AccountId: 011433970860
ContactId: 1f16bd17-4796-4536-a2e0-964e0f7ba3cf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 815869 ms
Total Talk Time (AGENT): 382280 ms
Total Talk Time (CUSTOMER): 279704 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/1f16bd17-4796-4536-a2e0-964e0f7ba3cf_20250624T18:04_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] Yes, ma'am. I'm calling um to find out how to um initiate a claim for a cancer policy um.
[CUSTOMER][NEUTRAL] From a, and this is a, an initial diagnosis.
[AGENT][NEUTRAL] OK, so are you the ins
[CUSTOMER][NEUTRAL] We're not really.
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] We weren't just weren't really sure where to start like how to start the process.
[AGENT][NEUTRAL] OK. So are you the insured?
[CUSTOMER][POSITIVE] I am, I, I have this, uh, policy through my employment and my husband is covered.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And he is the patient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I was starting about a cancer claim form and then I realized I was.
[CUSTOMER][NEUTRAL] Am I considered the insured?
[AGENT][NEUTRAL] You're the, OK, so you would be the policy holder, but I, I can help you with how to go about filing a claim with us. Um, first, I'll need to get some information from you to get your policy pulled up. So who am I speaking with?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you. And Ms. [PII], OK. All right.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is a good call back number for you please, Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, and your policy number?
[CUSTOMER][NEUTRAL] Uh, I don't know that I have that with me. Do I give
[AGENT][NEUTRAL] OK. What is your full social so I can, and I can look it up that way since you're the primary policy holder.
[CUSTOMER][NEUTRAL] Hold on
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I might have it on here you look.
[CUSTOMER][NEUTRAL] How
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] My social is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm so sorry. On the last 4 numbers, your voice cut out, Ms. [PII], what were the last 4 again?
[CUSTOMER][NEUTRAL] That's a
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][POSITIVE] Yes, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, so first off, Miss [PII], any information provided will be a verification of benefits and not a guarantee of payment. I will also need to verify several things with you first for security. So if you could first please verify your date of birth and then your husband's name and date of birth.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, my, my date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And his date of birth is [PII].
[AGENT][POSITIVE] Thank you and his name?
[CUSTOMER][NEUTRAL] His name is um [PII]. I'm gonna give you his full name it's A [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, that's, that's how.
[AGENT][NEUTRAL] Oh, OK. We do have him as [PII].
[CUSTOMER][NEUTRAL] [PII], yeah.
[AGENT][NEUTRAL] Mhm. OK. All right. And then what is your home mailing address, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And then the phone number that we have on file for you is the same as the one that you provided for me, so that is your best contact number, is that correct?
[CUSTOMER][NEUTRAL] It's my best contact number, but I feel like I should give you his number.
[CUSTOMER][NEUTRAL] Because he's a patient is.
[AGENT][NEUTRAL] Well, we need to have, no, this is for the policy as an overall.
[CUSTOMER][NEUTRAL] Or do you
[CUSTOMER][NEUTRAL] You need both
[AGENT][NEUTRAL] They have on file as, so that is your contact number, right?
[CUSTOMER][NEUTRAL] OK, yeah,
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Mhm it sure is. Uh, it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] yes ma'am. uh-huh and then what is your email address and this does appear to be your work email that is on file.
[CUSTOMER][NEUTRAL] You got [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so that's gonna be [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Now, do you want to leave that on file or do you want to change that to your personal?
[CUSTOMER][NEUTRAL] Probably be better if I put my personal, don't you think? I think it would. I feel like it so.
[AGENT][POSITIVE] OK. OK. All right. So what is this, yeah, I'll be happy to change that for you.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] That's going to be [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, alright, thank you.
[AGENT][NEUTRAL] Now I have gotten this changed for you Miss [PII]. I do wanna let you know that because of how we receive your district's enrollment information there is a possibility that it may come across on a file that still has your work email on it and if that is the case it would override this change, but.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The reason I've updated it is so that you can set up your profile in our portal called the online service center.
[AGENT][NEUTRAL] Because that's gonna give you access to your information online and it will also um you can file your claims directly into that portal that's the most efficient way to submit claims to us for review and you can also fax them or email them. I'm not sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Claims can either be uploaded to your portal, faxed or mailed. We cannot receive claims via email.
[CUSTOMER][NEUTRAL] Uploaded through portal.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm, that's the best way, uh-huh, or mailed, but not emailed.
[CUSTOMER][NEUTRAL] That.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] So you mhm.
[AGENT][NEUTRAL] I'm gonna go ahead and send you this um.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] The information on the portal about creating your profile and also about using it so it's gonna be two separate attachments and I am sending it to your personal email.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the email you're gonna get is gonna come from [PII].
[AGENT][NEUTRAL] And then since I'm already I'm sending.
[CUSTOMER][NEUTRAL] Did you say, did you say?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Did you say [PII]?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm also, since I'm sending you this, I'm gonna go ahead and just include the cancer claim form.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] So that you'll have that.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome, and you can get this claim the same claim form off of our main website at [PII], but this way you can just have it in your email and.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You know, print it as many times as you need to.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, I, I think I have a copy of.
[AGENT][NEUTRAL] Alright, so
[CUSTOMER][NEUTRAL] Of that of the cancer claim form and so when it says statement of insured am I considered the answer.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. That is.
[AGENT][NEUTRAL] OK, so give me one second to look at, to get something, one more screen pulled up, OK? 1 2nd.
[CUSTOMER][POSITIVE] Sure, sure, absolutely.
[AGENT][NEUTRAL] OK, so on on this cancer claim form the entire first page has the instructions, OK? Is that I wanna make sure you have the correct form.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEGATIVE] Page one is nothing but instructions.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's see, so.
[AGENT][NEUTRAL] The
[CUSTOMER][NEUTRAL] Complete the statement that says complete the statement of insured which is sections A through D. So on, on the statement of when it says about the insured, is am I the insured and he's the patient or both?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct. Yes. He is the patient.
[CUSTOMER][NEUTRAL] So I need to put
[CUSTOMER][NEUTRAL] So I need to put myself down for the insured.
[AGENT][POSITIVE] That is correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK, that's what I was.
[CUSTOMER][NEUTRAL] So it's gonna ask my social got you OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][POSITIVE] Alright, well, we're just getting started on this and I sure we were doing it right because I figured it's probably something we're gonna be doing a lot of.
[AGENT][NEUTRAL] And then
[AGENT][POSITIVE] Um, yes, yes, you will. Yes, ma'am, you will.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] Now, um, let's, I was gonna look at one other thing on your, give me just a second.
[CUSTOMER][POSITIVE] All right, well thank you.
[CUSTOMER][NEUTRAL] You have a question and she needs to if it needs to to be the pathology report or the doctor's uh note.
[CUSTOMER][NEUTRAL] For what it is for the free food.
[AGENT][NEUTRAL] Ms. [PII], I'm, I'm
[CUSTOMER][NEUTRAL] OK, he's asking, I'm sorry, he's asking if it to be the.
[AGENT][NEUTRAL] Oh, I'm sorry. Uh-huh. No, that's OK. It's just kinda hard to hear him.
[CUSTOMER][NEUTRAL] Yeah, the pathology report or?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The doctor's note.
[AGENT][NEUTRAL] Yes, if you'll notice on the top part of the, on those instructions, the 3rd bullet point.
[CUSTOMER][NEUTRAL] For
[AGENT][NEUTRAL] The pathology report must be submitted when filing a claim for the initial diagnosis of cancer or a new diagnosis of cancer or surgeries.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That is one of the required pieces. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, all right.
[AGENT][NEUTRAL] And then if you have any questions Ms. [PII] or need any assistance with the portal again you should have that email by now um then you can call us back, but once you get that set up you'll be able to upload your claim form and the claims um information directly into the portal for review.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][POSITIVE] OK, well thank you so much, take your time and all your help.
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] Well, you
[AGENT][POSITIVE] Well, you're certainly very welcome and I wish Mr. [PII] all the best with his treatment.
[CUSTOMER][POSITIVE] Thank you. I
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] That's so much thank you. Let's say.
[AGENT][POSITIVE] Well, you're welcome. And can I help you out with anything else today?
[CUSTOMER][POSITIVE] Anything else? No, no, that you helped tremendously.
[AGENT][POSITIVE] OK, well that was my pleasure in speaking to you both and thank you again for calling APL. I hope you have a nice afternoon.
[CUSTOMER][NEUTRAL] To thanks bye bye.
[AGENT][NEUTRAL] Yes, ma'am. Bye-bye.