AccountId: 011433970860
ContactId: 234e7187-3c1f-41a4-9b8c-958ba65dbf00
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 444679 ms
Total Talk Time (AGENT): 90728 ms
Total Talk Time (CUSTOMER): 212352 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/234e7187-3c1f-41a4-9b8c-958ba65dbf00_20250304T15:46_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm with TRS Blue Cross Blue Shield. This is a recorded call.
[CUSTOMER][NEUTRAL] And I have.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] The our member is deceased, right?
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] And maybe you can transfer it to the right department and his sister is the beneficiary for his um life insurance.
[CUSTOMER][NEUTRAL] And she's stating that
[CUSTOMER][NEUTRAL] Um, American Public Life Insurance wants explanation of benefits from [PII], and I'm sure that's not correct.
[CUSTOMER][NEUTRAL] And can you uh transfer me to somebody or can you look and see exactly what is needed, what you guys are requesting?
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh, what's that policy number, Ms. [PII]?
[CUSTOMER][NEUTRAL] The policy number I think it's 2078422.
[CUSTOMER][NEUTRAL] Member ID.
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] It's [PII], you got it? OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I forgot my phone number.
[CUSTOMER][NEUTRAL] [PII] I don't know um.
[CUSTOMER][NEUTRAL] [PII] let me find my phone number, girl, that is something else.
[AGENT][NEUTRAL] It happens.
[CUSTOMER][NEGATIVE] I can't find it just a minute. [PII] that's probably not it doesn't sound right.
[CUSTOMER][NEUTRAL] Oh [PII].
[AGENT][NEUTRAL] So those fives and sixes.
[CUSTOMER][NEUTRAL] Uh-huh, but I can spit this out at any time. [PII].
[AGENT][POSITIVE] Awesome. Thank you, ma'am. And what's the insured's name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, TRS Blue Cross Blue Shield.
[AGENT][NEUTRAL] No, no, the insured, the, the patient's thing.
[CUSTOMER][NEUTRAL] Oh, the guy is [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you say he passed away?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] I'm so sorry to hear that.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] So his sister
[CUSTOMER][NEUTRAL] Just the beneficiary and um.
[CUSTOMER][NEUTRAL] She was saying y'all needed something.
[CUSTOMER][NEUTRAL] And what was your name again for my notes?
[AGENT][NEUTRAL] Uh, it's [PII] and you're calling from the group, Ms. [PII]?
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] I'm calling from the insurance company, yes ma'am.
[AGENT][NEUTRAL] Oh, you're calling from the insurance company, um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] From his uh medical policy.
[CUSTOMER][NEUTRAL] From Blue Cross Blue Shield.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] And he must have 2, he must have had 2 policies. I see 2 ID numbers.
[CUSTOMER][NEUTRAL] That she gave me.
[AGENT][NEUTRAL] Well, first thing we would need is a copy of the
[AGENT][NEUTRAL] Death certificate, um.
[AGENT][NEUTRAL] And any EOB for any treatment he received.
[AGENT][NEUTRAL] Because it's
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] No, any ELB for any treatment he received from for cancer? Why would y'all need that? It's dating back from [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] When was he diagnosed?
[CUSTOMER][NEUTRAL] We wouldn't have all that.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] When was he diagnosed, you know?
[CUSTOMER][NEUTRAL] She said, um.
[CUSTOMER][NEUTRAL] Sometime in [PII], so I'd have to look for that.
[AGENT][NEUTRAL] Yes, ma'am. Um.
[AGENT][NEUTRAL] But this type of policy, yes, ma'am. We're needing uh EOBs, past reports, any itemized billing for treatment he received.
[CUSTOMER][NEUTRAL] Oh man.
[CUSTOMER][NEUTRAL] OK, since [PII]. That's not gonna be possible. We're not gonna go back that far. This is [PII]. We pro I'll see however far back we can go. I'll find out.
[CUSTOMER][NEUTRAL] Um, I, I get what I can. I'll call you back, but it's gonna take some days, you know.
[AGENT][NEUTRAL] Yeah, uh, we don't have a time limit to submit, but in order for us to process claims, that's the information that is needed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, any OBs from date of diagnosis?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Any treatment
[AGENT][NEUTRAL] And when was he diagnosed, you say in [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, ma'am, especially that pathology report, um.
[AGENT][NEUTRAL] Initial pathology report, that information is needed for his plan.
[CUSTOMER][NEUTRAL] OK and.
[CUSTOMER][NEUTRAL] Pathology.
[CUSTOMER][NEUTRAL] Report for.
[CUSTOMER][NEUTRAL] The diagnosis of cancer, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] For diagnosis.
[CUSTOMER][NEUTRAL] Of cancer.
[CUSTOMER][NEUTRAL] And any ELBs from data diagnosis.
[CUSTOMER][NEUTRAL] Um, the ELBs from date of diagnosis and any treatment visits and the pathology report.
[CUSTOMER][NEUTRAL] For the diagnosis of cancer.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Alright. Let's see what I can do.
[CUSTOMER][POSITIVE] And [PII], thank you very much.
[AGENT][POSITIVE] Oh, you're welcome.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] You have a great rest of your day.
[AGENT][POSITIVE] Alright, you too. Thank you for calling APL.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh bye-bye.
[AGENT][NEUTRAL] Bye.