AccountId: 011433970860
ContactId: 2613bf0a-61e0-468b-9d2f-69adbc87f285
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 840289 ms
Total Talk Time (AGENT): 233899 ms
Total Talk Time (CUSTOMER): 485527 ms
Interruptions: 7
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/2613bf0a-61e0-468b-9d2f-69adbc87f285_20250221T17:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes.
[CUSTOMER][NEUTRAL] [PII], my name is [PII]. Um, I have, my husband now has cancer and I have a cancer policy through you. I went and got a lot of the records from his surgery where they removed some nodules and now he's taking radiation. Um, do I need to, this is gonna be hard to scan all of these pages. Do I have to send all of these pages in?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That I got from the hospital.
[CUSTOMER][NEUTRAL] Or is it a certain thing that, that the cancer policy will pay on the actual surgery?
[AGENT][POSITIVE] OK. All right, Ms. [PII], I can help.
[CUSTOMER][NEUTRAL] I've read through what I have.
[AGENT][NEUTRAL] Yes ma'am, I can help you with your claim. Uh, can you please give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] OK, I'm at [PII].
[AGENT][NEUTRAL] Thank you. And then what is your policy number?
[CUSTOMER][NEUTRAL] Um, let me look, I'm online, um.
[CUSTOMER][NEUTRAL] See if it's on some of this stuff I have right here.
[CUSTOMER][NEUTRAL] I'm with through Webster Parish schools. I'm not actually looking at my policy number. Hang on and may take me a minute to find something that's got it on there.
[AGENT][NEUTRAL] I can look with your social if you'd like to give that to me.
[CUSTOMER][NEGATIVE] OK, my social and you're breaking up. I'm in the back of my house. It doesn't pick up as well. Um, my, my social is [PII].
[AGENT][POSITIVE] OK thank you so much and let me pull that real quick.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I've got the policy.
[AGENT][NEUTRAL] Well, didn't load for me. Let me try it again.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have the policy number now. I'm looking online.
[AGENT][NEUTRAL] And I just found it
[AGENT][NEUTRAL] OK. The 711167?
[CUSTOMER][NEUTRAL] Yeah, 711167.
[CUSTOMER][NEUTRAL] 67, yeah.
[AGENT][NEUTRAL] Yes, ma'am. OK, Ms. [PII], uh, just for security purposes, can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[AGENT][NEUTRAL] OK, and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] OK. Um my address is [PII].
[CUSTOMER][NEUTRAL] And I'm in [PII], and you asked me something else.
[CUSTOMER][NEUTRAL] My phone number or birthday. I gave you that.
[AGENT][NEUTRAL] Your email address please?
[CUSTOMER][NEUTRAL] OK, my email is my first.
[AGENT][NEUTRAL] Yeah, you gave me the birthday your phone number and your email.
[CUSTOMER][NEUTRAL] OK, my email is uh my first name is [PII] my last name [PII] [PII]
[CUSTOMER][NEUTRAL] And the next is my zip code [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, M. and then um the phone number that you provided for me if we're disconnected, is that your cell phone number?
[CUSTOMER][NEUTRAL] And I
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you, Ms. [PII]. I appreciate that so much.
[CUSTOMER][POSITIVE] Mhm mhm. No problem.
[AGENT][NEUTRAL] So, um, I'm gonna go to our website.
[CUSTOMER][NEUTRAL] OK, I'm on the website. I'm trying to get where I can hear you better.
[CUSTOMER][NEUTRAL] Are you there?
[CUSTOMER][NEUTRAL] OK, we're breaking up but.
[AGENT][NEUTRAL] Yes ma'am, I'm here.
[AGENT][NEUTRAL] Can you hear me? Oh no, let me see if I can fix that.
[CUSTOMER][NEGATIVE] OK, it's breaking up on my end.
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] On our website, um, if you go to claims and forms on the website, it, uh.
[AGENT][NEUTRAL] Let's see if you and you look at the cancer claim form.
[AGENT][POSITIVE] It has uh a really good cheat sheet on that first page of everything that you need to send in.
[AGENT][NEUTRAL] And you mentioned that he was going through um.
[CUSTOMER][NEUTRAL] OK, um
[AGENT][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] He's still, yes, it's this very coy. Um, I have all of this printed out but it's showing. Um, I, and I have done.
[AGENT][POSITIVE] Oh, OK, good.
[CUSTOMER][NEUTRAL] I have done, I've uploaded um files before so I I I'm I'm, I'm acquainted with that but my thing is I, I don't have a scanner.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I was gonna take, I didn't know if I needed to include where he had the surgery or just his treatment. I know they give a certain amount of money for the diagnosis. I've done that cause 2 years ago, we, he, well, about 10 years ago, he had a diagnosis of cancer, but they got it the first go around, you know, through the surgery. This time they didn't. And it's um
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] You know, he's taking radiation now. Uh, and I know I've read all the stuff about, they'll pay on the mileage, but it says it has to be at least 50 miles and it's 47.3 from my house to the cancer center. So I pretty much figured that it wouldn't pay on that. But um we've got a little foundation that's helping pay that through the cancer center. So they're helping out with the gas cause it's expensive going every day.
[AGENT][NEGATIVE] Oh darn.
[AGENT][POSITIVE] Mhm. Good.
[CUSTOMER][NEUTRAL] You know, from my house to [PII], it's about an hour and a half drive. So, but anyway, he had, what I was asking is, I don't want to have to scan all these pages from the hospital if they're not gonna pay anything on his surgery.
[AGENT][NEUTRAL] Ma'am.
[AGENT][POSITIVE] Oh, goodness.
[CUSTOMER][NEUTRAL] I know they'll pay for the doctor and he still sees that doctor and I went and got the medical records so far. Well, I stopped on the [PII].
[CUSTOMER][NEUTRAL] Collect and stuff. Um, and I'm, I can send some of it in, but I have to wait on the, the radiation because they're about a month behind on getting everything posted. Uh, uh, so what I'm saying is, do I need to send everything in that I got from the hospital from the surgery.
[CUSTOMER][NEUTRAL] Do I have to send that in or because it's, it's multiple pages and it would be so hard. I don't have a scanner but I use my phone to scan and I can send it that way but and I'd rather send it digitally, um, and that's why I'm asking if, if I have to send every one of these pages with is it just diagnostic codes that they need? He's got an assessment plan he's got all kinds of stuff in this file that.
[AGENT][NEUTRAL] Mhm. Yes, ma'am.
[CUSTOMER][NEUTRAL] From the surgery.
[CUSTOMER][NEUTRAL] So, do you know, can you look and tell if
[AGENT][NEUTRAL] Yes, ma'am, and uh.
[AGENT][NEUTRAL] Yes. Uh, so looking at, um, when filing a claim for services for hospitalization, surgery, chemotherapy, immunotherapy and radiation, um, you'll need the itemized bill from each medical provider.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You and you'll also need the explanation of benefits if you have another medical insurance carrier.
[CUSTOMER][NEUTRAL] OK, so let me write that down.
[AGENT][NEUTRAL] You need the operative report.
[CUSTOMER][NEUTRAL] OK, hang on, so we need an operative report.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think I have that. Um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what was the explanation of benefits?
[AGENT][NEUTRAL] Right, if you have another insurance that you're
[CUSTOMER][NEUTRAL] Now where do I get that?
[AGENT][NEUTRAL] From the insurance company.
[AGENT][NEUTRAL] If, then that's only if you have another medical insurance that you're using.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, we're, we use, he has Medicare and then he has a supplemental policy that I have to send that in. Is there a form you have to do that with?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, ma'am, you can just ask for the explanation of benefits from the insurance carrier for the date of service that he went and had the surgery done on.
[CUSTOMER][NEUTRAL] OK, so I would, how would I get that? Did they have that at the hospital or do I have to call my insurance company?
[AGENT][NEUTRAL] You'll have to call the insurance companies.
[AGENT][NEUTRAL] Usually they can send it over to you um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] By email.
[CUSTOMER][NEUTRAL] And I asked for explanation of benefits.
[CUSTOMER][NEUTRAL] For that date.
[CUSTOMER][NEUTRAL] That he had the surgery?
[AGENT][NEUTRAL] Yeah, for that date of service, yes.
[CUSTOMER][NEUTRAL] OK [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then when I get that y'all have to have that in order to pay this is what you're saying?
[AGENT][NEUTRAL] Yes, ma'am. Um, and you'll also need your itemized medical bill from each medical provider.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So each person, each medical provider that helped with the surgery, like you'll probably have the anesthesiologist, you'll probably have the, the surgeon himself, each medical provider, um, that helped with the surgery, you'll need your itemized statements from each one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's gonna be a lot. Um, if I send this by mail, which I don't, I don't trust the mail system anymore, I think I have everything that you're asking already except for an explanation of benefits, so.
[AGENT][POSITIVE] Oh, good, good.
[CUSTOMER][NEGATIVE] Um, but this is not, I will, I don't know if I need to hold all of this and send it all in at one time or because they will not.
[CUSTOMER][NEUTRAL] OK. We're having trouble getting to [PII] every day. It's very expensive and all of that, and I raising a [PII], I shouldn't have to, but I am. And my thing is I need to get that money to help out with other things, you know, just getting in there and uh cause we always have to go and get something to eat because he feels a little sick in the stomach. So,
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, it's just expensive. So if they're a month behind, should I just wait until, I mean, the surgery was in December, uh, well, it was in January, but it was diagnosed in December. So it, it, would it be better just to send it all at one time?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Cause if, if I have to upload it on to here, it's big files.
[AGENT][NEUTRAL] You can do that.
[AGENT][NEUTRAL] Yes ma'am, yes ma'am, it, it's up to you um we do not have a timely filing limit, so any time that you want to send in.
[CUSTOMER][NEUTRAL] Are you
[AGENT][NEUTRAL] The claims information that's purely up to you when you when you would like to do it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, well, I'm uh.
[CUSTOMER][NEUTRAL] I may just start scanning some of this, uh, from his ENT that I actually did his throat cancer surgery. And I went to the hospital, uh, this is clinical and then he's got the operative report that came from the hospital. So I'll try to get those uploaded and I've got it marked on everything that every day and everything. I'm keeping a log of all of that because it's gonna get very
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hard to keep up with before it's done. So, all right, well, I will, uh,
[AGENT][NEUTRAL] Right. Yeah.
[CUSTOMER][POSITIVE] I will go ahead and turn in what I can turn in and it'll take me a little bit to get this explanation of benefits I guess they can email it but I'll get on that today then but I thank you for your help.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you're so very welcome and I hope you guys have a blessed day and I wish you guys both well and hang in there. You're being a good wife.
[CUSTOMER][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And thank you so much for calling ATL.
[CUSTOMER][POSITIVE] OK. All right, thank you. Talk to you later. OK, bye-bye.
[AGENT][NEUTRAL] Bye-bye, Ms. [PII].