AccountId: 011433970860
ContactId: 16291d67-b27e-4821-8902-238d607a6273
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 434600 ms
Total Talk Time (AGENT): 202598 ms
Total Talk Time (CUSTOMER): 201307 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/2025/02/05/16291d67-b27e-4821-8902-238d607a6273_20250205T20:41_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], my name is [PII], and my, um.
[CUSTOMER][NEUTRAL] We filed a claim. I believe we actually filed probably 2 claims, um, one of them, my hands, my, my, my husband was diagnosed with, um, cancer.
[CUSTOMER][NEUTRAL] Uh, in the middle of December. And um had you know a couple of MRI's and some PET scans and CT scans and so we've, we filled out all the paperwork um sent in what I believe was the pathology report and all the receipts for everything and doctor statements and we haven't heard anything on our claim and so I was just checking to see if we're missing something or if I need to do something else.
[CUSTOMER][NEUTRAL] Um, for this claim.
[AGENT][NEUTRAL] OK, sure, I can take a look at that and [PII], what's a good callback number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 570
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what's the policy number?
[CUSTOMER][NEUTRAL] Uh, I don't know.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, oh, I got, uh, 246.
[CUSTOMER][NEUTRAL] 3103.
[AGENT][NEUTRAL] All right, thank you and verify your address and date of birth.
[CUSTOMER][NEUTRAL] Uh, address is [PII].
[CUSTOMER][NEUTRAL] [PII] and my date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you, and also verify your email address.
[CUSTOMER][NEUTRAL] Uh, I'm not sure which one you have, but, um, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And if it's not that one.
[AGENT][NEUTRAL] Oh, actually,
[AGENT][NEUTRAL] We don't have an email I'm sorry.
[CUSTOMER][NEUTRAL] The other one I have is [PII].
[CUSTOMER][NEUTRAL] Oh, that's OK.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, we don't have one on file. Did you wanna add it?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And which one would you prefer the OK.
[CUSTOMER][NEUTRAL] So it's [PII]
[CUSTOMER][NEUTRAL] Uh, Rhonda Ream.
[CUSTOMER][NEUTRAL] 68
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, thank you. I'll go ahead and have that updated and you're calling in regards to a claim submitted right for Mr. [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'm sorry?
[AGENT][NEUTRAL] And the claim is for Mr. [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] I don't show that we have any claims on file.
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] How did you submit it? By fax, mail, or online?
[CUSTOMER][NEUTRAL] Uh, yeah, he, he, he faxed it in.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah, that's the correct fax number. And when was it sent?
[CUSTOMER][NEUTRAL] Uh [PII].
[AGENT][NEUTRAL] Yeah, we should absolutely have it on file by now. I don't show that we have received any claims on this policy, bear with me let's see, there is, did you submit a claim for yourself?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mm, I
[CUSTOMER][NEUTRAL] Uh, no, but all of them were for my husband, I believe, yeah.
[AGENT][NEUTRAL] OK, because I do show something.
[AGENT][NEUTRAL] That's um in line to be processed that was received on the [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Of January.
[CUSTOMER][NEUTRAL] Oh, you know what? I did. I filed. I thought I did file a wellness claim. I did.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, so we have that on file, but I don't show anything for Mr. [PII].
[CUSTOMER][NEUTRAL] OK, so, um.
[CUSTOMER][NEUTRAL] Then I guess what I will do is when I leave here.
[CUSTOMER][NEUTRAL] Um, do you, so do you, do you not have a wellness claim for him either?
[AGENT][NEUTRAL] I am pulling up the document we have to see what it is because it hasn't been reviewed just yet. And it's possible that it could be for him. It just hasn't been placed on his portion of the policy just yet. Um, and yeah, this information is from Mr. [PII]. The first page, it does have um your name as the insured, but I show about the patient is [PII].
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So we do have that on file and it looks like just a glance I do show um imaging.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So that looks like what you are inquiring about a CT scan on [PII]?
[CUSTOMER][NEUTRAL] Yeah, so, so there's actually, um, we filed a couple of wellness claims for, for him which, um, yeah, CT scan which was on the [PII], um, MRI he had on [PII].
[CUSTOMER][NEUTRAL] Um, there's like 4 different things, but then we also included with that, uh, cancer claim form.
[AGENT][NEUTRAL] OK, got it, yeah, so I show it's 17 pages. So, um, once that claim is pulled and processed, then it'll be sorted out, um, right now it, it typically takes 7 to 10 business days from the date of receipt and that claim was received. What was that? That would have been last Wednesday, so it'll be any day now, um, but it just hasn't been reviewed, but it is on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, perfect then, um, that's all I needed and then so will you guys um send me like an update through email?
[AGENT][NEUTRAL] It will not be through email. You'll receive an um a response. You'll receive correspondence in the mail. Um, and also, if you registered for the text messaging on the online portal, then you'll receive a text update anytime there's been any changes with the claim, any activity.
[AGENT][NEUTRAL] But um if not there, then it would be by mail.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, because I, I, I've never, I haven't been online. I don't, I don't didn't even really know that I had this policy. It's just like something I I paid for and I didn't really ever check into it, um, so I, I doubt that I'm signed up for the text, the text, so I'll just have to wait for male correspondence.
[AGENT][NEUTRAL] Understood, yeah, but if, um, if you give us a call back after that 10 business day time frame for an update, uh, we'll also be able to assist you that way, but every, uh, claim activity you'll receive that in the mail.
[CUSTOMER][POSITIVE] OK perfect then I'll just wait till sometime next week and and call you back.
[AGENT][POSITIVE] OK, good deal. Well, is there anything else I can help you with today, [PII]?
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] All right. Well, thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thanks bye.