AccountId: 011433970860
ContactId: 2cd6b574-b5ed-429f-bc87-ed889483cc3b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 2015969 ms
Total Talk Time (AGENT): 1081829 ms
Total Talk Time (CUSTOMER): 1126350 ms
Interruptions: 41
Overall Sentiment: AGENT=1.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/2cd6b574-b5ed-429f-bc87-ed889483cc3b_20250307T20:12_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII] how you doing?
[AGENT][POSITIVE] I'm doing well how are you?
[CUSTOMER][POSITIVE] Oh, I'm trying to hang in there. That's about all we can do.
[AGENT][NEUTRAL] Almost there. It's Friday. We're almost there.
[CUSTOMER][NEUTRAL] Hey, that's right, it's Friday. Um, I am trying to um get some claims filed for my brother. Um, he's pretty elderly, and I, I did all the legwork before on some wellness stuff and all. And also he had, he had cancer claim that we got. I did all the legwork on my computer and all I got it, but I need to find out what exactly.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] You will need for me to get.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] For, um, he has had, um, 2 rounds of radiation.
[CUSTOMER][NEUTRAL] Um, and, uh, I understand looking at this policy, it does pay a yearly benefit for radiation and chemo.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, and I'm, I'm pretty sure I know some of the stuff you're absolutely gonna have to have, but one of them I'm afraid is gonna be difficult to get. Um, I understand that you need a line by line itemized bill.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, and that comes, I guess from the billing department from the hospital where he was at.
[AGENT][NEUTRAL] Typically it's and I'm sorry to add to the confusion but all of these providers and facilities do operate quite differently um I would think most of the time yes it would be in their billing department um before we go any further I'm so sorry um can I get your name and then a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] If they
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, my name is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. Do you happen to have the policy number, [PII]?
[CUSTOMER][NEUTRAL] I do, um, it looks like I don't know if you need all these zeros, but it looks like on here it says 006.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 50596
[AGENT][POSITIVE] OK, I appreciate that. Um, give me just a moment so I can get that pulled up here.
[CUSTOMER][NEUTRAL] Yeah, it's under [PII].
[AGENT][NEUTRAL] Got you. All right. um, so let's see.
[AGENT][NEUTRAL] And of course I don't see you. I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Because I know y'all
[CUSTOMER][NEUTRAL] Go, no, go ahead. I know what you're fixing to say, but I sure thought I was. Maybe he was here with me and was able to say, you know, she can say anything to her.
[AGENT][NEUTRAL] No, that's OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right, OK, so obviously.
[CUSTOMER][NEUTRAL] Um, because he doesn't know how to.
[AGENT][NEUTRAL] Sure, so, um, of course with that being said, if he's not present, you're not listed, um, I'm not able to disclose anything particular to the policy or claim information and yada yada. However, I will say if you haven't been told already um that we do have a third party authorization form.
[AGENT][POSITIVE] Uh, that [PII] can fill out and send to us that would essentially give you access and permission that we could be completely open with you, um, regarding this policy, uh, without having to get his permission every time.
[AGENT][NEUTRAL] And if that was something you're interested in you can get that on our website um but just so that you're aware um now I can of course go through and let you know what is required for claims though so that's not an issue um let me know yes ma'am yes yes so that's nothing particular to his this is gonna be a round all round thing so yes that itemized statement and then it has to show diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] 00, that would be great. That would be great.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, ICD 9 and CPT.
[AGENT][NEUTRAL] OK. Right. Yes, ma'am. OK, and then for.
[CUSTOMER][NEUTRAL] I used to work at B.
[AGENT][NEUTRAL] They're OK, so you already know what you're doing all right, awesome. So that's going to be the general general rule of thumb for all across the board for any kind of claims. The only thing different we would need for his radiation and if he ever received chemo as well, we would need of course still that itemized statement with those codes, but we would also need the explanation of benefits from his primary insurance.
[AGENT][NEUTRAL] Um, showing you just essentially showing what they paid, um, and of course the provider facility that he went to will have that information.
[CUSTOMER][NEUTRAL] Which is Medicare.
[CUSTOMER][NEUTRAL] Oh they will? OK, because we get now I'll tell you this, I'm gonna tell you this, he has, he has Medicare and then he has Cigna as a supplement. So what we get, I think once a quarter is this thing that is an explanation of benefits and but it doesn't break it as much as what you're saying like it shows like that month that he had the radiation.
[AGENT][POSITIVE] Oh yes, absolutely.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it has a total amount of bills like for all 5 of those treatments and what Medicare approved what they paid and then what Cigna paid.
[AGENT][NEUTRAL] Sure, OK, yes.
[CUSTOMER][NEGATIVE] Um, that's not good enough, that's not good enough though, is it?
[AGENT][NEUTRAL] That
[AGENT][POSITIVE] That should be fine as long as because they can be separate um as long as we have that itemized statement with those diagnosis and procedure codes and the explanation of benefits um showing what was contributed to it that's what we need that is perfectly fine yes ma'am.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][MIXED] So it might be OK, because I thought it was a little too condensed on this explanation of benefit.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And as long as it shows that information what was contributed um to his radiation and or chemo um that's perfectly fine because that's going to be separate of course from that actual itemized statement.
[CUSTOMER][NEUTRAL] Oh yeah, yeah, you see it only says I have dates of service and then it goes type of service outpatient hospital.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And the provider and but then it goes build amount.
[AGENT][NEUTRAL] Oh, so it doesn't actually state what it is, um, you know that's interesting what I would do.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So I don't know how you get, how do you get something.
[AGENT][NEUTRAL] Yeah I've not, I've not run into that. You should I always, I know you can get it from the provider wherever he went for treatment they will have that explanation of benefits um so the only problem of course is that depending on the facility and the provider they can be a little bit um.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][POSITIVE] Confusing and difficult, but hopefully, um, and if they have any questions they're more than welcome to give us a call as well [PII] um so you can more than welcome to give them our phone number and you know maybe we could try to alleviate some confusion.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, OK, so I didn't realize that they might have exactly what an EOB.
[AGENT][NEUTRAL] Oh yes, yes, um, right, because of course the um primary uh would have sent them that payment so they should have record of that explanation of benefits.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Oh well, true, they have to know what they did get paid and what didn't get paid, what to write off, I guess, because the patient can't be more vulnerable, you know, um, for it because you can see patient responsibility 0 even though they build 20,000 and they only approved 5000. Patient is zero, which is great, which is great, you know, because, oh my [PII], um, so the biggest thing is hopefully I'm gonna go because he's gonna start some stuff Monday.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yep.
[AGENT][POSITIVE] Exactly.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] And um I'm gonna have plenty of time. I'm gonna be with him, but I can go to the billing office hopefully and maybe get a lot of this information for you um I do do yes go ahead.
[AGENT][NEUTRAL] Sure, now, well, oh go ahead.
[AGENT][NEUTRAL] No, no, no, go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] Well, let me ask you
[CUSTOMER][NEUTRAL] Let me go ahead. When I, when we filed and got this first diagnosis and they got the 5000 for the first diagnosis of cancer, we had to fill out this thing here that I see was called a cancer claim form.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And you know that's part A, B, C, D, whatever. Um, you have to do this with every single one of them. I mean, you already got that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] On, you know what I'm saying?
[AGENT][NEUTRAL] Um, right, are you using our online portal, Joy?
[CUSTOMER][NEUTRAL] Yes, I'm looking at it, yeah.
[AGENT][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] Typically will divide the claims you do need to fill out that claim form, but it's going to be per submission. So for if you're uploading a lot of information at once, you can just fill out that one claim form um and if it's too much, you know, you do have to kind of split it into a couple that would be a separate claim form.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, because the only parts that I would really need to fill out is section A and section B. There's nothing about non-local transportation member and, and it will let you do it. I tried to do it. It will actually let everything be done online except down here on the last page when it says signature, it won't let you click on that.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, what, what browser are you using? Is it, uh, Google Chrome?
[CUSTOMER][NEUTRAL] So you do have to print that out.
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] OK, now if you go it's a little bit weird um and it's a little hard to explain over the phone of course um but you there should be a way that you can hit print like you're going to print it and then of course you can write in those fields and such and that should be sufficient um but if you need to print it off you know you don't have to scan it you can just simply take a picture of it and upload it that way if that's easier.
[CUSTOMER][NEUTRAL] But you
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Hm. Oh, OK. Um, because yeah, it would let me, you can, every other space, it will give you the cursor when you click on it, you put your mouse on it, but signature, um, it says signature of patient or personal representative if applicable. It won't allow it. It, yeah, that's it. It won't allow and I, I think we faxed everything. I think we faxed everything before. Um, I would love to do.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Weird. OK.
[AGENT][NEUTRAL] Oh, I see. OK.
[CUSTOMER][NEUTRAL] I would love to do online submission for the whole thing, but then I'd have to scan all of these this EOBs and all of that in, right?
[AGENT][NEUTRAL] Well, oh, so you've got the physical copies. OK. Well, like I said, you can scan them if you have, um, if you have it, if you prefer, but you can also just take pictures, um, as long as it's clear and legible, um, you can do it that way.
[CUSTOMER][NEUTRAL] Oh, what can you do?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So if they give me, if they print off all this stuff for me, you know, has the line by line itemized bills and the EOB.
[AGENT][NEUTRAL] If they have to print it, yes, you can, um, of course I would strongly ask them, beg them to send you them electronically because that's a lot less you have to worry about, um, because I know how long those can be, it could be tons of pages, um, or they can even send them straight to us, um, you can give them our fax number and they can file the claims with us. The only difference is, um, they would receive those payments.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] I don't think
[CUSTOMER][NEGATIVE] Yeah, well, that, that is not gonna happen. Uh uh, we're not gonna let them, no, ma'am. mm mm.
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Got you sure have to present all the options have to let you know, um, alright, well, and that's what I was going to mention you already did, um, of course was making sure that we did receive that initial pathology report, so, um, uh, that you sound good to go.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Uh, yeah, did you have any other questions for me?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, um, like I said, there were 2 rounds and I'm gonna try to get that, you know, figured out, but now he also had, and when I was looking at the policy, which I thought was interesting, there's surgeries that it pays for and he also had a lung biopsy and a prostate biopsy.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, um, OK. Did that, was there actual cancer there?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] That
[CUSTOMER][POSITIVE] Um, well, that's how the lung definitely, you know, there was a biopsy that was done and the prostate didn't show the Gleason scores were not bad, which was, oh, thank goodness, you know, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That's amazing. Yes, absolutely.
[CUSTOMER][NEUTRAL] But you know, he did have it done and there might be a uh they would still consider there was, you know, several sixes which I think is the lowest and maybe a couple of 7, but there was no 8, 9s or 10s and no I was like, you know, thank goodness.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Goodness, yeah.
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] But they say that's the easiest to treat on a man though. So, you know, but um if you're a man, you get cancer, you want prostate cancer.
[AGENT][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] That's interesting.
[CUSTOMER][NEUTRAL] They say
[CUSTOMER][NEUTRAL] That's what they say, but, um, he still wasn't bad, but his lung cancer is, so, um, but, so I wanna be able, I just get on those make sure during those for those dates get the exact information like the line by line itemized bill and all.
[AGENT][NEUTRAL] Huh.
[AGENT][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] And again, the only um thing that we would need the explanation of benefits for his primary for would be chemo and radiation, um, or immunotherapy, excuse me, if he receives that. Anything else, we just need the itemized statements with those diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, OK, so those will be easy then, OK, um, all right.
[AGENT][POSITIVE] Yeah, absolutely. And if it's easier as well, there's no timely filing limit, um, because I know some, uh, patients have to go, you know, get radiation very regularly and they stress about getting to one at a time. And you know, you can do that if you want to or if you'd rather wait and maybe do it like monthly or a couple months, you can absolutely do that too.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well, now this first set of radiation that he had did um it's around [PII] or [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, the second set of radiation he had just happened this year, like in January.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, or February maybe, you know, it was very, very, you know, but um.
[AGENT][NEUTRAL] OK, yeah.
[CUSTOMER][POSITIVE] Mm, and I knew because we, we were able to go back on, yeah.
[AGENT][NEUTRAL] Just however you prefer.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And also I think I read somewhere now. I don't know if I, it was a, I'm sure it was you, even if for whatever reason, if he was to pass away before I can get all this filed.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] If it, if it still occurred while of course while he was alive, supposedly you still can get it on in and possibly it paid.
[AGENT][NEUTRAL] Absolutely, absolutely, as long as the policy, it happened while it was effective, um, then yes, now again that being said, we don't have any information for um any third parties or beneficiaries or anything like that. So if someone else were to, if he were to pass away and someone were to file claims on his behalf, we would have to of course have that death certificate and proof of next of kin um unless there was a power of attorney or a listed beneficiary.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Now I thought I was listed as the beneficiary on this. I could have swore I had forms that we had faxed in and showed that I, I am because my, our mother.
[AGENT][NEUTRAL] No, I don't have you listed. No, um, all I've got here is [PII] as, but again, um, you can get if you go to our website, um, not the portal, um, our public website which is [PII], they'll have all kinds of forms there but they'll have that third party authorization form and then also have the beneficiary forms as well.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, what is this one that says authorization to disclose information?
[CUSTOMER][NEUTRAL] Is that one of them?
[AGENT][NEUTRAL] Um, let me see, are you on our website right now?
[CUSTOMER][NEUTRAL] Yes, because it starts with accident and very next one is authorization to disclose information.
[AGENT][POSITIVE] I'm gonna look with you.
[AGENT][NEUTRAL] Yeah, I'm gonna look with you. Give me just a second. I think that's it. I think that's the third party, but.
[AGENT][NEUTRAL] They change it sometimes, so.
[CUSTOMER][NEUTRAL] And change and request.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let's say.
[CUSTOMER][POSITIVE] You're right, I know.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] They have uh let me see what is.
[AGENT][NEUTRAL] Yes, that does look like that's it. Let me see.
[CUSTOMER][NEUTRAL] Another one here request changes.
[CUSTOMER][NEUTRAL] And request of change of beneficiary and change of ownership and
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] But I thought we did some of this. That's the thing, because I thought we'd already put some of this.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] If you did, we did not receive it um because this is the, I mean he's had this policy since [PII] um so and we only have him listed on there so yes you're right, I'm gonna have to stop calling at that third party because that's gonna confuse people they have to keep changing it only so yes that's the one of the forms you want and then yes the beneficiary change form.
[CUSTOMER][NEUTRAL] Mm mhm.
[CUSTOMER][NEUTRAL] Right, he's mama again.
[CUSTOMER][NEGATIVE] No, no.
[CUSTOMER][NEUTRAL] OK, so the second one, the authorization to disclose information is the one.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK. All right. And that could be faxed to you or take a picture and upload it to get it quicker.
[AGENT][POSITIVE] Oh yes, absolutely, um, or those kinds of forms you can email to us as well if you prefer.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, I'll have to figure out how to do that then.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, I can give you our email address whenever you're ready.
[CUSTOMER][NEUTRAL] Yeah,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, OK, yes, so it's [PII]
[CUSTOMER][NEUTRAL] What what is it?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] [PII].
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK, so [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Wow, OK.
[CUSTOMER][NEUTRAL] OK, because I, I tried it while I had you on the phone. I wanna make sure I asked everything, you know, that I need to get, so I'm gonna get.
[AGENT][POSITIVE] Absolutely.
[AGENT][POSITIVE] I'm glad there are questions I can answer um usually when we get people that aren't listed or covered I'm like, oh I can't tell you anything, but I can definitely tell you how and what we need.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, see, that's because that's across the board thing, you know, that's, that's not even asking for HIPAA or anything like that.
[AGENT][POSITIVE] Yeah, absolutely.
[AGENT][NEUTRAL] Exactly, exactly, I'm not disclosing any of his personal information.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Right, right, but, um, yeah, so I'm just hoping like I say, I can get all this information and I'm glad you told me about possibly taking a picture of it, you know, because you know you can get.
[AGENT][NEUTRAL] Yes ma'am, as again, as long as it's clear and legible, well, a lot of people don't have access to scanners and you know that's.
[AGENT][NEUTRAL] Time consuming and sometimes they're even larger in size um because on our website we do have a size limit as to how much can be uploaded at once it's a little sensitive um and so with those larger files you know you'll be much more limited.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] But I would say,
[CUSTOMER][NEUTRAL] Yeah, and see, a lot of times on our cell phones, our cell phones is too much of a, what do you call it like the it, it, it records it.
[CUSTOMER][NEGATIVE] Too, uh, you know, like JPEG is too high or something.
[AGENT][NEUTRAL] Oh, the details and such. Oh yeah, everybody loves the high resolution and then you go to send that's for the worst. I was trying to email something like that. I take a beautiful picture and they're like, oh wow, that's huge. You can't send that like, oh yeah, look at the detail.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] Yeah, you know, or even with documents.
[AGENT][NEGATIVE] But technology can't keep up with technology.
[CUSTOMER][POSITIVE] Yeah, so I mean if I could do that and then of course you know I, I'm gonna dang dang sure try to do it that way because they say it's faster, you know, payment, um.
[AGENT][NEUTRAL] Well, uh, what I would recommend before, I mean that's good to have as an option, but I would still ask them if there's any way they can send it to you electronically if they can like just simply email you that information, uh, as like a PDF or something like that, that would be so much easier on you. All you'd have to do is drag and drop that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Look at a PDF that's that's the way they need to do it, PDF.
[AGENT][POSITIVE] Well, uh, any kind of file like that, um, as an electronic copy, you know, they do that hard work for you, that's even better.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] But is that kind of for y'all?
[CUSTOMER][NEUTRAL] Yeah, if that, if that's kind if that's one of the options is that probably the better one, the PDF?
[AGENT][POSITIVE] I would say so, um, well, not as far as like the file type isn't really a huge deal, um, but it's the fact that you know it be easier on them and on you because all you would have to do is download it straight to your computer and then upload it straight from your computer you wouldn't have to worry about sifting through all of it and snapping pictures and all that.
[CUSTOMER][NEUTRAL] Do you think?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] True, true, true.
[AGENT][NEUTRAL] Because the the website again I don't know if you're aware of this or not but while I've got you I wanna make sure you know um that the website really doesn't have support for mobile devices so phones, tablets, you won't be able to upload claim information from there it does have to be done on a desktop or a laptop computer.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh, when I have a desktop, I have an Apple, um, an iMac.
[AGENT][NEUTRAL] Oh that's fine. Uh no, no, no, that's that's still a computer that's fine, um, it does have support for Safari uh, um, I still think it works best with Google Chrome, um, but it does work with Safari. It's just something about the mobile version of like on a phone or a tablet it's where it kind of struggles.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Good.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, well, I don't even mess with Safari. I have messed with it, but to me, Google Chrome works better, um, so.
[AGENT][POSITIVE] Yes, I agree.
[CUSTOMER][NEUTRAL] Yeah, but, um, yeah, so I'm gonna see about trying to get this, uh, um, trying to think what this oh change request is like when you're changing different things um form but um so I need those two forms, yes, so I need those two forms to do, um, which will be the uh.
[AGENT][POSITIVE] I agree.
[AGENT][POSITIVE] Oh yes, for the beneficiary.
[CUSTOMER][NEUTRAL] Authorization disclose information then you said, oh, the beneficiary thing, yeah, I need to get both of those.
[AGENT][POSITIVE] Yes, um, and I would get that especially that authorization form to us, um, as quickly as you can because once you upload the claims if you wanted uh to check on it or if you wanted information if you were confused on a note or something then we'd be able to actually openly speak with you without having to bother [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Yeah, yeah, he's poor [PII].
[CUSTOMER][NEGATIVE] Yeah, yeah I see it right here. So actually this, but this form though, even on this it's not gonna let me, oh, this is one we'd have to try to take a picture of because it won't let me signature it. You can do anything else on it. Well, no, it's not even letting me do I even let me.
[AGENT][NEUTRAL] I can imagine.
[AGENT][NEUTRAL] You know, are you doing it on, are you on a computer right now? or are you, are you on your phone?
[CUSTOMER][NEUTRAL] Yeah, actually.
[CUSTOMER][NEGATIVE] I'm on my computer, you know what this form won't let you do anything on the computer when I'm clicking on these, it won't let it do it.
[AGENT][NEUTRAL] Let's see, if you go.
[CUSTOMER][NEUTRAL] It won't let it do it, so I would print this off and then fax it.
[AGENT][NEUTRAL] That's interesting because it it is for me. I went to uh if you click download um and you scroll it's not gonna let you type in any of the boxes.
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] Mm mm when I'm clicking on any of the boxes on this one, they'll do it on that claim form we were talking about. It will do it on that one it's not doing any of this, so this would absolutely.
[AGENT][NEUTRAL] Weird
[AGENT][NEUTRAL] Huh.
[AGENT][NEUTRAL] I guess so. I don't know.
[CUSTOMER][NEUTRAL] And I guess you'd only need when it pays too.
[CUSTOMER][NEUTRAL] You'd only need page 2 and then I guess we could just fill it out and then.
[AGENT][NEUTRAL] Oh yeah, right, the top is just for your information, but um no that's weird. I'm, I'm on Google Chrome on my computer and it's, it's letting me type. I don't know. I mean.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] I don't know. Technology just drives me nuts.
[CUSTOMER][NEUTRAL] 00, this is weird. This is weird to actually. I, I'm gonna let you, I'm gonna, you're not gonna believe this, but when I was clicking on these different areas, it will let the zip code work. It will let the state work. It won't do the city, won't do the address, won't do the home phone number. It'll do the sale and it'll do the email address.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK. Hang on, I'm gonna try it now.
[AGENT][NEGATIVE] Now it's letting me type in all of them. That's weird. I wonder why it's being so picky with you.
[CUSTOMER][NEUTRAL] And it, but it wouldn't.
[CUSTOMER][NEUTRAL] Mm mm.
[CUSTOMER][NEUTRAL] I don't know. Or maybe safari would work better. I don't know.
[AGENT][NEGATIVE] Oh man, I don't like that either.
[AGENT][NEUTRAL] I don't know because I'm using Chrome right now. That's weird. Um, I don't, I mean, you could also try like updating the browser and seeing if that helps or if your computer has any updates, but I mean if it's easier, you don't want to mess with it, you can oh, does it? OK, yeah, I mean, however you gotta do it, that's just strange.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So it's supposed to be automatic update.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, so, because I, I prefer to type it because y'all see it better versus trying to write it.
[AGENT][NEGATIVE] Absolutely. Oh, my handwriting is atrocious. If there was any a time that I could do that instead, I did cursive, but I do it so fast that you just, it, you know, nobody can tell what it says.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, right, but, or I wish I had an old-fashioned typewriter. If I had an old fashioned typewriter just print it off and I'd type it in.
[AGENT][NEUTRAL] All right, Ms. [PII].
[AGENT][POSITIVE] Oh, that'd be fun.
[AGENT][NEUTRAL] Oh my gosh, my grandma had one but it dropped and nobody can fix it, and I wish I could get one. They were so cool.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][MIXED] Yeah, I loved them, but um, but anywho, but I think I've got because those there's actually 4 things like say it's 2 things of 2 biopsies and 2 radiation sets of 5 radiation and he's starting chemo on Monday. So and I, I hate doing that. I really do, um, and I couldn't figure out from any of the information on these policies. I guess it doesn't tell you. I know it has a yearly benefit of 10,000.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] But I don't know, you know, like how much they pay for each one, you know, like each radiation treatment.
[AGENT][NEUTRAL] So I'm not looking at his policy, but I can explain that to you. Um, hopefully if you wanted more detailed information once we have you listed I can give that to you, typically, yes, that's going to be a yearly maximum amount so if it says 10,000 then it's 10,000 and that year [PII] will start from the first time that he receives any of that treatment, um, so it will be replenished, uh, the following year on that date, so it will pay up to that amount.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Um, per calendar, well, not calendar year from the dates that he first received treatment, so it will pay the full amount up until it reaches that point.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh, OK, um, but I, I just wasn't sure, you know, what it does as far as, um, um, like if it had a certain amount for each time he had it, you know, I mean, I guess it does.
[AGENT][NEUTRAL] No, no, it doesn't have a specific amount for each, uh, session or um treatment time, um, it's just that cap, that yearly cap once it reaches that then it's, um, uh.
[AGENT][NEUTRAL] It's been met until next year.
[CUSTOMER][NEUTRAL] Well, the, the funny thing about that, then how would they know what to pay?
[CUSTOMER][NEUTRAL] If they don't have like let's say $500 for treatment.
[AGENT][NEUTRAL] They'd have to itemize statement in the EOB.
[CUSTOMER][NEUTRAL] Oh, OK. Well, OK, um, yeah, uh, um, because, you know, some things like you'll say, OK, if you had this surgery, we'll pay $2000 you know, I didn't know if it had like.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Sure. And that's, that's where it's a bit different. It's a bit more specific. Um, chemo radiation and immunotherapy are usually grouped into one kind of bucket of that yearly amount, that yearly maximum.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right. And I'm gonna ask you one other quick question and I'll let you go. Um, our last wellness visit that I've documented and got paid for, I think was in [PII]. Um, I can't remember, I wanna say it was maybe in [PII] or something like that. Um, oh [PII], where was it? But I was gonna ask, do you have to, with the way the benefits goes like what if.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] He had his PSA check saying [PII] or [PII] and say we filed for [PII]. Do I need to be, does it need to be past [PII]?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Not typically no um and of course I'm I'm not able to pull up the policy and give you that explicit detailed information, but I will say um most of the time with the wellness benefits that is going to be on a per calendar year, uh, basis so simply yearly, yes.
[CUSTOMER][NEUTRAL] Like a [PII] through December.
[CUSTOMER][NEUTRAL] Yeah, OK, and it doesn't matter like when you pay your premium in the year either it doesn't based on that like a lot of things are based on that.
[AGENT][NEUTRAL] No ma'am, it, it is calendar year is typically what it is um and there's always that chance that it's different so once we get that authorization form we can go through and look a bit more in depth, but I will say most cancer policies I've seen that's how they operate.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. All right. Well, that's, that'd be good because I'm, I'm trying to get with him. OK, give me a date because the wellness thing is easy to do. It is so easy. It's almost, you know, um, yeah, so easy. But, um, so anywho, I, I think, um, uh, if we can get this information and I'm glad you told me different ways to try to make it easier because, you know.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Absolutely, yes ma'am. Of course the easiest would be if they could just send it to you through an email or something like that, but however they've got to, you have options.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, well I'm glad you told me that because in that way the uploading to you would be so much easier.
[AGENT][POSITIVE] Yes, absolutely.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][POSITIVE] Yeah, OK, all right, well, you have, you've helped me a lot. I just hope like I say, I can get this information.
[AGENT][POSITIVE] Oh, I'm good, yeah.
[AGENT][NEUTRAL] Of course I know that was information overload. Did you have any other questions for me at the moment?
[CUSTOMER][NEUTRAL] And get it.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Not at the moment. If I can just get this information that you need, I think it will be great. I can just upload it into the computer and roll.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Absolutely, yes, ma'am.
[CUSTOMER][NEUTRAL] You know, there was one other thing y'all send checks, don't you? Or do you do direct deposit?
[AGENT][NEUTRAL] Direct deposit can be set up um and that's let's see I'm not.
[CUSTOMER][NEUTRAL] But is it better to do checks?
[AGENT][NEUTRAL] I that's a matter of preference that is simply a matter of preference. Personally I like direct deposit better. I feel like it's safer and definitely a lot quicker um paper checks if direct deposit's not set up, we would send a paper check, um, but with that, um, if you've not received it within 30 days, that's the mark, then we can void and reissue. So if for some reason it got lost in the mail or something like that, you know, it can be a little bit of trouble getting that payment to you.
[CUSTOMER][NEUTRAL] Are y'all with the mail.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm. Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Right, so, uh, yeah, because direct deposit, I think that is the way to go and y'all have a form for that too so.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] There's a form um it can also there's a spot on our online portal where you can uh enter that information as well if that's easier.
[AGENT][NEUTRAL] Um, on the online portal you can there's a direct deposit section, yes.
[CUSTOMER][NEUTRAL] Oh, OK, so we did see it OK.
[CUSTOMER][POSITIVE] Oh well then that'll be even easier. That, that'll be even easier.
[AGENT][NEUTRAL] Absolutely and I'll I'll say this too because this this kind of just a little weird thing that happens on the website sometimes when you enter in the bank routing number it will pop up a completely different random bank that may not be yours and that's OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh oh.
[AGENT][MIXED] So that's just a weird little glitch. I don't know what's wrong with it, but I can say as long as you know and verify that you entered in the correct routing and account number it will work.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh boy, yeah, but sometimes it will give the correct one though, right? It's just sometimes it does that.
[AGENT][NEUTRAL] Oh yeah, sometimes it will. I just, yeah, I've had several people call where they're just like that's not my bank and I was like, I know, but it's OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yeah, so long as that's what's on your check at the bottom, on your checks.
[AGENT][POSITIVE] Right, the numbers are what matters.
[CUSTOMER][POSITIVE] Yeah. Yeah, OK, alright, well, uh, like I say, I totally and completely appreciate this and I just hope that the billing department will be not y'all are y'all are one of the easiest people to work with. You really are y'all are one of the easiest people because he's got another one, he's got another one that mama got him and it's, it's like there's a million hoops to jump through, a million.
[AGENT][POSITIVE] Oh, you're very welcome. Happy to help.
[AGENT][POSITIVE] Oh yeah, hopefully they're good.
[AGENT][POSITIVE] Well, I'm glad to hear that.
[AGENT][NEUTRAL] We should try.
[AGENT][NEUTRAL] Oh man.
[CUSTOMER][NEGATIVE] And you know, and I hate so bad she bought that, but I want them to pay some stuff, you know, but.
[AGENT][POSITIVE] Of course, yes, you got it, absolutely.
[CUSTOMER][NEUTRAL] The past when we're doing wellness things, that's when they'll do those easy, but when you wanna do something else, you, you better get ready.
[AGENT][NEUTRAL] Oh man.
[AGENT][POSITIVE] Oh my gosh.
[CUSTOMER][POSITIVE] I mean you're in for, yeah, they're not Aflac either if they were Aflac it'd be super easy too. I have Aflac super easy, super but um you're you're literally as easy as Aflac and that's saying a lot. It really is.
[AGENT][POSITIVE] Well, I'm good. I'm glad to hear that. That's really good.
[CUSTOMER][POSITIVE] Yeah, y'all are um but anywho, so I'm gonna try to get all this information and hopefully we can um.
[CUSTOMER][POSITIVE] Get all this sent to you and hopefully, you know, y'all will um
[AGENT][POSITIVE] Yes, ma'am. Get all squared away soon.
[CUSTOMER][POSITIVE] Yeah, because I do need to make sure I hope to goodness um I guess I'm gonna have to get him to agree.
[CUSTOMER][NEUTRAL] I need to make sure I get the bill so I don't know what what address y'all have on file. I, I don't know if it's mine or his that then you, you can't tell me and oh boy. I gotta make sure that fill it out right, fill it out wrong, but um.
[AGENT][NEGATIVE] No, ma'am, unfortunately, no.
[CUSTOMER][NEUTRAL] But, cause I, I know I get.
[AGENT][NEUTRAL] Well, if there's ever a time where he's able to just hop on the phone, all we would need is and you're present, of course, um, all we would need is for him to verify his name, date of birth, uh, address, and then of course his verbal consent that it's OK to speak with you um if you needed that information before you can get that form to us, of course.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Yeah, well, maybe I can get it Monday morning from, you know, because y'all are y'all are open on Monday through Friday, right? When is it when do y'all?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Monday through Friday, um, uh, [PII] Central time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK, so that's 8 for us 8 because we're Eastern. So, OK, so 88 Eastern. OK. So yeah, I'm gonna try to just see if I can get you one of y'all on the phone, you know, um, to at least, yeah, but that's only for that one phone call though, right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][NEGATIVE] Yeah, see that's kind of sucks in a way, you know, but um.
[AGENT][NEUTRAL] It does, but that's what that form is for.
[CUSTOMER][NEUTRAL] Yeah, I'll see if I can get that form downloaded and get it to y'all, um, get it, uh, maybe even take a picture of it to get it on up in there, maybe um.
[AGENT][POSITIVE] Sure, yeah, however is easier for you.
[CUSTOMER][POSITIVE] OK all right well I appreciate your time though and I know you got other callers to help.
[AGENT][POSITIVE] You are very welcome. No, you are perfectly fine. It was a pleasure speaking with you. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] You too thank you so much.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] Mhm.