AccountId: 011433970860
ContactId: 22513104-fe01-47d5-b295-05abca0b5596
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2656699 ms
Total Talk Time (AGENT): 1253550 ms
Total Talk Time (CUSTOMER): 1306700 ms
Interruptions: 30
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/22513104-fe01-47d5-b295-05abca0b5596_20250403T15:53_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] Uh yes, my name is uh [PII].
[CUSTOMER][NEUTRAL] And I got some questions on claims uh.
[CUSTOMER][NEUTRAL] Before I get started into the.
[CUSTOMER][NEUTRAL] You know, having any surgery and I, I, I don't even know where to start with the claim process and what, what do you gotta do what forms you do you have to have receipts or.
[CUSTOMER][NEUTRAL] Um, and what do, what do you, what can you claim, right, you know, I, um.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] I started actually.
[CUSTOMER][NEUTRAL] And here's what I don't understand about my cancer policy. This is what I got, uh.
[CUSTOMER][NEUTRAL] Maybe let's see, maybe you could look at my maybe you need my account number first maybe.
[AGENT][NEUTRAL] Yes, sir, if that's OK, please, sir.
[CUSTOMER][NEUTRAL] OK, my policy number is 236.
[CUSTOMER][NEUTRAL] 9191
[CUSTOMER][NEUTRAL] That's on the cancer part.
[AGENT][POSITIVE] Thank you, Mr. [PII]. I've got it pulled up.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I got 55 different, yeah.
[AGENT][NEUTRAL] All right, and I can help you with that. I did need to verify your information if you don't mind. Can I get a first can I get a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] OK, and your email address and
[AGENT][NEUTRAL] Date of birth.
[CUSTOMER][NEUTRAL] The email address is [PII].
[AGENT][NEUTRAL] It looks like I might have maybe a work email on file.
[CUSTOMER][NEUTRAL] The what?
[AGENT][NEUTRAL] Do you have a work email?
[CUSTOMER][NEUTRAL] Uh yeah. [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] That is the one we have on file and if you would like I can update that to your personal email, whichever you would prefer.
[CUSTOMER][NEUTRAL] OK, that's
[CUSTOMER][NEUTRAL] Yeah, if you could update it to my personal.
[AGENT][NEUTRAL] All right. And I apologize. Do you mind giving me that personal email again, please?
[CUSTOMER][NEUTRAL] OK, it's [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, so I've got [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] All right. I have updated that. And if we could also just uh uh verify your date of birth and current mailing address.
[CUSTOMER][NEUTRAL] OK, date of birth is [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] And I don't know which one you got on file as far as my address. I got a [PII].
[AGENT][NEUTRAL] That's it.
[AGENT][NEUTRAL] That's what we have on file.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. So, yes, sir, I do see that you have a cancer policy as well as critical illness, hospital indemnity, uh, excuse me, accident and life policy with us.
[CUSTOMER][NEUTRAL] OK, uh, here's my situation. I, uh, started in January where uh.
[CUSTOMER][NEUTRAL] I went to Urologist and he scoped me.
[CUSTOMER][NEUTRAL] He recommended that I go to a cancer center in [PII].
[CUSTOMER][NEUTRAL] I went to the cancer center.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And of course, I went, they went in, they put me out, uh, put me under then a outpatient thing, went in, put a stent in for a time, took a biopsy, sent that off, and said, OK, you got kidney cancer, OK.
[CUSTOMER][NEUTRAL] I've done
[CUSTOMER][NEUTRAL] CT scans, uh, about 3 or 4 of them already.
[CUSTOMER][NEUTRAL] I'm due to do a PET scan come Monday.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I don't know, and here's the other thing I, I don't know if I'm gonna stay with this guy. I'm trying to get set up with MD [PII] in [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] All right, but I'm looking at the policy and there's so many different things, uh.
[CUSTOMER][NEUTRAL] OK, like the CT scans. How does this work? I mean, do I got to file something on the CT scan, the anesthesiologist, every time I've been, I've been on the 3 times already. I mean, one time by year I just one time.
[CUSTOMER][NEUTRAL] Uh, 2 times. One time I rologist and the other time by the cancer doctor so he can go check it out.
[CUSTOMER][NEUTRAL] So I mean
[CUSTOMER][NEUTRAL] Uh, and then I'm sure when I go do surgery to get the kidney removed.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'll be out again. So that's, that'll be probably 3 times they put me out. Um, I don't know.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What does this pay? I mean, what is it, how do I go about, do I file all three claims or, and also I'll be probably taking the way they talk, the some kind of radiation or chemotherapy after, OK?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I'm I'm looking at the schedule of benefits.
[CUSTOMER][NEUTRAL] And if I go to [PII],
[CUSTOMER][NEUTRAL] It also says on here that they would pay a motel room, you know, so much of, of motel, you know, lodging and mileage and
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I mean, how do
[CUSTOMER][NEUTRAL] Oh, am I on the right track? Are they gonna pay for this?
[AGENT][POSITIVE] I got you.
[AGENT][POSITIVE] I got you, Mr. [PII]. I can help you. It is overwhelming, isn't it?
[CUSTOMER][NEUTRAL] I don't know, I don't know what to do.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, I am, I am here to help you. It's just like looking at a different language, isn't it?
[CUSTOMER][NEUTRAL] Yes, it is.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah, yeah, I don't know what's covered, what ain't covered, uh, you know what, and, and do I have to go to each one of these individuals and fill a form out or, you know, I, I, I don't know what to do.
[AGENT][POSITIVE] I've got you. I can help you.
[AGENT][POSITIVE] You, uh, I'm gonna, I'm gonna give you kind of a step by step. How about that?
[AGENT][POSITIVE] And make, make it easy for you.
[CUSTOMER][POSITIVE] That works.
[AGENT][NEUTRAL] And first of all, I just wanna say thank you for saying [PII] because I have been arguing with a friend of mine, and they say [PII], and I'm like, mm mm, it's not [PII]. I'm from [PII], it's [PII] you know.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, you, you're in full good?
[AGENT][NEUTRAL] I'm, I'm outside of [PII], yes, sir.
[CUSTOMER][NEUTRAL] You, you're around.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I got a place over there in, uh, I don't know if you know where [PII] is.
[AGENT][NEUTRAL] I sure do. In fact, that's around from where some of my family's from.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Aros Summit and home.
[CUSTOMER][NEUTRAL] Yeah, I got a house over there in my walk.
[CUSTOMER][POSITIVE] They are uh so so and Laurel up that way.
[AGENT][NEUTRAL] Right. Right out of [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Cause I got, I got a place up there.
[CUSTOMER][POSITIVE] Yeah, my wife's from over there and we got a house up there and I got a little bee farm up there, you know, I raised honey bees and honey and all that stuff.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Do you sell honey?
[CUSTOMER][NEUTRAL] Yeah, so.
[CUSTOMER][NEUTRAL] Yeah, yeah, when, uh, well.
[AGENT][NEUTRAL] I've been looking for some local honey. Do you sell it anywhere around [PII]?
[CUSTOMER][NEUTRAL] I go to [PII] all the time, you know, uh, I probably won't be going to after my surgery, probably be, uh, probably July before I go, you know, because, well, I sold all my honey. I sold 13 drums of honey this year. Um, and a lot of it was in [PII].
[AGENT][POSITIVE] Oh my goodness.
[AGENT][NEUTRAL] Do you have a vendor?
[CUSTOMER][NEUTRAL] I go to [PII], Philadelphia, Meridian.
[AGENT][NEUTRAL] Or do you just come up for shows?
[CUSTOMER][NEUTRAL] No, I do.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] I do in uh [PII] on the I-49 flea market and in [PII] they got a flea market called 589 Flea Market.
[AGENT][POSITIVE] I got you.
[CUSTOMER][POSITIVE] But, uh, normally, uh, you know, I, I've been selling to, uh, you know, by the buckets and by the case what I sell it for, and actually I'm cheaper than everybody else so.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, that
[AGENT][NEUTRAL] That makes you in demand.
[CUSTOMER][NEUTRAL] Yeah, I, I sell it. I mean there's uh.
[CUSTOMER][POSITIVE] Keep my number and give me a holler, you know, by, uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I usually, I'm probably not gonna pull to [PII], you know, this this year I usually pull in May, but all with all my problems right now I'm gonna have to wait till July, you know, so.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, you, you might want to take a little rest first.
[CUSTOMER][NEUTRAL] Yeah, I don't know. Mm.
[AGENT][POSITIVE] That local honey is the best. I, I just keep staying buying from grocery stores and stuff. I mean, you know, unless it's local, uh.
[CUSTOMER][POSITIVE] But uh that's right.
[CUSTOMER][NEUTRAL] Well, there's something in the.
[AGENT][NEUTRAL] It's just not
[CUSTOMER][NEUTRAL] Hey, you don't know what you get in the store, you know, a lot of it's imported from overseas and it's not regulated, you know, so you don't, you don't, plus they got, plus they overheat it to keep it from crystallizing. And when they overheat it, it, um, it takes all the, the good stuff out of it.
[AGENT][POSITIVE] Exactly.
[AGENT][NEUTRAL] Didn't it kill some of the properties? Yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, if they don't do that, it's.
[AGENT][POSITIVE] I want all the good stuff I can get.
[CUSTOMER][NEUTRAL] So, yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, wasn't it? Well that's just interesting.
[CUSTOMER][POSITIVE] Um, but that's what I do up there. I go up there every weekend.
[CUSTOMER][POSITIVE] Yeah, I like going to that pro shop up there.
[AGENT][NEUTRAL] Very
[AGENT][NEUTRAL] There you go.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Do you come all the way to [PII] or is there one in [PII]? I don't even know.
[CUSTOMER][NEUTRAL] No, I got, yeah, I go all the way in [PII]. They don't have one. They got one in [PII] Rouge and, um, and [PII], but I mainly go to [PII] about an hour from there.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Yeah, that's, I don't live far from the best pro shop as a matter of fact.
[CUSTOMER][NEUTRAL] hour and 10 minutes.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And [PII]. Yeah.
[CUSTOMER][POSITIVE] Oh really? Well, that's where I meet, that's where I meet. I meet all my customers, like when I sell the honey by the buckets and the case and all that.
[CUSTOMER][NEUTRAL] They all come, we, we make arrangements to meet at a certain time at Bass pro shop parking lot, you know, and then they come back and they pick it up and, you know.
[AGENT][NEUTRAL] Oh, got you.
[CUSTOMER][POSITIVE] Yeah, you know, cause it's, I mean, [PII]'s a big place for me to run around not knowing nothing, you know, so that's.
[AGENT][NEGATIVE] Yeah, and it's not a good place to run around anymore, you know.
[AGENT][POSITIVE] You're safer doing it in [PII].
[CUSTOMER][NEUTRAL] No, it's not.
[AGENT][NEUTRAL] For sure. It's kinda, kinda gotten like [PII], I think.
[CUSTOMER][POSITIVE] Yeah, so that's, that's where I meet all my people right.
[AGENT][POSITIVE] That's really interesting.
[CUSTOMER][NEGATIVE] Oh yeah, I don't even wanna get up there.
[CUSTOMER][NEGATIVE] I don't even get off the interstate over there.
[AGENT][NEUTRAL] Yeah. I, I don't go into [PII] anymore.
[CUSTOMER][NEUTRAL] But
[AGENT][NEGATIVE] It's sad how things have gotten, but that's.
[CUSTOMER][NEUTRAL] No.
[AGENT][POSITIVE] The way it is these days. OK, so thank you. I enjoyed that conversation. That was very interesting. Thank you.
[CUSTOMER][NEUTRAL] Yeah, I know, I mean.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Um, let's get, so what we're gonna need for your cancer claim, the very first thing we need.
[AGENT][NEUTRAL] Mister, can I just call you [PII], Mr. [PII]? Would that be all right?
[CUSTOMER][NEUTRAL] Yeah, that's fine, yeah.
[AGENT][NEUTRAL] OK, thank you. OK, so the very first thing we're gonna need is the pathology report from your biopsy indicating a positive diagnosis of cancers. Just the pathology lab report.
[CUSTOMER][NEUTRAL] You need the images too?
[AGENT][NEUTRAL] It doesn't have to include images.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You should be able to to get that easily from your physician.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And there is
[CUSTOMER][NEUTRAL] Yeah, well, I'm trying to get it and, and what happened, what I'm doing, I'm trying to change over from this Mary Bird Perkins Cancer Center.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] To MD [PII] because I feel they got better qualified people there, you know, and so no, so, but they're hard to get into, you know, uh, my problem's been going on since, you know.
[AGENT][NEUTRAL] Oh yeah.
[AGENT][POSITIVE] Oh, you can't beat MD [PII] from what I hear.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, that
[AGENT][POSITIVE] Oh my goodness.
[CUSTOMER][NEUTRAL] So, and I haven't been able to get really get any kind of treatment for it yet.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You know,
[AGENT][NEUTRAL] Well, I've, you know, cancer is not what it used to be. They have got so many treatments and it's just, you know, it's, I mean, growing up, you know, when I heard cancer, we, we would always think.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] You know, you always thought, well, that's it, but.
[CUSTOMER][NEGATIVE] Yeah, you're gonna die.
[AGENT][NEUTRAL] Exactly, but now it's not that way, so.
[CUSTOMER][NEUTRAL] Yeah, I know.
[AGENT][NEUTRAL] And I'm sure there's still that fear when you're diagnosed, you know.
[CUSTOMER][NEUTRAL] But
[AGENT][POSITIVE] But the treatment has gotten so great.
[CUSTOMER][NEGATIVE] Well, they, they just taking their time and, and, you know, if it, if it does spread, I don't want, you know, all this time is wasted because we, you know, they just put things off, you know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] It's, do you feel like you, yeah, do you feel like you feel the urgency, but the doctors don't?
[CUSTOMER][NEUTRAL] It's hard to see a doctor, you know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] That's how I would feel.
[CUSTOMER][NEUTRAL] Well, you take like, I was supposed, the week of Mardi Gras, I was supposed to see the doctor and they canceled it because of Mardi Gras, you know, that week, you know. So, I mean, you know, that kind of made me feel.
[AGENT][NEUTRAL] Because of Mardi Gras when you've got cancer. Yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, he said, I'm not, I, I'm not gonna see you Mardi Gras week, you know, you know, Mardi Gras week, so I mean, we'll wait till the next week I'll come I'll see you again, you know, and I said to myself, I'm not worried about Mardi Gras, you know.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Right. That's not on your worry list right now, is it?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, so.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, we
[CUSTOMER][NEUTRAL] But yeah, he got that report and he came back and he said it was a stage 3 cancer, the kidney had to be removed, OK?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, and then followed by the oncologist.
[CUSTOMER][NEUTRAL] Who says, um,
[CUSTOMER][NEUTRAL] That I'll probably have to have some kind of chemotherapy or something. Um.
[CUSTOMER][NEUTRAL] But I'm doing this PET scan Monday. I've did several CT scans, um, on my chest and my abdomen, uh, and they found enlarged uh lymph nodes, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] I, I don't know where, what all we gonna need to get this, you know, to file these claims that's why I'm asking, you know.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Gotcha. OK, so you, I'm sorry.
[CUSTOMER][NEUTRAL] Um, and then if I, if I go to MDA, it's a different story there, but, you know.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yeah, that's not a problem either. We can.
[CUSTOMER][NEUTRAL] So what's the next thing?
[AGENT][NEUTRAL] So there is a claim form, it's called the cancer claim form.
[AGENT][NEUTRAL] And if you go to, are you, are you online right now looking at your policy? You said you were looking at the policy certificate, the scheduled benefit.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] Well, I, I see, I see all my different I see all my different policies, uh.
[CUSTOMER][NEUTRAL] Uh, I guess if I click on the policy number, give maybe I'll open it up.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] It will open up this your cancer policy and you can view what is covered.
[AGENT][NEUTRAL] Under your cancer policy. So you've got benefits for a lot of things on this policy.
[CUSTOMER][NEUTRAL] Like us.
[CUSTOMER][NEUTRAL] I print out, yeah, I printed this out and check.
[CUSTOMER][NEUTRAL] Let's see, that's one of like 5060 pages.
[AGENT][NEUTRAL] You're right. And then the schedule of benefits pages around page 19.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And that's in my documents, so maybe a little bit different than yours.
[AGENT][POSITIVE] It's gonna have schedule of benefits at the top.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Well, I got that printed out, yeah, I mean the first thing is radiation therapy.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Is that it? Mm, yeah, OK, I got to print it out. I got it.
[AGENT][NEUTRAL] That's right. So you're gonna see your benefits and the things that are covered. Now, your medical imaging is after the diagnosis of cancer, we can cover 2 medical imaging tests per year.
[AGENT][NEUTRAL] And then you see that benefit amount on the right is 500 per test.
[CUSTOMER][NEUTRAL] You say that, let's see, medical imaging, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Now that would be what? CT scan, PET scan, or what?
[AGENT][NEUTRAL] MRIs, any type of medical imaging after the diagnosis of cancer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, if you went in.
[CUSTOMER][NEUTRAL] Well I did, uh,
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Yeah, go ahead, I'm sorry. Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Well, I mean, after the diagnosis, after he diagnosed it, I had 2 CAT scans, 2 CT scans, and I'm doing a PET scan.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Monday.
[CUSTOMER][NEUTRAL] OK, so that would, that would be 3, so that would be that it's only covered up to 2, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that is per calendar year so.
[CUSTOMER][NEUTRAL] So that would be one.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, for your biopsy,
[CUSTOMER][NEUTRAL] Uh, but you, you, you would, you would just need the report or uh.
[AGENT][NEUTRAL] We need to itemize bills for any of these charges or services that are covered.
[CUSTOMER][NEUTRAL] Oh well, how would I get that from the doctor?
[AGENT][NEUTRAL] From the doctor. Yes, sir.
[AGENT][NEUTRAL] And your doctor should help you if you've got this.
[CUSTOMER][NEGATIVE] They had never sent me a bill.
[AGENT][NEUTRAL] Cancer policy, they should be able to help you with any of these.
[CUSTOMER][NEUTRAL] Well, CT scans were being done at the hospital.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, you may need to call the hospital for that and I my bill for the CT scans.
[CUSTOMER][NEUTRAL] So they would probably have it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, your doctor can help you with that pathology report if you don't have that. He should be able to help you get that.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah, and you need a bill for that too?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Or just a report. Oh, you need to bill for that too?
[AGENT][NEUTRAL] And the bill.
[AGENT][NEUTRAL] Well, we need these sur did they, you said they did a biopsy. We'll need that itemized bill for the biopsy as well.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the anesthesia.
[AGENT][NEUTRAL] So if you're going through your policy certificate and you see these benefits listed for any to pay any benefit, we're gonna need the itemized bill either from the doctor or the facility.
[AGENT][NEUTRAL] Either for from the physician charges or the facility charges or both.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then what if you get in.
[CUSTOMER][NEUTRAL] Now the anesthesia is the only thing, yup.
[AGENT][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] You only pay for 11 time only.
[AGENT][NEUTRAL] We'll pay 25% of what is paid uh.
[AGENT][NEUTRAL] Let me go back to that. It, um, well, it's a percent of amount paid for the coverage surgery, so we pay 25%.
[AGENT][NEUTRAL] Of the amount paid for the surgery.
[AGENT][NEUTRAL] So what whatever we pay, the benefit amount is 25% of that for anesthesia charges.
[CUSTOMER][NEUTRAL] OK. I, it, this one, this, this one, I'm confused right here. When I went in, he went in and got the biopsy. They did the anesthesia and, and
[CUSTOMER][NEGATIVE] And then they put a stent in me now.
[CUSTOMER][NEUTRAL] That's not removing the kidney or nothing. So, I mean, when I go back to get the kidney removed and have anesthesia again,
[CUSTOMER][NEUTRAL] That's a whole different thing or you can just go just one time only is all you could charge, I mean, I mean.
[AGENT][NEUTRAL] Now, it's
[AGENT][NEUTRAL] No, sir. It's, how many ever surgeries you have, you always send in that itemized surgery bill.
[AGENT][NEUTRAL] And anesthesia.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So when he went in to, to get the biopsy, I could.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sending that out of my building, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] For a biopsy and.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I would need a bill for him, that would be including his bill and, and the hospital bill?
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then, um,
[CUSTOMER][NEUTRAL] Alright, got this.
[AGENT][NEUTRAL] Let's just, I know you were asking about the transportation. So, hopefully, when you get into [PII], what they will do is for each data service, like if you go there for treatment.
[AGENT][NEUTRAL] Um, we'll need the itemized bill for that treatment with the physical location of [PII]. Then they'll calculate that from your home address, so make sure we have your home address on that.
[AGENT][NEUTRAL] As well, and if it's over 50 miles, then they can.
[CUSTOMER][NEUTRAL] Oh OK yeah.
[AGENT][POSITIVE] Reimburse you for transportation and lodging.
[CUSTOMER][NEUTRAL] And it's 300 and 3 312 miles one way, yeah.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] From here, from my house.
[AGENT][NEUTRAL] They just have to have that physical address for transportation for the uh.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Location of the
[CUSTOMER][NEUTRAL] So I guess um.
[AGENT][NEUTRAL] Facility.
[CUSTOMER][NEUTRAL] What I'm asking is each one of these things will have to have a claim form or you just need a bill for each one.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Once you submit that claim form, you don't have to submit the claim form again. Now, the cancer claim form on page one is going to have instructions and documents that are needed for each type of service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The page one has, it's, it's pretty lengthy.
[AGENT][NEUTRAL] With the instructions.
[AGENT][NEUTRAL] And you just go under the claims and forms section and go to the cancer claim form.
[CUSTOMER][NEUTRAL] On page one.
[CUSTOMER][NEUTRAL] Online
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] You can do that all online, OK.
[AGENT][POSITIVE] You can do it all online and when you get those itemized bills and things you can just upload it online as well.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I mean, it has to be like I went different dates. I went on the [PII]. I've had some scans done on the [PII], uh, and then no tell them I was having another scan done.
[CUSTOMER][NEUTRAL] This coming Monday, then I'm gonna be going so the dates you have, do I need to put them in order I guess or.
[AGENT][NEUTRAL] No, sir. Here's what I suggest. First of all, if you will go ahead and complete that claim form when you get that pathology report and the itemized biopsy bill, go ahead and submit that because your policy has a lump sum benefit upon a positive diagnosis of cancer.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, that will initiate that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I've seen where I've seen it at. It was like a kid that was $2500.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, yeah, I don't know if that's correct.
[CUSTOMER][NEUTRAL] Um, like the removal of it, you don't really have cancer.
[AGENT][POSITIVE] Well, that's gonna be the surgical. Yeah. So, upon a positive diagnosis of cancer, there is a first occurrence rider, and that, that is just for the positive diagnosis of cancer. There's a benefit of $2500.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] That we pay one time.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that's upon the diagnosis. And then that will, you know, with that pathology report, with that positive diagnosis of cancer, that will make all these other benefits um
[AGENT][NEUTRAL] Available.
[CUSTOMER][NEUTRAL] Available.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then if you're looking on the schedule of benefits, go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] OK, on the rate.
[CUSTOMER][NEUTRAL] Uh, I just want to ask you on the radiation or the chemotherapy, you, you do the same thing, you submit a bill for that too.
[AGENT][NEUTRAL] That's right. So anything that any medical services that are covered under the policy, just always ask for that itemized bill.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] And they'll, they'll.
[CUSTOMER][NEUTRAL] I don't an I.
[AGENT][NEUTRAL] Yeah, honestly, Mr. [PII], the places that you're going are probably used to people having cancer policies, and they're probably gonna already know what's needed for you to file. So when you tell them you have a cancer policy and you need an itemized bill, you should not have any problem whatsoever.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Getting that and then just, you know, you can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Save it, you know, take a picture of it and upload it on your policy.
[AGENT][NEUTRAL] If you want to do it that way, you can fax it to us. Our emails, we do not accept claims by email just because of security reasons for your personal health information. We want to keep you safe.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, but you can mail it, fax it, or upload it on your portal.
[CUSTOMER][NEUTRAL] Yeah. OK.
[CUSTOMER][NEUTRAL] So really I'm just gonna submit one claim and then I start submitting all these itemized bills, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] See how that works I mean.
[AGENT][NEUTRAL] That's how that works.
[CUSTOMER][NEUTRAL] Yeah it'd be uh
[CUSTOMER][NEUTRAL] So one claim and, but when I, when I, if I stay, go to the hospital and stay overnight, that's a whole different claim form or?
[AGENT][NEUTRAL] So, are you near a computer and let's look at that claim form.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, if you go to the claims form section and we'll look at the cancer claim form.
[CUSTOMER][NEUTRAL] Yeah, I'm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Actually it'd be 2 times you would submit this.
[CUSTOMER][NEUTRAL] Let me log back in.
[AGENT][NEUTRAL] That's fine. They've uploaded the form, so I've got to update the information I told you.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] They've made it so much easier.
[CUSTOMER][NEUTRAL] So I go.
[CUSTOMER][NEUTRAL] I go, I go to lay farms on top, on top, top of.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Play for good.
[AGENT][NEUTRAL] And then you should see on page one the cancer claim form.
[CUSTOMER][NEUTRAL] OK, and then.
[CUSTOMER][NEUTRAL] Well, it says male paper.
[CUSTOMER][NEUTRAL] No, I don't see that.
[CUSTOMER][NEUTRAL] Uh, I'm with.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Claim forms and
[CUSTOMER][NEUTRAL] Uh, claim forms or claims, uh, yeah, claims and forms.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, OK, I see that.
[AGENT][NEUTRAL] And it should have accident claim form, authorization to disclose information, and then the cancer claim form. Should be the 3rd 1 down.
[CUSTOMER][NEUTRAL] The 3rd 1 down.
[AGENT][POSITIVE] Yes, sir, on that list.
[CUSTOMER][NEUTRAL] Cla
[CUSTOMER][NEUTRAL] OK, claim form and policy change documents.
[AGENT][POSITIVE] Keep going, yes sir.
[CUSTOMER][POSITIVE] Keep, keep going.
[CUSTOMER][NEUTRAL] OK, authorization to disclose information Can claim form, OK.
[CUSTOMER][NEUTRAL] Alright, I download the form?
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm looking at it here. Let's see.
[AGENT][NEUTRAL] So you see on page one there's all these instructions and.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What type of documents needed to file for those services.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, if you.
[CUSTOMER][NEUTRAL] So I would a bit, yeah.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] I will submit this one, right? I will submit the the uh.
[CUSTOMER][NEUTRAL] Cancer claim form would
[CUSTOMER][NEUTRAL] Yeah, then I would start submitting documents uh pertaining to whatever's covered, right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I mean, do I have to write where it is what it is, and then once they get it, they'll know where it's at. They'll know where it is?
[AGENT][NEUTRAL] They will.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] They will.
[AGENT][NEUTRAL] Now, the only thing that, and I did tell you in.
[CUSTOMER][NEUTRAL] So all I gotta do is like.
[AGENT][NEUTRAL] I'm sorry, go ahead. Mhm.
[CUSTOMER][NEUTRAL] No, I mean, as well.
[CUSTOMER][NEUTRAL] Uh, I was just gonna like, uh.
[CUSTOMER][NEUTRAL] When I submit them like uh.
[CUSTOMER][NEUTRAL] I, I, I don't know. I, I'm lost. I forgot what I was gonna ask you. I mean, uh, uh.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] I'm so sorry.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] I'm just trying to comprehend all this stuff, you know.
[AGENT][NEUTRAL] Well, it's a lot to take in and actually.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It might just be easier if you just start with that pathology report and your biopsy itemized bill and the claim form, just to get started.
[AGENT][NEUTRAL] And then when you start getting the itemized bills, you know, from surgeries other than the biopsy, you can just upload those.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So
[AGENT][POSITIVE] And just kind of take it one step at a time.
[CUSTOMER][NEUTRAL] Biopsy reports.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] An itemized bill and then the.
[CUSTOMER][NEUTRAL] Is a pathology report.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And which, which other one I don't and uh.
[AGENT][NEUTRAL] Itemized biopsy surgery bill. That's correct.
[CUSTOMER][NEUTRAL] Biopsy report.
[AGENT][NEUTRAL] And the, you know, an itemized bill of the charges for that biopsy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And this claim form I think if we start there.
[CUSTOMER][NEUTRAL] And the doc and, and, and the doctors.
[CUSTOMER][NEUTRAL] need the doctor's charges too for, for doing the surgery?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] So we need to
[AGENT][NEUTRAL] So, so let's get started and let's let's just take it step by step. So if you will first of all submit the claim form.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] With the pathology report?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And the itemized surgery bill for your biopsy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's from the surgeon. That's what I would start with.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, if you've got the itemized bills for the CT scans, you can also submit those. So what's gonna happen is the adjuster's gonna get your information, they'll pull your claim document.
[AGENT][NEUTRAL] And they're gonna see every all the charges that you have submitted for and then they're gonna look at your policy and see what can be payable, what's what's covered under your plan.
[AGENT][NEUTRAL] And so they'll uh see that those benefits are payable for those charges.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If they need any type of additional documentation, they'll send you a letter.
[AGENT][NEUTRAL] In the form of an explanation of benefits, it's an EOB they'll say this is not a bill, it's an EOB um or explanation of benefits and there'll be an explanation of any additional documents needed of what is needed.
[AGENT][POSITIVE] But this will get you started with your benefits.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And your claims and then along the way as you get.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Any bills or if you go for any of the covered services, ask them for an itemized bill for those services, for those charges.
[AGENT][NEUTRAL] And then as you get them, you can just upload them. You don't have to upload the claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, just uh, OK, just upload them.
[AGENT][NEUTRAL] Mhm. And she came on.
[CUSTOMER][NEUTRAL] I m[PII] you got a reference to claim form or.
[AGENT][NEUTRAL] Mm. Not a thing. Just upload them on your policy. That's right. And we'll do the work as far as connecting it to your cancer diagnosis.
[CUSTOMER][NEUTRAL] You just, just upload them or you?
[CUSTOMER][NEUTRAL] Mm, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] You just upload them and let us work our magic.
[CUSTOMER][NEUTRAL] OK, now how do you know?
[CUSTOMER][NEUTRAL] How do you know, like this may linger on for 2 months, maybe 3 months, I don't know. I mean.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, all this is not gonna get settled until after it's completed, right?
[AGENT][NEUTRAL] That's right. So, um, after the.
[CUSTOMER][NEUTRAL] I mean,
[CUSTOMER][NEGATIVE] That's not good, yeah.
[AGENT][NEUTRAL] After the charges have been submitted to us, then the adjusters will review your policy certificate for benefits and your claim documents for charges.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now, it sometimes takes a while with cancer diagnosis because there's so many documents. You know, normally we try to keep our claim turnaround time to 7 to 10 days, but because cancer products have so many more benefits and, you know, it may take.
[AGENT][NEUTRAL] You know, about 2 weeks to process a claim or maybe even a little longer if they need additional documentation.
[CUSTOMER][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] And then there's also an option for direct deposit if you would prefer benefits to go directly to your bank account on our portal.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] There's an option and once you're submitting claims it should ask you if you would prefer payment to go to your bank and you can complete that form.
[AGENT][NEUTRAL] That's done online and it's automatically activated.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's not anything you need to submit to us.
[CUSTOMER][NEUTRAL] Now I'm looking at the
[AGENT][NEUTRAL] You just fill it out online.
[CUSTOMER][NEUTRAL] Uh, the transportation part. It says begin date of travel. You put the date, method of travel, you would put like your personal car and you put where you
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] You put where you're going trading location OK yeah.
[AGENT][POSITIVE] That's right.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So that
[CUSTOMER][NEUTRAL] And they'll just calculate it from.
[AGENT][NEUTRAL] Exactly, from your home address to that service location and that is what I when I told you earlier I'm gonna have to go back um this is where you would submit for transportation and lodging say if you do get into [PII] which.
[CUSTOMER][NEUTRAL] It
[AGENT][POSITIVE] I've got my fingers crossed for you, um.
[AGENT][POSITIVE] I think you will. I hope you do. Um, this is what he.
[CUSTOMER][POSITIVE] I hope so.
[AGENT][NEUTRAL] This is what you would file for transportation just that front page of that claim form and sign it.
[AGENT][NEUTRAL] And just complete that information for your.
[CUSTOMER][NEUTRAL] Yeah, it has non-local transport. It has, has non-local transportation and then family member lodging.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Which, what they're telling me is you go down there, you can stay 3 to 5 days for examination and treatments and, you know, so there's a hotel connected to the, to the hospital.
[CUSTOMER][NEUTRAL] You know, so.
[AGENT][NEUTRAL] Mhm. And you can also submit your receipt from the hotel where you paid for that lodging.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But on the, on the mileage part, you would put the, you don't know an actual in the mileage you spell out section C and family member lodging.
[AGENT][NEUTRAL] So section C is for your transportation that'll only pay for mileage. If y'all stay in a hotel, then you would fill out the lodging information.
[CUSTOMER][NEUTRAL] Yeah, really.
[CUSTOMER][NEUTRAL] Lodgers, OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you would probably fill out both at the same time, yeah. Yeah.
[CUSTOMER][NEUTRAL] OK, treatment locations and stuff, yeah, I see.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Well, what is, what is your name again? So I, if I need help again, I wanna talk to you, you know.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure. My name is [PII]
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, and what extension you have?
[AGENT][POSITIVE] It's [PII] or you can just call our our [PII], and if I'm available, it would be a pleasure to assist you.
[CUSTOMER][NEUTRAL] Well, how did I get you?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] And if not, any of our representatives will be happy to assist you.
[CUSTOMER][NEUTRAL] OK. Are you.
[CUSTOMER][POSITIVE] Yeah, you helped me a lot. I'd rather talk to you. I mean, you've used my mind a lot of this. I mean, as far as where to start because I mean it was.
[AGENT][NEUTRAL] Well, you know,
[AGENT][NEGATIVE] Overwhelming.
[CUSTOMER][NEUTRAL] You know, with all this.
[CUSTOMER][NEGATIVE] Yeah, this is overwhelming. This cancer stuff is overwhelming. I mean, and, and plus I'm still working. I'm still trying to work, you know. So, I mean, it's just a lot of stress on me.
[AGENT][NEUTRAL] Sure it is.
[AGENT][NEUTRAL] And I'm sure your mind is just.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] It's wandering.
[AGENT][POSITIVE] Yeah. I mean, if I was trying to work during all that, yeah, exactly. My mind would be just racing everywhere. But we've got you, Mr. [PII].
[CUSTOMER][NEUTRAL] You know, it's, it's going all over the place.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, I mean, it's hard to.
[AGENT][POSITIVE] And we'll be happy to help you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So just, you can breathe. You just, you just breathe.
[CUSTOMER][NEUTRAL] Alright then I'm gonna.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Um, just, um, take your time. There's no time frame to file a claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] The most important thing is that you take care of your health. That's correct. There's no time frame.
[CUSTOMER][NEUTRAL] Oh, there's not.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But I just wanna, I need to start gathering these things up with the ones I've done already because later on, I won't be able to do it, not right away, you know.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah and you know what, if you go ahead and submit what you've got then it won't be so difficult, you know, just as you do it then you can just upload that itemized bill and that way you don't have to worry about getting, you know, documents for 6 months or whatever, you know.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Now, there is also an authorization form if Ms. [PII] needs to call and check on something for you, we would need an authorization form completed to give her claim information for you.
[CUSTOMER][NEUTRAL] Alright, so, OK, that's what I'm gonna do.
[AGENT][NEUTRAL] Because you're the policy holder.
[CUSTOMER][NEUTRAL] Oh, OK, that's on the website too?
[AGENT][NEUTRAL] That is correct. It's a third party authorization form, you know, that's just in case that y'all just, you know, let's just say you're doing better and you're at work and you don't have time to call and check on the claim and.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You need to check on
[AGENT][NEUTRAL] Your radiation claim. And with that authorization form, Miss [PII] can call in and we can disclose that information to her.
[AGENT][NEUTRAL] Regarding your claims.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] They're not gonna pay.
[CUSTOMER][NEUTRAL] As you go, huh? I mean, they're gonna wait till the whole thing is finished, then make one lump sum payment. Is that how it's gonna work?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, sir.
[AGENT][NEUTRAL] It is as you go. It is as you go. When we get those claims.
[CUSTOMER][NEUTRAL] Huh?
[AGENT][NEUTRAL] When we receive them, if they're payable, we're gonna process and pay for that service.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] As you go? Oh, really? Mm.
[AGENT][NEUTRAL] As you go. Yes, sir. That, that's why I'm suggesting to start with the pathology and the biopsy and then as you go and start receiving bills, just upload them and let us take care of it for you.
[CUSTOMER][NEUTRAL] Yeah, I.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You know, if it's covered.
[CUSTOMER][NEUTRAL] So let me ask the the doc all the bills when I go asking for the bill.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, that's the bill that they submitted to the insurance company.
[CUSTOMER][NEGATIVE] Cause that, cause they haven't sent me nothing, you know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, now, your cancer policy is separate from your um primary insurance or your your medical insurance.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] So it's gonna be the same bill that they do send to the insurance companies. It should be the itemized bill that they send to your insurance.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] To the same bill OK.
[CUSTOMER][POSITIVE] Alright, that's what I needed to know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Because I know they always negotiate.
[CUSTOMER][NEUTRAL] You know, prices on the insurance. I'm looking on my insurance and it might be this like it was $19,000 for me to go to the emergency room, you know, at night.
[AGENT][NEUTRAL] Isn't that crazy?
[CUSTOMER][NEGATIVE] That's ridiculous.
[AGENT][POSITIVE] I completely agree.
[CUSTOMER][NEGATIVE] And then I had to wait 4.5 hours.
[AGENT][POSITIVE] Oh my gosh.
[CUSTOMER][NEGATIVE] I had to wait 4.5 hours. I was in pain and for $19,000 you know wheel me in and I was on the floor and everything else, you know, and I only stayed in there 3 hours, uh, in the emergency room after, after waiting 4.5 hours, you know, so.
[AGENT][NEUTRAL] It's
[AGENT][NEGATIVE] That is crazy. I just don't know what's gotten, I don't know why we've gotten, I don't know. I just, that's one of my pet peeves is medical costs these days. You could get me so I'd start to preaching. You better watch it now.
[CUSTOMER][NEUTRAL] Yeah, I know.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Oh, it's outrageous, you know.
[AGENT][NEGATIVE] It's outrageous. It's ridiculous.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEGATIVE] I mean, you can't even afford to get sick.
[CUSTOMER][NEGATIVE] And then I get bills from people I don't even know who.
[AGENT][NEUTRAL] Uh, you probably get bills.
[CUSTOMER][NEUTRAL] I, I'm fixing to put a chart in my room if I you know.
[AGENT][NEUTRAL] You're probably getting bills for breathing. Exactly.
[CUSTOMER][NEUTRAL] Yeah, but you don't even see the people.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] It's like if you take a breath, they're gonna charge you. Gosh.
[CUSTOMER][NEUTRAL] O.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] If they come in there and ask me how I'm feeling, you can have a bill for $300 somewhere, you know, I've had, you know, I've had that happen already. People just come in and they check off on you and get a bill for it.
[AGENT][POSITIVE] Exactly.
[AGENT][NEUTRAL] And you get a bill.
[AGENT][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Exactly.
[CUSTOMER][POSITIVE] All right, well, I appreciate your help. You, he's answered me a lot of questions and got me on the right track at least started, so.
[AGENT][POSITIVE] Oh, it's been a pleasure.
[CUSTOMER][NEUTRAL] So, it's a lot, it's gonna be a lot to do.
[AGENT][NEUTRAL] It seems overwhelming right now, but as you go along and kinda see how it works, I think it'll be
[CUSTOMER][NEUTRAL] You know.
[CUSTOMER][POSITIVE] Good.
[AGENT][POSITIVE] A little bit easier than what you feel like it's gonna be.
[CUSTOMER][NEUTRAL] So, really, I need to start on this.
[AGENT][POSITIVE] But besides, we're here for you.
[CUSTOMER][NEGATIVE] On the [PII] is when I actually went to the, before the [PII], I went to the urologist and went to the hospital, and that's when it seemed I had something wrong with my kidney. That was before the [PII]. On the [PII] is when they admitted, you know, admitted me to the hospital, went in, put a stent, biopsy. So that's when I really need to start, right? I don't need to start back.
[CUSTOMER][NEUTRAL] Then I went to the emergency room and then I've seen the urologist and he went into, I don't need to start there. I need to start when he did the pathology and biopsy.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Is that correct?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, that's what I'm gonna do.
[CUSTOMER][POSITIVE] All right. Well, I appreciate your time, so.
[AGENT][POSITIVE] It's been a pleasure.
[CUSTOMER][POSITIVE] I got any questions I'll give you all a holler back, you know, and you need, honey, you got my number, so just give me a call later on, uh.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][POSITIVE] All right, after July, I can get some for my birthday in July.
[CUSTOMER][POSITIVE] In July, hopefully I'll be, yeah.
[CUSTOMER][NEUTRAL] Uh, I'll be, uh, I'll be running around then hopefully, you know, so.
[AGENT][POSITIVE] That's right. You will be. You'll be up and going good by then.
[CUSTOMER][POSITIVE] Alright, I hope so.
[AGENT][POSITIVE] We go, we, we gonna have faith.
[CUSTOMER][NEUTRAL] Mhm. Yeah.
[CUSTOMER][POSITIVE] Alright well you have a good day this week.
[AGENT][POSITIVE] Well, I hope you do too, and call us if you need anything.
[CUSTOMER][NEUTRAL] You see, I see.
[CUSTOMER][NEUTRAL] OK, I sure will.
[AGENT][POSITIVE] All right. Well, thank you, Mr. [PII]. You have a wonderful day.
[CUSTOMER][POSITIVE] Well thank you very much.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.