AccountId: 011433970860
ContactId: 1a0f1142-c7cf-4cdf-95ab-1fc430a7aeba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1490910 ms
Total Talk Time (AGENT): 521204 ms
Total Talk Time (CUSTOMER): 568827 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/1a0f1142-c7cf-4cdf-95ab-1fc430a7aeba_20250611T13:48_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, how are you?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] Alright, I am calling because I'm trying to, I just discovered that I had been paying for um cancer treatment for me and my husband a cancer policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] After going over my um.
[CUSTOMER][NEUTRAL] My check, looking at my check, uh, and I talked to someone and they told me to um go to [PII] and print off this form to file a form of a claim.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So my question to you is, um, do I send just send all the bills we had, uh, just copies of all the bills in the mail and um the ones that pertain to it is for my husband, the one that's that are covered, they'll look at those but just sent all of them.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, and
[CUSTOMER][NEUTRAL] Because it's from [PII].
[AGENT][NEUTRAL] Yeah, as long as your policy was active at the time of service, um, go ahead and submit all of those bills. Um, if any of them have, do any of them have procedure codes on them or is it an itemized bill?
[CUSTOMER][NEUTRAL] He had prostate cancer, yes, and it's uh uh itemized bill from the Kansas City, uh, City of Hope.
[AGENT][NEUTRAL] Yeah, you can, you can send those in with your claim documents and they will process that. Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And do you have the
[CUSTOMER][POSITIVE] And it'll show where my, my insurance paid so much uh and then we have like a balance.
[AGENT][NEUTRAL] Yeah, so we don't do the patient responsibility portion, but yes we can file the, you can file the claim and um we can see what all we uh what we will pay for and the amount that we'll pay for mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me, let me just ask you this.
[CUSTOMER][NEUTRAL] Uh, the, the most recent, um, was this, this year.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What I'm going, what I'm asking you is, do I just send those uh.
[CUSTOMER][NEUTRAL] Charges or I mean just in those bills because he's been on it since um.
[CUSTOMER][NEUTRAL] [PII], so don't even worry about sending the 23 bills.
[AGENT][NEUTRAL] No, was your policy active in [PII]?
[CUSTOMER][NEUTRAL] Mine was in [PII] and when uh when the next school year came around, I added him, uh, but I didn't never use it.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I would go ahead and send everything in.
[CUSTOMER][NEUTRAL] And so he's been flying back and forth.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] And they can just throw out what's not and because I have to send his original where he was diagnosed with the prostate cancer, correct?
[AGENT][NEUTRAL] Yes, you, yeah, you will, um, and the, the most that I could see happening is that they'll deny the charges for the first one since the policy wasn't active, but they separated out based off of the data service and um different procedures so they'll be able to sort that out.
[CUSTOMER][NEUTRAL] OK, and uh when it says uh about the insured, is it my name or his name?
[CUSTOMER][NEUTRAL] Because after the on the paper, then it goes about the patient, so.
[CUSTOMER][NEUTRAL] I was wondering if I was supposed to put my name on that line or his name.
[AGENT][NEUTRAL] Uh, yeah, you will be the insured because you're the policy holder.
[AGENT][NEUTRAL] Let me pull up the file and I can look at it.
[CUSTOMER][NEUTRAL] OK, and do they?
[CUSTOMER][NEUTRAL] Do they mind white out then I'm gonna have to white out this information.
[CUSTOMER][NEUTRAL] Because I put his name.
[CUSTOMER][NEUTRAL] First, on everything instead of mine.
[AGENT][NEUTRAL] Let me see where, OK, about the insured, yeah, that would be you.
[AGENT][NEUTRAL] Um, and then the patient, yeah, that would be him.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I, it's OK to write, write up this, OK, alright, and so how do I do this? How do I mail it to you guys or I do I, um, fax it or what do I do?
[AGENT][NEUTRAL] And yeah, why that should be OK.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Um, you can mail it or fax it.
[CUSTOMER][NEGATIVE] They don't have any instructions about that.
[AGENT][NEUTRAL] Yeah, you can mail it or fax it. um, do you have an online account with us?
[CUSTOMER][NEUTRAL] Um, I don't know. Like I say, this is my first time even dealing with this.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, what is your um
[CUSTOMER][NEUTRAL] So I don't know no I don't have an online account.
[AGENT][NEUTRAL] OK, um, if you sign up for an online account, you can, um, submit these claims through there, through your portal as well, and then you can click, uh, check claim status. Um, if you fax it or mail it to us, you can always call us back and we can give you claim status as well. um, and when you're ready we can help you set up an account if you need help, um, but for now, would you like me to give you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Would you like me to help you set up an account or do you want to just uh fax it in first, help you set up account, OK?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] I'll fax it in, uh, that would be, I wouldn't have to go to the mail uh to the post office, so I don't mind faxing it in.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right, um, our fax number whenever you're ready.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942-3 and you'll put attention claims department.
[CUSTOMER][NEUTRAL] Oh, you know what? I can't fax it. My, uh, they took our fax machine from. They want, can I scan it and email it? Will that work?
[AGENT][NEUTRAL] Um, you won't be able to email it. Um, if you'd like, you can mail it in, and I have our mailing address too.
[CUSTOMER][NEUTRAL] Yeah, they, I forgot I faxed the lightning struck it and they never came out and fixed it. OK, go ahead and give me your address.
[AGENT][POSITIVE] Oh wow.
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEGATIVE] And they're trying to get everybody to not.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And mhm.
[AGENT][NEUTRAL] Yes, ma'am. In [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the zip
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] [PII], um, hold that attention to?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] It will be attention claims department.
[CUSTOMER][NEUTRAL] To where I'm sorry.
[AGENT][NEUTRAL] Claims department.
[CUSTOMER][NEUTRAL] Claims
[CUSTOMER][NEUTRAL] OK, I got it.
[CUSTOMER][POSITIVE] OK, well I'll just do that and I think I asked you everything I needed to know.
[AGENT][NEUTRAL] All right. Well, if there's nothing else, um.
[CUSTOMER][NEUTRAL] Um, and whatever, is it a one time fee for, um, when you get cancer or?
[CUSTOMER][NEUTRAL] Do you know that?
[AGENT][NEUTRAL] Um, if you'd like, I can look up your policy number. It depends on your policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, let me give you the policy number. I have it right here.
[CUSTOMER][NEUTRAL] 252-631-5
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] And can I get you to verify your uh first and last name for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what is your address that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull up your policy.
[AGENT][NEUTRAL] Give me just a moment while I pull that up.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, here we go.
[AGENT][NEUTRAL] And this is just an explanation, an explanation of benefits. It's not a guarantee of payment. It looks like you do have an internal cancer first occurrence, um, a lump sum benefit of $10,000.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and you do have some diagnostic testing and, uh, imaging, uh, benefits as well. You said it was prostate cancer.
[AGENT][NEUTRAL] Yes, and depending on, uh, if you got radiation therapy, chemotherapy, or immunotherapy, um, you are allotted up to $20,000. Um, that's the maximum uh for a 12-month period.
[CUSTOMER][NEUTRAL] Yeah, he had all that but but he had, he got all that um.
[CUSTOMER][NEUTRAL] When he first started going.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, but, uh, he just had a radiation thing, uh.
[CUSTOMER][NEUTRAL] In [PII], I wanna say no [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, prostate, mm urinalysis.
[CUSTOMER][NEGATIVE] Well, we'll just see what happens uh because I, I totally blew this. I didn't, I didn't.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I just forgot about it.
[CUSTOMER][NEUTRAL] I took it out because we were smokers and
[CUSTOMER][NEUTRAL] Wind it up. I had um
[CUSTOMER][NEUTRAL] A diagnosis and not had a threat of cancer as well, but they're watching it, uh, so.
[CUSTOMER][NEUTRAL] I didn't file that either.
[AGENT][NEUTRAL] Yeah and we don't have um we don't have timely filing so as long as your claim or as long as the your date of service was while your policy was active, um you can you can submit the paperwork, submit everything.
[CUSTOMER][NEUTRAL] Even though I didn't then I would need another claim form for me correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][MIXED] Well, I didn't get, I didn't have cancer. It came negative, so I was blessed with that, but then he got it shortly after. So, um, mine's I, I have did the surgery thing to uh get it checked. So I don't know if that's cancer and
[AGENT][POSITIVE] That's good.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] I ain't gonna worry about it.
[CUSTOMER][NEUTRAL] If I can just get his covered because we're running into now um.
[CUSTOMER][NEUTRAL] Having to pay they're flying in for surgery and everything, but you know he hasn't been on his job.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, to get insurance and so now they're charging us and when we didn't have a bill it wasn't a problem but now it's a bill and that's what made me look at it, yeah, so if I can get whatever, uh, a dollar would help.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, well, yeah, you should, you should be covered. Uh, my name is [PII].
[CUSTOMER][NEUTRAL] So what was your name?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] They just did the biopsy on me, so that that's not because it has to be confirmed, right?
[AGENT][NEUTRAL] Um, right.
[AGENT][NEUTRAL] But you do have cancer screening benefits.
[CUSTOMER][NEUTRAL] OK, let me ask you one.
[CUSTOMER][NEUTRAL] OK, yeah, I do.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Uh, yeah, it looks like on your policy you have a diagnostic testing benefit, um, a maximum of one test per year.
[AGENT][NEUTRAL] Uh, per calendar year of $50 and then you have follow up diagnostic testing, um, up to $100 per calendar year. So, um, make sure to get an itemized receipt of all of that testing too. You're only allotted one, diagnostic test per calendar year, um, but it should cover that too.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me ask you something else, uh, one more thing, [PII], is there a way you can send me, I hate to send this with all this white out on it, is there a way you can send me, uh, a claim form so I can refill this out?
[AGENT][NEUTRAL] Sure, um, let me get that just real quick.
[CUSTOMER][NEUTRAL] And I'll just make a copy and put my stuff with it and see what happens.
[AGENT][POSITIVE] Sure, and any time you do need a form, I will email this to you, um, but any time you do need a form you can just go over to [PII], click claims and forms, and they'll all be right there for you.
[AGENT][NEUTRAL] Let me get this one started for you.
[CUSTOMER][NEUTRAL] OK, I think this uh.
[AGENT][NEUTRAL] Alright, give me just one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And is the email that we have on file a good email to send it to?
[CUSTOMER][NEUTRAL] What is the email you have?
[AGENT][NEUTRAL] It looks like I have your work email.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So will they send me a letter if the form, the claim is denied or well how would I get notification of that?
[AGENT][NEUTRAL] Uh, you should get a letter, um, if you ever decide to get the online service account or the online account, you'll just go to secured.
[CUSTOMER][NEUTRAL] Let me go ahead and do that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Go to what?
[AGENT][POSITIVE] Secured. [PII].
[CUSTOMER][NEUTRAL] OK, what do you want me to go to?
[AGENT][NEUTRAL] Uh, secured, so SEC.
[CUSTOMER][NEUTRAL] Wait a minute.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. Oh, go ahead.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, I have it on here, wait a minute, I see this.
[CUSTOMER][NEUTRAL] OK, I want to do I have an online account?
[AGENT][NEUTRAL] Well we do we did um get a new um portal provider so you'll have to reregister anyways um I will say when re-registering um I would only fill out.
[AGENT][NEUTRAL] The um portions that have an asterisk on it. So it should just be your
[AGENT][NEUTRAL] Last name, email, and date of birth. I wouldn't fill out all the other uh stuff just yet, um, just go ahead and get the account set up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you want me to click click on uh create your OSC account?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] That's what it said online oh click on that.
[AGENT][NEUTRAL] You click that.
[CUSTOMER][NEUTRAL] And then do.
[CUSTOMER][NEUTRAL] Uh, which role best describes you? OK, I'm the insured.
[AGENT][NEUTRAL] You are insured. Mhm.
[CUSTOMER][NEUTRAL] And then next.
[CUSTOMER][NEUTRAL] And then you said with the asterisk on it?
[AGENT][NEUTRAL] Yes, so last name, email, and date of birth.
[AGENT][NEUTRAL] You will need to use the email that we have on file which is your uh it looks like your work email with the [PII].
[CUSTOMER][NEUTRAL] Yes, OK, and then my birthday.
[CUSTOMER][NEGATIVE] No, no.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] No, [PII].
[CUSTOMER][NEUTRAL] Not [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Where is [PII].
[CUSTOMER][NEUTRAL] Oh, it's here.
[CUSTOMER][NEGATIVE] I'm not a good stroller.
[CUSTOMER][NEUTRAL] I don't know, [PII].
[CUSTOMER][NEGATIVE] It keeps going back.
[AGENT][NEUTRAL] Is it having issues with the date of birth?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] Yeah, it won't let me type it in.
[CUSTOMER][NEUTRAL] And I'm not, uh oh, now I'm way in [PII].
[AGENT][NEUTRAL] Oh, you have to scroll it.
[CUSTOMER][NEUTRAL] On the way. OK, I'm just gonna roll it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] September, OK, got it.
[CUSTOMER][NEUTRAL] No user was found with this information that was in. Please try again if the error persists call because.
[AGENT][NEUTRAL] Mm. All right, let me try real quick.
[AGENT][NEUTRAL] Let me see what I can do.
[CUSTOMER][NEUTRAL] Do I have to put my social security number in there?
[AGENT][NEUTRAL] Um, no, you shouldn't need to.
[CUSTOMER][NEUTRAL] Uh, my member number?
[AGENT][NEUTRAL] No, um, let me see.
[CUSTOMER][NEUTRAL] And I didn't put my zip code in either.
[AGENT][NEUTRAL] Let me see, your birthday was [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And with that then.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] Yeah, because I'm getting the same error message, so let me see.
[AGENT][NEUTRAL] A D G E R [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, well, it's not working for me either. Um, let me put in, let me put in a service ticket just real quick and we'll see what's um going on.
[AGENT][NEUTRAL] Um, but in the meantime I did email you that form. Um, do you wanna check and make sure while we're on the phone that you received it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] I will.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Care team
[AGENT][NEUTRAL] Yes, that would be it. Mhm.
[CUSTOMER][POSITIVE] Yes ma'am, I have it.
[CUSTOMER][POSITIVE] Yep I have it.
[CUSTOMER][NEUTRAL] And go for me too.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And let me see.
[AGENT][NEUTRAL] And it said number not found, right?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] M.
[AGENT][NEUTRAL] I'm putting in a ticket real quick.
[AGENT][NEUTRAL] Let me see what we got here.
[AGENT][NEUTRAL] And um when we get this resolved, would you like us to call you or send you an ema[PII]?
[CUSTOMER][NEUTRAL] You can send me an email.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, real quick.
[AGENT][NEUTRAL] Um, what's the best phone number to call you back at? Is it the [PII]? Is it the one ending in [PII]?
[CUSTOMER][NEUTRAL] Uh, no, call me on my, you can call me at [PII]. That's my direct line.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and what browser were you using? Was, is it blue? Is it multicolored?
[CUSTOMER][NEUTRAL] I'll call you right back.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Oh, I'm sorry.
[AGENT][NEUTRAL] What browser are you using Chrome, Edge, Safari?
[CUSTOMER][NEUTRAL] Um, oh, I don't know.
[AGENT][NEUTRAL] What's the little, what's the little picture? Is it blue or is it uh yellow, green, and red?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, I've, I've, uh.
[CUSTOMER][NEUTRAL] Little picture uh that I have on screen.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Picture of what?
[AGENT][NEUTRAL] What's the little icon, what's the icon that you click to get onto the internet?
[CUSTOMER][NEUTRAL] What are you asking me? Say it again.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] It's blue and green.
[AGENT][NEUTRAL] OK, so that is edge.
[CUSTOMER][NEUTRAL] Red, blue, and green, red red, yellow.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Red, gold and green with a blue dot in the middle.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right, well, I put in a ticket um to get that resolved, we'll give you a call whenever it's or we'll give you a call if you have any issues and once it's ready, we'll get that online account set up for you. Uh, in the meantime, I did send you the email, uh, just in case.
[AGENT][NEUTRAL] Uh, and then you'll be able to fill that out and at least get it started. You have the uh fax number and the um mailing address, so that should be fine for now, um, while we work on getting your account done.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] So I'll go mail this today.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, appreciate you.
[AGENT][POSITIVE] Alright, thank you so much for calling APL Delma. I hope you have a, I hope you have a great day.
[CUSTOMER][NEUTRAL] Bye
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][NEUTRAL] Mm bye.
[CUSTOMER][NEUTRAL] Mm bye bye.