AccountId: 011433970860
ContactId: 1fc0db09-05c0-445a-a557-8836c9877f90
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1454609 ms
Total Talk Time (AGENT): 658367 ms
Total Talk Time (CUSTOMER): 524170 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/1fc0db09-05c0-445a-a557-8836c9877f90_20250501T15:53_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is um [PII], and I believe I've had a uh cancer policy with y'all, and I can't seem to find my policy, so I was wanting to um see if I could get a new one or
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] A copy
[CUSTOMER][NEUTRAL] We moved and and uh it's probably somewhere in all these boxes, but I can't seem to find it. So I was just gonna give you a call.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Of course, so that's no problem at all. I'll be more than happy to help you with getting your policy. Now, when you say you need your policy, are you saying like your breakdown?
[CUSTOMER][NEUTRAL] Um, well, I
[AGENT][NEUTRAL] Because the cancer policies don't really have, they don't have cards. Is that what you're looking for?
[CUSTOMER][NEUTRAL] Well, I don't know. Uh, this is new to me. I was diagnosed with breast cancer.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Yesterday and so it's just real new so I don't know the process. I don't know when I
[AGENT][POSITIVE] OK, well, I can help you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so the first thing, um, Ms. [PII], may I have a good contact number in case we're disconnected, and then if you don't have the policy, I can look it up with your social if you like.
[CUSTOMER][POSITIVE] OK, that'd be great.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And did you say [PII] or [PII]? Because the phone kind of went in and out. [PII], OK.
[CUSTOMER][NEUTRAL] Yeah, I
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] Alright, and Ms. [PII], what's a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I know, but uh yeah, and then, and I can give you my number which we're talking on right now.
[AGENT][NEUTRAL] Yes, ma'am, whichever you prefer.
[CUSTOMER][NEUTRAL] My.
[CUSTOMER][NEUTRAL] OK, the number I just gave you was my husband's phone number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then my phone number is [PII].
[AGENT][NEUTRAL] Thank you for that and I just located the policy. It's coming up now. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right, and I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Um, my date of birth is [PII].
[CUSTOMER][NEUTRAL] And my mailing address is, now we've moved, so it's probably different. It is uh um [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, yes, we have a different one. So the [PII] is the old address?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so hold on one moment, let me update this for you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And that was [PII].
[CUSTOMER][NEUTRAL] Uh huh just put just.
[AGENT][NEUTRAL] And did you say [PII]
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Put a [PII], uh, don't spell out the word. Just put a [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's the.
[CUSTOMER][NEUTRAL] And they like
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, the phone's breaking up. Can you spell that one more time? You're spelling the city, right?
[CUSTOMER][NEUTRAL] Yes, ma'am. [PII].
[AGENT][NEUTRAL] Can you spell it one more time for me? You said [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I, I'm gonna take you off the speakerphone. Is this better? OK, it's [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Alright, so I have [PII].
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] All right, let me save this for you. Hold on one moment.
[CUSTOMER][NEUTRAL] That's not
[CUSTOMER][NEUTRAL] Yeah, I'm, I'm gonna clean it up anyway, so yeah, well I need to, I, I gotta clean it up anyway.
[AGENT][NEUTRAL] Alright, I'm just saving the address. Hold on one moment.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, so the address is updated for you and then let me pull your policy benefits. So, basically how the uh policy, well, first, thank you for verifying and all the information provided is a verification of benefits, not a guarantee of payment. So, um, when you go to your doctors or um hospital, anything, um,
[AGENT][NEUTRAL] Medical relating to the um treatments or anything, you would just give them your policy number, so let me give that to you when you're ready and then our phone number and they're gonna call us to verify benefits. Now, let me see.
[AGENT][NEUTRAL] Well, let me give you your policy number first and then we can go through the benefits. Um, so your policy number, you ready?
[CUSTOMER][NEUTRAL] Uh, yes, ma'am.
[AGENT][NEUTRAL] Alright, so it's 702.
[AGENT][NEUTRAL] 267.
[CUSTOMER][NEUTRAL] 702.
[CUSTOMER][NEUTRAL] 267.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And I'm trying to look on, I'm waiting for the all the benefits to populate here. Now, if you um would like a copy of your, like your cancer policy, I can email you a copy or I can mail you a copy, um, but it'll just list like all the coverages, all the dollar amounts that it will pay, how often, um, because you have, you have quite a few benefits. I can go over it with you if you like.
[CUSTOMER][POSITIVE] That'd be great. And my husband is on the phone with me because it 2 ears are better, 4 ears are better than 1, or whatever.
[AGENT][NEUTRAL] Yes, ma'am. OK, um.
[CUSTOMER][POSITIVE] OK thanks
[AGENT][NEUTRAL] So it covers, um, oh, I'm sorry.
[CUSTOMER][NEUTRAL] It's a little
[CUSTOMER][POSITIVE] Yeah, it, we're just trying to get through a little fog right now and, and, and get this uh going for her treatment, yes ma'am, thank you so much.
[AGENT][POSITIVE] OK. You're very welcome. So, um,
[AGENT][NEUTRAL] If ever you're confined to the hospital, the policy will pay up to $200 per day.
[AGENT][NEUTRAL] For the 1st 30 days?
[AGENT][NEUTRAL] And then $400 per day starting uh if it's $31 or starting the next month.
[CUSTOMER][NEUTRAL] Um, after 31st day, OK.
[AGENT][NEUTRAL] Um, let me see.
[AGENT][NEUTRAL] Medicine. OK, you have a drugs and medicine benefits. So if you're um
[AGENT][NEUTRAL] Confined to the hospital and receiving medication, it will, it will pay up to $200 per consignment and then once um like if you have any, once you're discharged, um, it'll pay up to $50 per prescription with the max.
[AGENT][NEUTRAL] of $100 per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, $200 per hospital, um, each medication, right?
[AGENT][NEUTRAL] Mhm. $200 per so each time she goes to the, well, if she has to go to the hospital for, you know, like any medication or anything, it would pay up to $200 each time.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then $50.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, uh, what is that $50?
[AGENT][NEUTRAL] Per prescription.
[AGENT][NEUTRAL] The $50 is for like after she's no longer in the hospital, like if they give you prescriptions to take home or, you know.
[CUSTOMER][NEUTRAL] For per
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] If ever surgery is needed,
[AGENT][NEUTRAL] So, each surgery has like a surgical unit, like the amount that it's worth. So depending on that unit, the policy will pay $30 per unit up to $3000 per operation. So the max we would pay on an operation is $3000.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If surgery is ever needed and you all want to get like maybe a 2nd or 3rd opinion for the surgery, the policy would pay up to $300 per diagnosis of cancer.
[AGENT][NEUTRAL] And an additional $300 if a third opinion is needed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If ever, um, you need to go to like an outpatient hospital or maybe like a surgery center, the policy will pay $400 a day per surgery.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, if surgery is ever needed, uh, depending on the total of the surgery, anesthesia will be 25% of the amount paid for the surgery.
[CUSTOMER][NEUTRAL] OK, so anesthesia, 25% of the 400 you say?
[AGENT][NEUTRAL] Oh, no, no, that's just, um, however much the surgery is, the anesthesia will be 2, so it will be the $3000 max really. So it'll be 25% of that or if it's less than the $3000 25% or however much we pay towards the surgery.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Anesthesia $3000 OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let's see what else. Where did I? I lost my place. I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, we also have, um,
[AGENT][NEUTRAL] Radiation, the radiation therapy, chemotherapy, and immunotherapy benefits, um, so the policy will pay up to $15,000 per 12-month period towards the treatment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Um, any, uh, oh, I'm sorry.
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Radiation and chemo.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, OK, for treatment for um for uh per year or just one time, one year?
[AGENT][NEUTRAL] Oh, no, per year.
[CUSTOMER][NEUTRAL] Per year.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If any like labs or administrative labs are needed, um, the policy will pay up to $75 towards the labs per month.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, there is a transportation and lodging, um, so as long as the, um,
[AGENT][NEUTRAL] Like if there is a facility that that you have to go to for treatments, if it's a minimum of 50 miles plus, like from your home to that center, you can file for transportation. Um, it would pay up to 50 cents per mile.
[CUSTOMER][NEUTRAL] Yeah, we're approximately uh 150 approximately 5050 miles from the facility, yeah, that we would probably be using.
[AGENT][NEUTRAL] And there's a max of $1500 that we would pay um per round trip.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Max
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, so you're saying once that $1500 is met.
[CUSTOMER][NEUTRAL] Um, that, that, that the $50 per mile won't apply, right? It's up to that amount, is that right?
[AGENT][NEUTRAL] Oh, no, sir. So you have a total of 12 round trips that you can use per year. Um, it's just saying the max that we would pay towards those trips would be $1500.
[CUSTOMER][NEUTRAL] OK, OK, OK, yeah, um, so we would just, um, uh, when we make a trip we would just keep up with our mileage and, and there would be a claim form per trip, uh, up to 12, up to 12 round trips, OK.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Um, you also have lodging, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, it's $60 per day, up to 90 days per calendar year?
[AGENT][NEUTRAL] Now this, um, the transportation and lodging benefits, she has for her and then she also has family too, so it'll, like, you know, if you go with her to her uh treatments or you stay at the hos hospital hotel, you can also file for that too, so both of y'all can, and it's still the same 12 trips, well, it's 12 each, not altogether.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Yes, yes, ma'am. OK.
[AGENT][NEUTRAL] And then, um,
[AGENT][NEUTRAL] Let me see what else.
[AGENT][NEUTRAL] Any medical imaging, um, the policy will pay up to $200 per image.
[AGENT][NEUTRAL] With a max of 2 visits per calendar year.
[CUSTOMER][NEUTRAL] $100 per image.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And 2 times a year.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, there is a diagnostic and prevention benefit, so, um, like if there was any testing, you know, like a mammogram or any preventative test, um, she can file that $60 or she can file and be reimbursed $60 if she, if you all have already paid.
[CUSTOMER][NEUTRAL] And we've already paid.
[CUSTOMER][NEUTRAL] Um, so is that a benefit, um, relative to the mammogram and then they had to do a special, um.
[CUSTOMER][NEUTRAL] A well they did a best test before they ordered the biopsy and then we just had the biopsy anything rela relative to what's been done.
[AGENT][NEUTRAL] Yes, sir. Um, you all can file for that now. You're, to be honest, the policy has been active since [PII]. So once you get this breakdown um of benefits that I sent to you all, if you have anything that goes along with these benefits from [PII] up to today, you you can file. As long as the policy is active, you can file at any time.
[CUSTOMER][NEUTRAL] So that means we could go back to to [PII] and for a mammogram, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] We get
[CUSTOMER][POSITIVE] OK, wow, that's that's awesome, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] A diagnostic, uh, what, what is the diagnostic again, um.
[CUSTOMER][NEUTRAL] That's the last thing we had was um um medical imaging $200 per image two times a year. That's what I have and then.
[CUSTOMER][NEUTRAL] Is that diagnostic.
[AGENT][NEUTRAL] And um the diagnostic benefit is $60 per year to reimburse for that testing.
[CUSTOMER][NEUTRAL] OK, OK, $60 per year. OK, great, it's [PII], right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Thank you that's good, OK.
[AGENT][POSITIVE] You're very welcome. And did you all want me to like, uh, I can mail this to you or I can email it to you, whichever you prefer, just so you can have a copy of her policy and all the benefits.
[CUSTOMER][NEUTRAL] Yeah you can you can email it um that way we can just run off a copy here. What is the best phone for contact um.
[AGENT][NEUTRAL] For us,
[CUSTOMER][NEUTRAL] [PII], that you had.
[CUSTOMER][NEUTRAL] Yeah, that you want us to know when we submit this.
[AGENT][NEUTRAL] Oh, OK, so our phone number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, um, now what about with what insurance we have now this, this is, um, uh.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Separate from that correct um how how how does that play into this?
[AGENT][NEUTRAL] So when they ask you all for your insurance information, you're going to give them all your insurance cards, um, they will if you have a major insurance, they'll bill all of that first, and then they'll see that you have this additional cancer policy. So they're going to bill everybody, um, everybody, meaning like your major insurance, uh,
[AGENT][NEUTRAL] I don't know who, if you have like Blue Cross Blue Shield, Aetna, or if you're on Medicare, whoever your major is, they're gonna bill them first. They'll receive an explanation of benefits from them, and then um they're gonna go ahead and bill us since we're on file as well. And then hopefully between major and us, you don't have any bills, but after all the insurances are billed and you know, give the answer or the payment.
[AGENT][NEUTRAL] At the very end, if there's anything remaining, then you all would uh receive a bill unless there's some type of write-off or, you know, um, but hopefully after the insurances, you won't have one.
[CUSTOMER][NEUTRAL] Um, was there any provision for, uh, uh, a one time up upfront payment, um, [PII] seemed to.
[CUSTOMER][NEUTRAL] If we didn't know if.
[CUSTOMER][NEUTRAL] Or not.
[AGENT][NEUTRAL] And I was looking um to see if there's like a first occurrence benefit, like a lump sum payment, but I don't, I didn't see it on this policy.
[CUSTOMER][NEUTRAL] I thought that's what I was, I thought that's what I had.
[AGENT][POSITIVE] I can definitely um double check though.
[CUSTOMER][POSITIVE] OK, I appreciate that.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yeah, this policy doesn't have the lump sum on it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, this is just for the um benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, I mean like the services, I should say.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK, well we.
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] But you're fine. Go ahead.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] For the breakdown of your policy, for the email, we don't have an email address on file, but I can add it for you. Um, what would you all like me to put down?
[CUSTOMER][NEUTRAL] Uh, it's it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] So [PII]?
[AGENT][NEUTRAL] Alright, so I will go ahead and email this over to you all now. Was there [PII]ng else I can help you with today?
[CUSTOMER][POSITIVE] Thank done a great job explaining it. Thank you thank you so much, yes, yes, and we, we.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The, uh, a surgery, uh, scheduled, um, she has her first uh appointment next Thursday. I'm not trying to speak for [PII] but. No, it's fine. Um. Yeah, I'll, I'll go see the surgeon on next Thursday.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You know, I.
[CUSTOMER][NEUTRAL] They'll get it taken care of pretty quickly. And then there'll be uh um um.
[CUSTOMER][NEUTRAL] Uh, plastic surgery, how to, how to, how will that, how will we manage that is just make claims accordingly?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Will the policy pay me.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] On that
[AGENT][NEUTRAL] It would just be listed as like, it would just be listed under the surgeries like there's no like additional for for like plastic surgery on here, but it would be listed that you do have the surgical benefits.
[CUSTOMER][NEUTRAL] Yeah, um
[CUSTOMER][NEUTRAL] And he may be following up behind the surgeon, the, the, the um cosmetic, uh, the surgeon, um, right [PII]? Will he be, will you follow up at the time of surgery? Uh, he will be in the operating room the same time the, the surgeon does. OK, yeah, OK.
[CUSTOMER][NEUTRAL] We'll know more after Thursday.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Alright, well, if you all have any questions or want to go over anything, we're definitely here. We're praying for a speedy recovery um for you, Ms. [PII]. And was there anything else I can help you out with today?
[CUSTOMER][POSITIVE] No, ma'am, I think it, you've explained it well. Thank you. And [PII], thank you for those prayers.
[AGENT][NEUTRAL] Oh
[CUSTOMER][POSITIVE] We, we're, we're believers in the Lord.
[CUSTOMER][POSITIVE] Time for um for this to have an amazing outcome under the circumstances. We got a big guide.
[AGENT][NEUTRAL] It sure will.
[AGENT][NEUTRAL] And you just remember, Ms. [PII], no if it gets hard, God's got you and just keep on keeping on, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] You so much, [PII]. I appreciate it. Thanks, [PII]. You're awesome.
[AGENT][POSITIVE] You're very welcome. Thank you, y'all are too. Thanks for calling APL and I hope you all have a good weekend, OK?
[CUSTOMER][POSITIVE] You too you too bye bye bye.
[AGENT][NEUTRAL] Bye-bye.