AccountId: 011433970860
ContactId: 2c4e0084-cbfd-4d1c-80ec-30a43818c6af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 750849 ms
Total Talk Time (AGENT): 135101 ms
Total Talk Time (CUSTOMER): 444098 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/2c4e0084-cbfd-4d1c-80ec-30a43818c6af_20250306T16:16_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII]. I was calling with a couple of questions, um.
[CUSTOMER][NEUTRAL] About my cancer policy. Um, last
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Last year, um.
[CUSTOMER][NEUTRAL] Uh, basically, I haven't sent in in a while. I haven't sent in any bills to be, uh, for reimbursement or any type of benefit. Um, so I had surgery last year in March. And, um, I'm not sure, is there a time limit on getting paperwork to you?
[AGENT][NEGATIVE] There's no timely.
[CUSTOMER][NEUTRAL] For reimbursement for.
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] OK. The next question is, uh, because since then, I had one surgery. I had some reimbursement happen with a couple of things, but the major part of it, um, I haven't filled out the forms yet, or gotten you the info. So, um,
[CUSTOMER][NEUTRAL] The, I guess it's the claim form. How do I get one? Is it online? Do y'all email it to me or how can I get more?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, you can
[AGENT][NEUTRAL] It is online, um, at [PII].
[CUSTOMER][NEUTRAL] AM public.
[AGENT][NEUTRAL] [PII] and then the word [PII].
[CUSTOMER][NEUTRAL] OK, I think that's different than last time. Hold on just a minute.
[CUSTOMER][NEUTRAL] I'm sorry, I'm trying to find my notes so I can write. OK, here we go.
[AGENT][NEUTRAL] No rush. No rush.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, and
[CUSTOMER][NEUTRAL] Can I still fax
[CUSTOMER][NEUTRAL] The uh
[AGENT][POSITIVE] Yes, you can. Yes, ma'am.
[CUSTOMER][NEUTRAL] The claim?
[CUSTOMER][NEUTRAL] OK, can you give me that phone number for that?
[AGENT][NEUTRAL] The fax number is.
[CUSTOMER][NEUTRAL] I mean
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm. [PII] are the three middle digits.
[CUSTOMER][NEUTRAL] Right, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And anything else I should know, um.
[AGENT][NEUTRAL] And so what type, what type of policy do you have?
[CUSTOMER][NEUTRAL] Anything else I should know?
[CUSTOMER][NEUTRAL] Um, it was cancer policy.
[AGENT][NEUTRAL] And so when you get to the one.
[CUSTOMER][NEUTRAL] And it's
[AGENT][NEUTRAL] When you get to when you get to the website, um, then you would, um.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] You know, search for the cancer claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, if I have any questions or problems, I'll, I'll give you all a call back but I'll go ahead and do this. Thank you.
[AGENT][POSITIVE] OK, alrighty, anything else I could assist with today, uh.
[AGENT][NEUTRAL] To assist you.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, I, I guess one more question. For multiple, I mean, um,
[CUSTOMER][NEUTRAL] What do I need to send with the claim? Do I need to send the itemized bill? or what exactly do I have to send everything?
[AGENT][NEUTRAL] OK, let me get your name and your policy number.
[CUSTOMER][NEUTRAL] OK. [PII], well, let me look.
[CUSTOMER][NEUTRAL] Sorry, it's under my husband's uh company, but I'm the patient, so it's [PII] I'm pretty sure. I've done this before, so I probably have the notes that they told me how to, how to do it, but so much has happened. Let's see.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And if I still have it.
[CUSTOMER][NEUTRAL] What's the fax number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] I'm not sure where to find my.
[CUSTOMER][NEUTRAL] Claim number, wait, hold on.
[CUSTOMER][POSITIVE] Maybe I can get my things together and give you a call back because I really had general question and then I didn't.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's your policy? What's the policy number, [PII]?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] That's what I'm looking for. I'm not even sure hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't know, um, I'm gonna have to, I guess I'm gonna have to call back because the envelope that I have here that I thought.
[CUSTOMER][NEUTRAL] Had all my info doesn't, I guess that's in the other cancer thing.
[CUSTOMER][NEUTRAL] Uh all added. Yeah, these are just.
[CUSTOMER][NEUTRAL] I have the wrong envelope. I'm not really sure. It's um.
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] Back some things before, um, and I had
[CUSTOMER][NEUTRAL] Maybe and I had the, the numbers, different.
[CUSTOMER][NEUTRAL] Different envelopes sorry.
[CUSTOMER][NEGATIVE] Yeah, it's I don't know this envelope has everything that I needed to send the first time, but it doesn't have my policy number so that's not my packet is what I'm getting at, um, so I'm gonna have to call back. I don't know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm spell the last name.
[CUSTOMER][NEUTRAL] It's the
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] First name is [PII] Why does it say cancer?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Got that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Claim forms.
[CUSTOMER][NEUTRAL] I thought was the your info.
[CUSTOMER][NEUTRAL] Is a bunch of stuff from the hospital so that I'm just saying I have the wrong.
[CUSTOMER][NEUTRAL] Envelope
[CUSTOMER][NEUTRAL] I know envelope, OK.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEGATIVE] Sorry, I'm a little frazzled because I'm all this time I thought this was the envelope and it's not. So where's the all the important stuff which is what you guys.
[CUSTOMER][POSITIVE] Sent me originally.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And all and all my document well all my notes that uh.
[CUSTOMER][NEUTRAL] That say what to do and how to do it. That's not it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEGATIVE] One more, I'll look at one more thing before I let you go just to see. I really don't understand why this isn't in here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Says
[CUSTOMER][NEUTRAL] It's a policy documents.
[CUSTOMER][NEUTRAL] Oh, faxed to OK.
[CUSTOMER][NEUTRAL] Let me look uh this is uh APL. Let's see what this says.
[CUSTOMER][NEUTRAL] Uh, at least here's a cancer claim form that I had already done so, and that's a social post policy number. OK, the policy number 2187427.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I don't know if I'm supposed to tell you, it says about the insured. The insured is my husband's name and then the patient is me.
[AGENT][NEUTRAL] Yeah, so all I need is your information, your name and your date of birth.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, so my name is [PII]. Date of [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And so we've given the website to download the claim form and what were your other questions?
[CUSTOMER][NEUTRAL] Um, oh, the other question was, the claim form, do I need multiple claim forms or can I send all the info?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Basically, um
[CUSTOMER][NEUTRAL] Anything I need to get reimbursed for or you know have any kind of benefit for do I do it, do I send like 5 different things with 5 different claim forms or do I do one claim form without all the paperwork behind it?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm, so if you're sending everything at the same time one claim form.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] OK good well then I will, OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Since I don't have the other folder, um, because it had all the info on it, but so when I send, what am I.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What do I need from the hospital or to send for reimbursement for, let me just say it's, it's gonna be um my partial mastectomy.
[CUSTOMER][NEUTRAL] Um, which, you know, would include some things like the, the, uh, anesthesia, the, the hospital stay. Um, so what
[CUSTOMER][NEUTRAL] What else do I need?
[AGENT][NEUTRAL] Yeah, so, so on the first page of the claim form, um, our instructions and it tells you specifically based on what type of service you had, what documents are required.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You want to claim form, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have the claim form pulled up?
[CUSTOMER][NEUTRAL] I have, I, no, I'm not in front of a computer. I'm in front of old papers from from APL. So, so this cancer, um, cancer claim form, yeah, OK, instructions for insured or patient, and then it says complete the statement, complete section A.
[AGENT][POSITIVE] OK, got you. I got you.
[AGENT][POSITIVE] I got you.
[CUSTOMER][NEUTRAL] In indicated documentation.
[CUSTOMER][NEUTRAL] pathology report. OK, that's, but that's
[CUSTOMER][NEUTRAL] That's for.
[AGENT][NEUTRAL] So if you're filing a claim for services such as hospitalization, surgery, chemo, immuno and radiation, it tells you that we'll need the itemized bill from each medical provider and then the explanation of benefits from your other medical carrier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, from Blue Cross, OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, I think I have.
[CUSTOMER][NEGATIVE] OK, I'll try to get that together and, and fax it, but I, the main thing was I didn't know if there was a time limit, and I didn't know, um, if there was if I how I got the claim form, but now you, you help me with that. I'm so late to this.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And we had back to back issues, um, family situations and death, so I kinda forgot, I don't wanna say I forgot about myself, but I forgot about the paperwork doing this, and, um, so now I am trying to play catch up and when it's old.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] And not fresh in your mind. It's, it's a little harder.
[AGENT][NEUTRAL] Right. Right.
[CUSTOMER][POSITIVE] Um, OK, well I got everything from you that I need to know. Thank you so much.
[AGENT][POSITIVE] OK, you're welcome. Yes, and if no other further questions, [PII], thanks for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Hello? Oh OK.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Uh bye-bye.