AccountId: 011433970860
ContactId: 2b1f4d08-e5fd-414d-a98e-32fcf1a93c47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 329869 ms
Total Talk Time (AGENT): 190808 ms
Total Talk Time (CUSTOMER): 110840 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/2b1f4d08-e5fd-414d-a98e-32fcf1a93c47_20250313T20:20_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] in customer services. How are you?
[AGENT][POSITIVE] Hey, I'm good. How are you doing?
[CUSTOMER][NEUTRAL] I'm good. I have, uh, [PII] Than on the phone, and he's got a cancer policy and he's on Medicare and he's wanting to know how this will pay with that, and he's also had surgery on skin cancer and wants to know if there's anything payable.
[AGENT][NEUTRAL] Cancer policy has Medicare and he was paid, you said he also has a, what was the last part? I'm taking notes.
[CUSTOMER][NEUTRAL] He, he's had a surgery for skin cancer and wanted to see if that's covered.
[AGENT][NEUTRAL] Skin cancer surgery, OK.
[CUSTOMER][NEUTRAL] And the policy number is 97125.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] 7125
[AGENT][NEUTRAL] OK, I got him here.
[CUSTOMER][POSITIVE] Alright thank you I'm here.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] You too, hold on just a second. I'm gonna get that screen back up. OK, here he is. Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, you're welcome.
[AGENT][NEUTRAL] Hello, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] Hi, this is [PII] with um APL and the care team. So [PII] was telling me that you had a few questions about the cancer policy and how it works with Medicare and then your um procedure you had recently.
[CUSTOMER][POSITIVE] That's correct, that's correct, uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so the cancer policy usually Medicare would be built first, um, the cancer policy, you can still file the claims, um, if there's something left over, we can pay to you or to the provider. Um, it just really depends on what Medicare doesn't cover if they, if there's something that they don't. Um, this would be like a, it's not really second to Medicare, but it would be like, you know, an additional policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK, I got you. OK, so that's just if there's anything left over from what Medicare pays.
[AGENT][NEUTRAL] Yes, sir. And then as far as the um procedure that you had, um, she said, she said it was skin cancer, was it, was it like a biopsy or they already know it was positive.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, they already know it was positive. They didn't do a biopsy. They just, they went ahead and did it and then sent it off and it came back, uh, positive, and it was, uh, sequoma cell carcinoma.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So you have, um, were you like hospitalized for it or anything? I'm looking at the benefits to see. OK.
[CUSTOMER][NEGATIVE] No, no.
[CUSTOMER][NEUTRAL] No, no, it's just done in the office.
[AGENT][NEUTRAL] So you have um coverage particular to skin cancer, the policy um for once it's, we received the pathology report, the policy, um,
[AGENT][NEUTRAL] would pay, let me see, up to $160.
[AGENT][NEUTRAL] Not to exceed $300 per month. This is for the treatment.
[CUSTOMER][NEGATIVE] OK, well, the treatment, all, all the treatment, there is no treatment. It was just the surgery and they said they got it all and so there's no treatment.
[AGENT][NEUTRAL] Um, so it
[AGENT][NEUTRAL] OK, you do have surgical benefits as well. I'm just going through the, the um coverage trying to see what may apply, but it sounds like you can definitely file the claim for it.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK, with the
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] With the doctor's office file, would the doctor's office file the claim?
[AGENT][NEUTRAL] So, if they have your your cancer policy number, yes, they would just file it, you know, in order with whatever other insurances you have. If they don't have the information, then they would file it with the insurances and then you will receive a bill. So it's not too late if you want to call them and see because they still can bill us.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, do you have that policy number because I don't have it.
[AGENT][NEUTRAL] I sure do. Hold on one second.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] It's 97125.
[CUSTOMER][NEUTRAL] 971-25, OK.
[CUSTOMER][POSITIVE] All right, very good now.
[AGENT][NEUTRAL] And if they
[AGENT][NEUTRAL] I was, I was gonna say if they need to call us to verify benefits or have any questions about your coverage, just give them our phone number. We help the providers all the time with the policies.
[CUSTOMER][NEUTRAL] OK, and let me have that phone number.
[AGENT][NEUTRAL] So it's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK, very good. All right, well, thank you very much.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, so the way I can look at that, this is really kind of like a supplemental policy.
[AGENT][NEUTRAL] Yes, you can look at it that way because Medicaid or Medicare usually um will take care of everything, but in the event that it doesn't, you have this fall back.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, well, see, I also have another supplemental policy too, but, but I mean.
[AGENT][POSITIVE] Oh, that's good.
[CUSTOMER][NEUTRAL] Yeah, yeah, so I'm sure that that's what they'll file on because I didn't give them any of this information because I really even forgot about it.
[AGENT][NEUTRAL] Oh, OK. Well, still, you, um, still, I will still try to give it to them and then if there's, if there is extra, um, it could come to you or um
[AGENT][NEUTRAL] You know, you still have those benefits, so it depends on once they process everything.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, well I'll go ahead and do that. All right, thank you very much.
[AGENT][POSITIVE] You're very welcome. Well, thanks for calling APR Mr. [PII]. I hope you have a great day.
[CUSTOMER][POSITIVE] OK you too thank you.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Oh bye bye.