AccountId: 011433970860
ContactId: 24625f1e-39c9-47cb-a975-571efe09e9bf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 558260 ms
Total Talk Time (AGENT): 286206 ms
Total Talk Time (CUSTOMER): 164708 ms
Interruptions: 7
Overall Sentiment: AGENT=1.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/20/24625f1e-39c9-47cb-a975-571efe09e9bf_20250620T17:28_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] Hi [PII], I'm not really sure, um, I think I signed up for this benefit, maybe not this year but last year, and I'm not sure if I was supposed to send like my mammogram and all that.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] OK,
[CUSTOMER][NEUTRAL] Is that how this one works or no?
[AGENT][NEUTRAL] OK, so you are not sure if you have a policy with APL or not. You're wanting to find that out and then you have a
[CUSTOMER][NEUTRAL] Right, I, I
[CUSTOMER][NEUTRAL] Right, like last year I know now the my workplace is through another company for this type of.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yes ma'am. And then you.
[CUSTOMER][NEUTRAL] Insurance, so
[AGENT][NEUTRAL] OK, so first off, um, well, I can help you with that. I can check to see if you have a policy, and then you also, if you did have coverage or do have coverage, you have questions about filing a claim. Is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, ma'am. I can help you with both. And so who am I speaking with?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And your full social please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. One moment while I look up um to see if I can look up your information. So just one moment, please.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, [PII], so first off, any information provided would be a verification of benefits and not a guarantee of payment. Um, I will have to verify several things with you first for security. So if you could first please verify your date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you, also your home mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number that is on file for you is the same as the one that you gave me, so that is the best contact number that we should have, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Thank you and then the last piece of information to verify is your email address and this would be your work email.
[CUSTOMER][NEUTRAL] Oh my word, hold on, um, uh, [PII] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so the
[AGENT][NEUTRAL] Most recent policy, Ms. [PII], uh, that you had with us was active from [PII].
[CUSTOMER][NEUTRAL] OK, last school year.
[AGENT][NEUTRAL] Yes, ma'am. Mhm. And that was the that was the last policy you had with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now with that being said, can I still put a claim for that year or no?
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] How was your day of service before [PII]?
[CUSTOMER][NEUTRAL] Hold on, let me look it I have it on my computer.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh this was in [PII], no, yeah, last year was [PII].
[CUSTOMER][NEUTRAL] Let me see what else I
[CUSTOMER][NEUTRAL] OK, now does the colon uh exam also count?
[AGENT][NEUTRAL] OK, so give me just one moment.
[CUSTOMER][NEUTRAL] Is it just mammogram?
[AGENT][NEUTRAL] And then it will be one or the other. I mean, you, your benefit is for one test. Yes, ma'am, per calendar, but yes, uh, a screening colonoscopy.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, so I did a call in.
[CUSTOMER][NEUTRAL] Yeah, yes, and [PII].
[AGENT][NEUTRAL] should be considered under your.
[AGENT][NEUTRAL] I'm so sorry. I didn't mean on what date?
[CUSTOMER][NEUTRAL] Under that, OK, no, go ahead.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh, I guess yeah this is covered under that, right?
[AGENT][NEUTRAL] Give me just one moment.
[AGENT][NEUTRAL] So yes ma'am, you could still submit your claim for that. I can give you the website that you would go to for the wellness claim form.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, can you please?
[AGENT][NEUTRAL] Sure, you will go to [PII].
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And when that
[AGENT][NEUTRAL] Page pulls up you're gonna see at the top there's a link or tab for um claim forms.
[AGENT][NEUTRAL] That's
[CUSTOMER][NEUTRAL] I'm going in there. Oh yeah, claim forms, uh huh.
[AGENT][NEUTRAL] Claims and forms, uh-huh, so you would click there, just click that link and you're gonna scroll down the page.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And about middle ways, let me, let me locate the specific tab for you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Where it says sign in register.
[AGENT][NEUTRAL] No, you're gonna click on claims and forms.
[AGENT][NEUTRAL] And then you're gonna scroll down.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And just one moment for me to locate your wellness forms.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so if you'll scroll all the way to the bottom of that page once you click claims and forms.
[AGENT][NEUTRAL] You'll see the different page numbers, click on page 3.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] No way, page 3.
[AGENT][NEUTRAL] And you'll see wellness and screening benefits claim form and out to the right there's a blue button that says download form.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] So I'm on the claim forms and then I see mail paper form.
[AGENT][POSITIVE] Keep going.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Scroll all the way to the bottom of the page.
[CUSTOMER][NEUTRAL] And then oh OK yeah where it says cancer uh huh, download form.
[AGENT][NEUTRAL] Keep going, not cancer. Keep going to the bottom of that page. OK, do you see where it has the numbers like 123 for page numbers?
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK, which one?
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Uh, hold on.
[AGENT][NEUTRAL] You may have to go back up just a little bit. OK, click on the 3, click on the 3.
[CUSTOMER][NEUTRAL] Yes, yes, yes, I see 123,
[CUSTOMER][NEUTRAL] And 3.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, all wellness screening, uh huh.
[AGENT][NEUTRAL] Yes, ma'am. Uh-huh, and click that blue download form button.
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] And that also has the instructions on it um for you, [PII].
[AGENT][NEUTRAL] And so you would just complete that form and then you can fax it. There is a fax number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm or mail it, right?
[AGENT][NEUTRAL] Well let's say I don't, yeah, there should be a, yeah, you can fax it or mail it in the PO box and the claims fax number is on the bottom of page one.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, now I don't see, I don't need a policy number or anything like that correct?
[AGENT][NEUTRAL] I'm gonna, I'm gonna give you that. Mhm.
[CUSTOMER][NEUTRAL] OK, OK, go ahead.
[AGENT][NEUTRAL] The policy number is 243.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 481 9.
[CUSTOMER][NEUTRAL] 243.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Alrighty thank you so much, [PII].
[AGENT][POSITIVE] Oh, you're very welcome. Is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] OK, well thank you so much then for calling APL and I hope you have a wonderful weekend.
[CUSTOMER][NEUTRAL] OK, how much did they reimburse you for this?
[AGENT][NEUTRAL] I can pull that information up while I had closed out of that, so give me just a moment.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's it I? I'm not your thing.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, you're gonna have told me I could have brought him in for you.
[CUSTOMER][NEUTRAL] Yeah, it is counting on.
[CUSTOMER][NEUTRAL] Oh, that's go for.
[AGENT][NEUTRAL] OK, that is a $50 benefit per calendar if if approved.
[CUSTOMER][POSITIVE] Alrighty, that's good, thank you, OK.
[AGENT][POSITIVE] OK. Well, you are very welcome. So yes, ma'am, again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, that's all. Have a great weekend.
[AGENT][POSITIVE] I hope you do too, and thank you again for calling APL. All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK bye bye.
[AGENT][NEUTRAL] Bye-bye.