then some people, it's the opposite. So that's a personal preference.
[CUSTOMER][NEUTRAL] Oh yeah I get that.
[CUSTOMER][POSITIVE] Yeah, I got you.
[CUSTOMER][POSITIVE] Alright darling, thank you so much.
[AGENT][POSITIVE] OK. Well, you are certainly very welcome. And is there anything else that I can help you with this morning, Ms. [PII]?
[CUSTOMER][NEUTRAL] No, ma'am, but I'm gonna say this again to make sure in my mind I am perfectly clear. As far as the initial diagnosis, you've submitted what we think we need to take care of that payment.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] I have, I have submitted a request.
[CUSTOMER][NEUTRAL] You, we think we have.
[AGENT][NEUTRAL] Yes, ma'am. I have submitted a request asking them to review this last large, um,
[CUSTOMER][NEUTRAL] OK, yes, yes.
[AGENT][NEUTRAL] Quantity of documents that was received because I think it's a 100 and something page it's 100 and something pages and I made a note about
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It was 70, 72 or 74 from the hospital and then a bunch of EOBs.
[AGENT][NEUTRAL] Right. So, yeah, it was like, it didn't have been 100 and I've already closed that out, but it was 100 and something total pages. Yeah. So I just asked them to look at that because the pathology report um should be included. It was dated [PII]. And then once they've had a chance to review that, which that could take, you know,
[CUSTOMER][NEUTRAL] Yeah, quite a few.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Several days, Ms. [PII], to do that. But I have asked someone to call you and referenced your phone number as well.
[CUSTOMER][NEUTRAL] I'm not, hey.
[CUSTOMER][NEUTRAL] I can't
[CUSTOMER][NEUTRAL] In general, in general, I can't ask people to move really, really fast because I'm pretty much lucky to be moving at all. So I'm, I'm kind of trying to judge people by my own, you know.
[AGENT][NEUTRAL] No.
[AGENT][POSITIVE] Well, that's caring for you because a lot of people don't do that in this day and time. But I can assure you that we will look into this for you and um and get back in contact with you, Ms. [PII].
[CUSTOMER][POSITIVE] So, uh, so I'm good.
[CUSTOMER][POSITIVE] Thank you so much darling. You have a wonderful day. I hope it is, I, I hope it is beautiful out there. My daughter is in [PII].
[AGENT][NEUTRAL] Well you
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Well, I actually am in [PII]. I'm in [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] So, yes, ma'am. Uh-huh. And my family is actually from Meridian. No, it's not cool, but I know exactly where Meridian is. My family's from Meridian.
[CUSTOMER][POSITIVE] Really? That's cool.
[CUSTOMER][NEUTRAL] Yeah, except it's not cool.
[CUSTOMER][NEUTRAL] Really?
[CUSTOMER][POSITIVE] I've been outside watering already this morning because I'm a I knew if I didn't do it early, early, early, it would not get done. So, so thank you so very much darling.
[AGENT][NEGATIVE] Oh, no.
[AGENT][NEUTRAL] No, no, I caught myself out watering a few things myself late last night before I went to bed doing so. I I get that too, Ms. [PII]. We have a lot in common.
[CUSTOMER][POSITIVE] Thank you, sweet darling. You take care.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] We, yes, ma'am. You too. And it was my pleasure in speaking with you, Ms. [PII]. So if that's all I can help you with at the moment, thank you again for calling APL. I hope you have a wonderful day and I hope everything goes very well with you for your treatment, OK?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Thank you, sweetie. Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye-bye.