AccountId: 011433970860
ContactId: 172bb657-5464-4766-97ab-244cb2298f38
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1096270 ms
Total Talk Time (AGENT): 508146 ms
Total Talk Time (CUSTOMER): 657352 ms
Interruptions: 23
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/172bb657-5464-4766-97ab-244cb2298f38_20250519T18:07_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], um, let me give you the policy number.
[AGENT][NEUTRAL] First off, who am I speaking to?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, Ms. [PII], and what's your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. Are you calling on behalf of your own policy or are you with the provider's office?
[CUSTOMER][NEUTRAL] It's my own.
[AGENT][NEUTRAL] OK, and what is your policy number?
[CUSTOMER][NEUTRAL] Well, well it's through my job too though, huh.
[AGENT][NEUTRAL] Mhm. Your policy number?
[CUSTOMER][NEUTRAL] It's 253.
[CUSTOMER][NEUTRAL] 1373.
[AGENT][POSITIVE] OK, thank you, mom, your information is loading. How can I help you today?
[CUSTOMER][NEUTRAL] OK, I have a few questions for you. I have some things just pending, um, and I have it up, um.
[CUSTOMER][NEUTRAL] I'm just now starting to
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I understand it, so, um, every time I do something, I always have a question. So, uh.
[AGENT][NEUTRAL] OK, so you're
[AGENT][NEUTRAL] OK, so you just have some questions on your on claims that we're processing in the process of working on, is that correct?
[CUSTOMER][NEUTRAL] Yeah, so, yeah, so.
[AGENT][NEUTRAL] All right, so yes, ma'am, I'll be able to help you with that, Ms. [PII], once we verify several things first for security.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][NEUTRAL] OK, and then any information that I provide for you will be a verification of benefits and not a guarantee of payment. So first off, if you will please verify your date of birth.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. The phone number that we have on file for you is different than the one you gave me.
[CUSTOMER][NEUTRAL] [PII] is my cell number.
[AGENT][NEUTRAL] OK, so that is a valid phone number for you.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Of course it is.
[AGENT][NEUTRAL] OK. And then the phone number that
[CUSTOMER][NEUTRAL] You guys should have my landline as my primary though I think you guys changed it around when I opened it, OK.
[AGENT][NEUTRAL] No, we don't have that.
[AGENT][NEUTRAL] And then the phone number you gave me today, is that your work number?
[CUSTOMER][NEUTRAL] It's my landline residential number.
[AGENT][NEUTRAL] Oh, the [PII] is your landline?
[CUSTOMER][NEUTRAL] Yes, and I want to add it because that is uh the number when I'm at home and I'm doing my business and calling people I usually call from my landline. I use my cell number for emergencies.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I can, I have added that your home number back on file for you and the last thing to verify is your email address.
[CUSTOMER][NEUTRAL] That I don't want you to take my cell number off it's just that I wanna add it so therefore when you guys are asking me for either one of the numbers, it will be verified.
[AGENT][NEUTRAL] No, ma'am, I didn't.
[AGENT][NEUTRAL] Your home number and your cell number are both on your profile now.
[CUSTOMER][NEUTRAL] Exactly. OK, so the email is [PII].
[AGENT][NEUTRAL] Now they are.
[AGENT][NEUTRAL] OK, thank you very much. All right, so I can see that we, you did have um there's one claim that's scheduled to go through processing tonight.
[CUSTOMER][NEUTRAL] of
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] And that was for information that we have received.
[CUSTOMER][NEGATIVE] Oh shit.
[AGENT][NEUTRAL] It was submitted on [PII].
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yeah, you guys received it on [PII] though.
[AGENT][NEUTRAL] Most recently?
[AGENT][NEUTRAL] There were some received on [PII], and [PII]. It looks like.
[CUSTOMER][POSITIVE] Yeah, exactly.
[AGENT][NEUTRAL] And that's going through processing tonight?
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] With the benefit to be paid in the amount of $5,669.87.
[CUSTOMER][NEUTRAL] I would.
[CUSTOMER][NEUTRAL] What is it?
[AGENT][NEUTRAL] $5,669.87.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, so that's for the 3 invoices there, OK, and then I faxed one but I've not uploaded, I should say, um, 1 yesterday, yeah, 3 yesterday because, no, no, no, that's fine. OK, I, I don't have a problem with neither one of them, but OK, so I was trying to understand what you guys because you said completed and I said it's not completed so.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That was done yesterday. Yes, ma'am. And that one is still in line for review. Mhm.
[CUSTOMER][NEUTRAL] I didn't see anything else and then I didn't see the decision thing either like somebody had explained to me like when I first when they were teaching me how to upload and what to look for and the explanation and I didn't see any of that so that was what one of my questions was the reason why I was calling you. OK, so when it um pays out it'll automatically go into my account that I gave to y'all, right?
[AGENT][POSITIVE] It is scheduled for yes ma'am. It should be a direct deposit.
[CUSTOMER][NEUTRAL] Right, OK, so second question, um, this is my.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Cancer policy and then is it for disability and
[CUSTOMER][NEUTRAL] Um, what is it, um, illness of like a heart attack or anything like that, or is it just straight cancer?
[AGENT][NEUTRAL] Uh, let me pull your policy information up to see what.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] If you have additional benefits on here, give me a moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] drink yourself.
[CUSTOMER][NEGATIVE] Fucking drink out before it turns like.
[CUSTOMER][NEUTRAL] probably
[CUSTOMER][NEUTRAL] found great so and they didn't that.
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] OK, so on this plan, this is your cancer policy with a surgical benefit rider and you have a hospital intensive care unit benefit rider on here.
[CUSTOMER][NEUTRAL] Right, OK, so it doesn't have anything to do with terminal illness like heart attacks, strokes, or anything like that. It's just straight for cancer.
[AGENT][NEUTRAL] A
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, good. OK, um, so my other one I'm, I'm asking because I have another uh.
[AGENT][NEUTRAL] Yes, I am.
[AGENT][NEUTRAL] Kind of determine which policies which.
[CUSTOMER][POSITIVE] Yeah, uh, I'm now I'm trying to do step 2 and the doctor needs to help me with that, so I just wanted to make sure that this other one here was for my disability and not for y'all. OK, so that's wonderful. Um, OK, one more question, the code cap I'm trying to.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Uh, get for the cancer treatment, which, um, I'll be having my surgery soon in a couple of weeks, so.
[CUSTOMER][NEUTRAL] Um, you know what a cold cap is, right, where they put it on your head during the chemo treatments? OK.
[AGENT][NEUTRAL] I do not.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Doing the chemo treatments, um, it's a cap that you wear and it's a part of, um, to help, um, you from, it's like a preventative to help with hair loss and to treat your scalp during the chemo session because it, you know, your scalp burns and all that stuff.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So I was wondering if you guys um.
[CUSTOMER][NEUTRAL] Is that, does that follow up on any treatments or how?
[AGENT][NEUTRAL] OK, so let, and give me just a moment before we move on to that because you you do on your policy have a heart attack and stroke rider on here as well. First occurrence, cancer and or heart attack and stroke coverage.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, alright then.
[CUSTOMER][NEUTRAL] OK, so I'll write that up on here too. Well, hopefully we don't, mhm.
[AGENT][POSITIVE] Yes, you do. And in your portal, hopefully you won't ever need that but yes ma'am, it does have that and in your policy, you would be able to also see that as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But yes.
[CUSTOMER][NEUTRAL] OK, so, OK, so that's, that's fine. I mean, that's good too, OK, but not the disability part, right? OK, OK, OK, no, I, I, that's what this other one here, so I just want to make sure, you know.
[AGENT][NEUTRAL] No, ma'am. This does not provide disability benefits. That's correct. Uh-huh.
[CUSTOMER][POSITIVE] I haven't, I've been very fortunate for many years. I haven't needed to touch any of this stuff, but now that I do, I just have it all packed up and, you know, tucked away, so I can't remember what is what, so.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, uh, no, ma'am, I understand.
[CUSTOMER][POSITIVE] So now that I need it, um, you know, you just pay for things and thank God I did. So, uh, now that I need it, um, God's blessings, I just need help with verifying what I do have.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sure. So, yes, you do, this policy does have those benefits for the heart attack and stroke.
[CUSTOMER][NEUTRAL] So I just need to make sure that.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] OK, so I I like that. OK, so, uh, the last thing is the treatments for the chemo. Do you guys help with assistance with that? Mhm, mhm.
[AGENT][NEUTRAL] So on the chemotherapy, you, your benefit for radiation, chemotherapy, and immunotherapy, that's all under one benefit, and that's a maximum of $15,000 per covered person per 12-month period.
[CUSTOMER][NEUTRAL] 38 that's a month and benefits.
[CUSTOMER][NEUTRAL] 24 hours she qualify.
[AGENT][NEUTRAL] So for example,
[CUSTOMER][NEUTRAL] OK, so whatever I need falls up underneath that umbrella or no?
[AGENT][NEUTRAL] Well, you have, that's only for radiation, chemotherapy, and immunotherapy.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It will be up on it's for uh uh I'm not getting radiation it's for chemo.
[AGENT][NEUTRAL] Yes. So for twelve-month period, so, for example, if your treatment were to start in June.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If that benefit.
[AGENT][NEUTRAL] A $15,000 would go from June when you started your chemo to next June. It's a 12 month, not a calendar year benefit.
[CUSTOMER][NEUTRAL] The first day.
[CUSTOMER][NEUTRAL] 413654.
[CUSTOMER][NEUTRAL] No, no, no, I'm following you on that, but I'm seeing all the utensils and everything falls up underneath the chemo treatment.
[AGENT][NEUTRAL] That is for the treatment itself.
[CUSTOMER][NEUTRAL] The treatment itself. OK, so how can I find out if the cap is
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, gonna be included or do you guys support that? How do I find that out?
[AGENT][NEUTRAL] Um, and you said this was an an elective?
[AGENT][NEUTRAL] Choice for the cap. Is that correct?
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] I guess I wanna know more detail on the [PII] when I go meet with my medical oncologist. I'm just trying to write down all my questions, see if there's an option that's available to me and see if my insurance is gonna cover it. So I don't have the hold as I guess some of the insurance companies would ask for because I don't know, I don't know it.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so under this, I can tell you and there's definitions of, of all of these terms, but your policy only provides benefits for hormone, the chemo and radiation, hormone therapy.
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For experimental treatment, it says that it's paid in the same manner as and the same maximums as any other benefit.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I don't know what type of cancer you have. Um,
[CUSTOMER][NEUTRAL] Breast cancer.
[AGENT][NEUTRAL] OK. So you have benefits for a mastectomy?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There's a confinement benefit that's $50 per day of hospital confinement. It's only $25. OK, so that's, that's all, all of that that you see, that are, those are your cover benefits under this plan.
[CUSTOMER][NEUTRAL] Yeah, I wrote all that stuff down.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, OK, so when I'm just gonna go for it so if I get the invoice I'll submit it over to y'all if it's covered, it's covered if not then I guess it'll be OK.
[AGENT][NEUTRAL] Do you
[AGENT][NEUTRAL] Well, do you have the cancer claim form, Ms. [PII]?
[CUSTOMER][NEUTRAL] What do you mean?
[AGENT][NEUTRAL] If you're gonna be submitting claims to us, have you not submitted your claim form with any of the documents that you've been submitting to us?
[CUSTOMER][NEUTRAL] I'm submitting everything that they're giving to me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Am I answering that right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, yes, ma'am, but there's also a claim form, a cancer claim form.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That I would have assumed you had been submitting with your other documents as well.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. I was just gonna ask you if you wanted me to email you that form, but you, if you already have it, that's, that's fine.
[CUSTOMER][NEUTRAL] I think, I mean she submitted everything to me and they submit, they told me to submit my, my verification of cancer and I did that.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. So I'm still gonna go ahead and email you the claim form.
[AGENT][NEUTRAL] Because the claim form too has all of the information that's Alfred, like for what documents are required when you submit to us for claims review.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh OK uh huh.
[AGENT][NEUTRAL] So you can kind of use that as your checklist. The entire first page has got bullets, bullet points on there with all instructions.
[CUSTOMER][NEUTRAL] I have the policy, is that what you're talking about?
[AGENT][NEUTRAL] No, no, I'm talking about a claim form that's titled Cancer claim form.
[CUSTOMER][NEGATIVE] Yeah, send it to me because I that it's not bringing a bell to me.
[AGENT][NEUTRAL] Yeah, I'll be happy to do that. So I'll, yes, ma'am. Well, I'll be, I'll send you that and just, um, uh, just when we get off of our call, and the form or the the email that you're gonna receive from me, Ms. [PII] will come from care team at [PII] and I will put [PII] in the subject line for you.
[CUSTOMER][NEUTRAL] OK, that's fine. I'll look for that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] So that that's easy to recognize. Yes, ma'am. You're welcome.
[CUSTOMER][POSITIVE] Oh yes thank you.
[CUSTOMER][POSITIVE] Yeah, that would be great. OK, so then I could use that as my check off when I'm uploading stuff to y'all? OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Right. Yes, ma'am. So you'll know, mhm, what uh,
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] But all you would need to submit.
[CUSTOMER][NEUTRAL] Yeah, cause it's also uh like.
[CUSTOMER][NEUTRAL] It's a lot, it's a lot, and I'm trying to keep up with it.
[AGENT][NEUTRAL] Yes, because you
[AGENT][NEUTRAL] Yes, it is a lot and that's why, um with that claim form, you know, it does, it tells you everything that you need would need to submit to us. One way for us to review a claim for you under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that's perfect then. So, yeah, because I'm pretty thorough, so yeah, as I submit them I write the date and confirmation, I printed copy showing all that stuff. So yeah, and I could just file it as I'm going. So that's what I've been doing. So that's why I had those questions and I called and I was like, they didn't complete nothing. I haven't got. I was like, what's that?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, that's
[AGENT][POSITIVE] Yeah, that's excellent that you do that.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Um,
[CUSTOMER][POSITIVE] But OK, I, I'm learning, so it's only like my first week and I'm trying to keep humor with it, so I don't cry because it's just just, it's so, it's a lot. Oh.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] Sure. Well, that's the best.
[AGENT][POSITIVE] It's overwhelming. I know it is. Yes, ma'am. I, I do know that it is and um I will certainly be keeping you in my thoughts.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] And prayers. Yes, ma'am. You're welcome. You're certainly welcome.
[CUSTOMER][POSITIVE] Thank you so much. Oh thank you so much. It's nice to have a person to say that. I used to be a customer service rep for 30 something years for on the bank side, so it's nice to hear awesome customer service.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh, well.
[CUSTOMER][NEUTRAL] When you're so used to giving it yourself, you know.
[AGENT][POSITIVE] Yeah, it is, well, uh, that's nice of you to say, but, uh, I mean, I genuinely am sincere when I say that to you. I will, I will be praying for you because this is a lot that you're going through. But just know that if you have any questions, Ms. [PII], on any of this process, you know, please give us a call and we'll be more than happy to assist you in any way that we can.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes it is.
[CUSTOMER][POSITIVE] Thank you so kindly, thank you so kindly, uh, yeah, that's all so new to me, but yeah, thank you, appreciate it.
[AGENT][POSITIVE] You're, you're welcome.
[AGENT][POSITIVE] Well, you're welcome. Yes, ma'am. And I hope you have a nice afternoon and again, thank you so much for calling APL and just be looking for this email from me in just a few minutes.
[CUSTOMER][NEUTRAL] OK, OK, I won't be able to open it until tomorrow because I'm on my way back to work. I have, I work for the school, so I have 4 more days to put in. I'm trying to.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Finish it out so before my surgery.
[AGENT][NEUTRAL] Well, I guess, yeah, school break is, uh, oh, and schools, school's about to be out, isn't it as well for the year?
[CUSTOMER][NEUTRAL] Yeah, yeah, Friday, yeah, Friday is my last day, so.
[CUSTOMER][NEUTRAL] Yeah, so I guess it hit me at at a kind of a downtime, so yeah, I'm able to get some rest and um get ready for my surgery and I think 2 weeks, the doctor said, so, yeah, yeah, about 2 weeks.
[AGENT][NEUTRAL] 2 weeks, OK.
[AGENT][POSITIVE] Well, I will certainly, again, I will keep you in my prayers.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you you have a good one.
[AGENT][POSITIVE] You're welcome. All right, Ms. [PII], well, you too. Yes, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] OK, bye bye.
[CUSTOMER][NEUTRAL] and bye bye.