AccountId: 011433970860
ContactId: 28704740-6e24-4743-a475-bb57fd1883eb
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 495200 ms
Total Talk Time (AGENT): 227578 ms
Total Talk Time (CUSTOMER): 200324 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/28704740-6e24-4743-a475-bb57fd1883eb_20250124T20:43_UTC.wav
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[AGENT][POSITIVE] Afternoon, thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. My name is uh [PII]. Yesterday I went to see the, uh, I went to see have a cancer test.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And I had a biopsy done on me to see if I, I, I ain't got the results back yet, but I got the paperwork I downloaded. So what else do y'all have to have for me cause I have to pay $500.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Now it was really 2000. I put $500 on it and they're gonna take out 10 $120 a month for my check cause everything was $2000 to have this done.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] So what would y'all need from me? besides the claim form I have in my hand.
[AGENT][NEUTRAL] Well, let me check that for you, Mr. [PII]. Do you have your policy number available?
[CUSTOMER][NEUTRAL] Let me see if I got all this thing here.
[CUSTOMER][NEUTRAL] Mm, so I can find it.
[AGENT][NEUTRAL] If not I can look it up by your social if that's OK.
[CUSTOMER][NEUTRAL] He is the sauce, yes, ma'am.
[AGENT][NEUTRAL] And that number.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you. Let me just get your policy pulled up. Do you mind verifying your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] Uh, date of birth [PII] mailing address [PII] zip code [PII].
[AGENT][POSITIVE] All right. Thank you, sir.
[AGENT][POSITIVE] Now, on this cancer policy, it does provide benefits if you are positively diagnosed with cancer.
[CUSTOMER][NEUTRAL] OK, what if I wasn't, then what happens?
[AGENT][NEUTRAL] Uh, let me see if you have that diagnostic benefit on here. Bear with me just one second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you do have a screening benefit.
[AGENT][NEUTRAL] And that is for, uh, to check for cancer.
[CUSTOMER][NEUTRAL] That's what I went did yesterday.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They did a biopsy and you know, they keep the little thing inside of you to pull tissue or skin yeah I had that done yesterday.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So I know you have your uh
[AGENT][NEUTRAL] Cancer screening benefit that is $100 and that is a verification of coverage, not a guarantee of payment.
[AGENT][NEUTRAL] The surgical.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Benefit will be payable if that diagnosis comes back positive.
[CUSTOMER][NEUTRAL] So we come back negative.
[AGENT][NEUTRAL] Now we
[AGENT][MIXED] Yeah, but we're not, that's right. And, but we're gonna hope it's negative for you.
[CUSTOMER][NEGATIVE] I had to pay it on my own.
[CUSTOMER][NEGATIVE] Yeah, so if it's, so if it's negative, I got to keep paying it on my own, y'all won't pay anything, right?
[AGENT][NEUTRAL] That's correct. Not, not unless it is a positive diagnosis of cancer.
[CUSTOMER][POSITIVE] So it is a positive diagnosis what happens then.
[AGENT][NEUTRAL] And well then you will have benefits payable and we can actually I can, we can mail you a copy of your policy or we have a portal if you are interested in creating a login and password, you could view the benefits that are payable on your portal.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, then what about when I have to put the money down yesterday, that's $500.
[AGENT][NEUTRAL] Now, that's going to be between you and the um medical facility. Now you, this policy is going to be like a reimbursement policy.
[CUSTOMER][NEUTRAL] So, OK, so basically when I get reimbursed for $500 I put down? Yes or no.
[AGENT][NEUTRAL] Well, it depends on if, if course, if it comes back.
[AGENT][POSITIVE] Um, a positive diagnosis, yeah, that's gonna be.
[CUSTOMER][NEUTRAL] 5.
[AGENT][NEUTRAL] Let me get that pulled back up on your surgical.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And come back angry. I'm just, go ahead.
[AGENT][NEUTRAL] And I
[AGENT][NEUTRAL] And tell me if it was, you're saying it was a surgical biopsy, correct?
[CUSTOMER][NEGATIVE] Mhm. No, they go inside the little thing the probe, and they cut off off you.
[CUSTOMER][NEUTRAL] Prostate little pieces of skin. Yeah, that's what I had done yesterday.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK. If you don't mind holding just one moment, Mr. [PII], let me get you to uh an adjuster in our cancer department. They can go over the surgical benefits with you.
[AGENT][NEUTRAL] And before I do, what is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Is it [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am. So what do they do? They look to see if I get any benefits off of this.
[AGENT][NEUTRAL] And we do
[AGENT][NEUTRAL] They'll they'll be able to check that for you and we don't have an email for you. Can I add an email?
[CUSTOMER][NEUTRAL] OK then.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right. I've got that added for you.
[AGENT][NEUTRAL] And that's [PII]?
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEUTRAL] [PII], you did say [PII]. I do apologize.
[CUSTOMER][NEUTRAL] That's right. So they let me know if I can get any benefits I would have to be yesterday, right?
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] Yes, so they'll be able to go over these benefits with you further. If you'll hold just one moment.
[AGENT][NEUTRAL] Give me just a moment, OK, Mr. [PII]? Thank you.
[CUSTOMER][NEUTRAL] OK. Yes, ma'am. Yes, ma'am.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling Eli [PII]. How can I help you?
[AGENT][POSITIVE] Howdy, my friend. How are you doing and Happy, happy Friday.
[CUSTOMER][NEUTRAL] I'm doing OK, and you?
[AGENT][POSITIVE] Yeah, I'm doing OK.
[CUSTOMER][POSITIVE] It's almost regular season. I had to laugh when you said that.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Oh, yeeha.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] I really am. I'm just really a good old cowgirl at heart.
[CUSTOMER][NEUTRAL] What you got?
[AGENT][NEUTRAL] I got policy number 256-6030 for [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And he had a biopsy yesterday and wants to know the surgical benefit. I told him, of course, it would only be payable if it comes back a positive diagnosis, but he wants to know the exact amount for that.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Biopsy that he could get paid because he had to pay $500 yesterday.
[CUSTOMER][NEUTRAL] Oh I better tell him exactly my um what's his callback number?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, you can send them through.
[AGENT][POSITIVE] All right, well, have fun and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Let me, let me get him on the line. Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Mr. [PII], thank you for your patience. I have [PII] on the line and she's going to assist you further, and you have a wonderful weekend.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] You too, ma'am.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Hi, Mr. [PII], this is [PII], um, on the cancer team. The rep stated you had a question um regards to a biopsy you had done yesterday.
[CUSTOMER][NEUTRAL] Yeah, uh-huh, they was checking, uh, my, the prostate here I had cancer.
[CUSTOMER][NEGATIVE] And I had to put the whole payment was 2000. I put $500 down and I set a payment plan with them and I won't know nothing I think till Thursday or Friday with my, if I had it, I didn't have it. So what all do y'all pay up on stuff like that there?
[CUSTOMER][NEUTRAL] OK, so, um, it all depends on if it comes back as a positive diagnosis, um, so if it's a positive diagnosis, um, then there's a portion that we pay, but as far as how much we pay, that's gonna be harder determine because the way we pay is based off of the procedure codes and um what the charges are.
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] But as far as other than that, I mean, if you have surgery done um after that or any kind of.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] chemo or anything like that, then, then that's covered.