AccountId: 011433970860
ContactId: 2c624504-5c85-408b-a4b1-20c00f308e94
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 746010 ms
Total Talk Time (AGENT): 341462 ms
Total Talk Time (CUSTOMER): 268108 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/2c624504-5c85-408b-a4b1-20c00f308e94_20250127T18:04_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hi, good morning. My name is [PII], and I talked to the Shay Bar last week. She sent me an email with some forms I needed to fill out.
[CUSTOMER][NEUTRAL] And I've got a question on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, one of them is a cancer claim form and the other is a wellness claim form.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The, the wellness claim form, what exactly is that just?
[CUSTOMER][NEUTRAL] I mean, I can see that it's got a, you know, a lot of boxes with different tests and diagnostic uh studies.
[CUSTOMER][NEUTRAL] Is that do you need receipts for all that or everything that I've had done?
[AGENT][NEUTRAL] OK, yeah, so, um, [PII], do you have a, do you have your policy number handy and I can pull it up and just make sure I'm looking at the right information.
[CUSTOMER][NEUTRAL] Yeah 246.
[CUSTOMER][NEUTRAL] 3103
[AGENT][POSITIVE] Thank you, I appreciate that. And while I'm pulling up your policy, sir, do you mind if I get a good callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, 623.
[CUSTOMER][NEUTRAL] 570.
[CUSTOMER][NEUTRAL] 9500.
[AGENT][NEUTRAL] Thank you, I appreciate that. And would you be able to verify for me please your um date of birth, sir?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Wonderful and I do just need to verify a couple of other bits of information real quick for you if you could verify your mailing address for me, [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Perfect. I really appreciate that.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] I'm going to.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Pull up that policy document.
[AGENT][NEUTRAL] So it's looking like.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] The note I'm seeing here on that cancer claim form.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] I want to make sure I'm reading this right.
[AGENT][NEUTRAL] Just trying to pull up some policy documents for you.
[AGENT][NEUTRAL] No.
[CUSTOMER][POSITIVE] I like that.
[AGENT][NEUTRAL] I'm so sorry my system's loading so slow and I think it's just like got a case of the Mondays and I'm really sorry it's so slow.
[CUSTOMER][POSITIVE] That's all right.
[CUSTOMER][NEUTRAL] At least it's still working.
[AGENT][NEUTRAL] Yeah, usually well I guess maybe I just needed to use it more this morning for it so.
[AGENT][NEUTRAL] I wanna work with me.
[AGENT][NEUTRAL] All right, maybe it is just a
[AGENT][POSITIVE] A meat problem. I'm so sorry. So on that wellness claim form, um.
[AGENT][NEUTRAL] Are you particularly are you looking for like your wellness benefit from this last year, uh, [PII]?
[CUSTOMER][NEUTRAL] Well, um,
[CUSTOMER][NEUTRAL] Actually, can what, what is the wellness portion of this? I'm not, this is all new for us, I think because.
[AGENT][NEUTRAL] That
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] No worries, yeah, let me take a look so I was trying to pull up like your whole policy document and it wasn't letting me in that system, um.
[AGENT][NEUTRAL] So I don't wanna steer you wrong, but typically the wellness benefit is um like diagnostic testing you might have had done so whether it's like a mammogram or a colonoscopy or a chest X-ray, um, you just would let us know which um which test you.
[CUSTOMER][NEUTRAL] Well, OK, I
[AGENT][NEUTRAL] Had done and when you have it done typically it's only one benefit once a year and it pays out a certain amount of money um but you and then all we do is we're just like gonna call where you have the work done verify it was done and then you you're able to be eligible for a benefit and so if you have um if you've had one of those procedures in the box done you can just check it and put its state of service that you had it done and then the name of the provider and um.
[AGENT][NEUTRAL] And that's about it and then all we do is we just process it from there.
[CUSTOMER][NEUTRAL] OK, and then the hold on my wife my wife [PII] has a question for you. Uh, so [PII].
[AGENT][POSITIVE] Oh, absolutely, I love questions.
[CUSTOMER][NEUTRAL] So [PII], I'm actually the policy holder on this, so, um, is so in [PII] I had like hospital indemnity, cancer, you know, all these different insurances, and this is through through my employer and through my union so I had all these different supplemental insurances and then [PII], some of those changed to different companies.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I'm not completely positive, but APL is it showing that I had this policy in in [PII] or is it showing this policy just started in [PII]?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK perfect so what I'm actually seeing is that you have this policy from [PII] and Ms [PII], I am only showing that you had this one policy with APL, so your other like supplemental policies might have been through another company.
[CUSTOMER][NEUTRAL] OK, and they, and they are so, so what I had, so what I had from March [PII] January through APL with you, was it, was it a wellness or was it cancer or was it critical illness?
[AGENT][POSITIVE] Oh perfect OK.
[AGENT][NEUTRAL] It's a cancer policy, um, but the wellness is a benefit on the cancer policies, and they are for those exams and screenings, and because you can receive your wellness benefit without ever having cancer, they just made an easier claim form for it, um, so it has its own claim form but it is a part of your cancer policy.
[CUSTOMER][NEUTRAL] OK, so what, what my husband had done was he had a biopsy on his pancreas.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] To determine if he had cancer.
[AGENT][NEUTRAL] OK, so for that I would recommend filling out um.
[AGENT][NEUTRAL] Yeah, I would fill this out. If it is biopsy, I guess.
[AGENT][NEUTRAL] Yes, biopsy for cancer under pathology lab services, um, is an option and I would use that and fill it out with the date of service.
[CUSTOMER][NEUTRAL] OK, also, I mean, I've also had CT scans and MRI's.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] Is that go on there as well?
[AGENT][NEUTRAL] You can if you want to, but it's only going to benefit you from one procedure once per calendar year for a set amount of money.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK then I will uh I'll just do the biopsy.
[AGENT][NEUTRAL] And then if your wife, if you, um, miss and [PII], is am I remembering that correct?
[CUSTOMER][NEUTRAL] no [PII].
[AGENT][POSITIVE] [PII], I'm sorry, there's no way [PII] was even remotely close. I'm so sorry.
[CUSTOMER][NEUTRAL] I'm glad you said it and not me.
[AGENT][NEUTRAL] I'm sorry about that, ma'am. Ms. [PII], if you likewise, if you had anything done like um a mammogram or a Pap smear or anything like that in that time period from March to January or the end of December, you're also able to submit a wellness form for yourself.
[CUSTOMER][NEUTRAL] So, but so are you showing on your end that we were ever paid out? Because like I, I have my mammogram and I had a colonoscopy and I had uh my yearly like I have all of that done and as well as my husband, like he has MRIs and um EKGs and all of that for, for his medical that he has to keep.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, so that's what I'm thinking is, and, and if I'm remembering correctly, it's only like I don't know, it's like $150 a year or something per person. I'm wondering if I've already done it for a different test we had, so does your computer show you if we've already done this?
[AGENT][NEUTRAL] So, I'm not
[AGENT][NEUTRAL] Yeah, I'm showing that neither of you guys um used your wellness benefit in that time period.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So then on that note,
[CUSTOMER][NEUTRAL] Let me see, um, I know that I should then I should just be able to fill it out online.
[CUSTOMER][NEUTRAL] Because I know what that form is let me see, um.
[AGENT][NEUTRAL] Yes, because your policy is no longer active, you're not gonna be able to use the online service center, but you can fax it to us or mail it to us.
[CUSTOMER][NEUTRAL] OK, so, so we will, we'll, we'll probably fax it. I'm not sure, but can you.
[CUSTOMER][NEUTRAL] Honey, do you still have this on your email where you could print another one of those? OK, I was gonna, I was gonna have you send me one, but my husband's got it on his, so I'll just print one off of his, and we'll, we'll, we'll get them both sent in.
[AGENT][POSITIVE] Perfect and yes absolutely um is there any, do you guys have any other questions that I can help you with on this one today?
[CUSTOMER][NEUTRAL] No, I think that's it. I don't have it. Well, actually I, I do with the, so basically all I need to do is fill out the wellness claim and not the cancer claim for this biopsy.
[AGENT][NEUTRAL] Yes, unless it was positive for cancer, in which case you might have benefits payable.
[CUSTOMER][NEUTRAL] It was?
[CUSTOMER][NEUTRAL] Well, it's, yeah, it was a they labeled it as a a neuroendocrine tumor.
[AGENT][NEUTRAL] OK, so,
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] If you, if you, I would fill out the wellness claim for sure because it's a totally different benefit and I'd send it in and then if that biopsy came back and I'm not sure exactly what the different types of cancers are um and I'm so sorry I wish I was more educated on that, um, but you can also fill out the cancer claim form and you would submit like your path.
[AGENT][NEUTRAL] report um your procedures like the itemized procedures and explanation of benefits from your major medical and those sort of things and if you have any benefits payable even though your policy is not active as long as what happened in your date of services were during your effective date with us you can have benefits payable so.
[CUSTOMER][POSITIVE] OK, all right, cool.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] And then [PII] and [PII], anything else I can help you out with today?
[CUSTOMER][NEUTRAL] No ma'am, that'll that is everything.
[AGENT][POSITIVE] All right, well, hey, it was my pleasure if you guys have any more questions or you're getting along the way and you're like I'm not really sure if this is needed, don't, don't hesitate to reach out to us and we'll do our best to take care of you, OK?
[CUSTOMER][POSITIVE] Alright thank you so much.
[AGENT][POSITIVE] My pleasure, thank you.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye bye.