AccountId: 011433970860
ContactId: 2d9a239c-6c97-4b3c-ad68-764787757fe6
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 417799 ms
Total Talk Time (AGENT): 189493 ms
Total Talk Time (CUSTOMER): 190920 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/2d9a239c-6c97-4b3c-ad68-764787757fe6_20250321T18:39_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] Good afternoon, [PII]. My name is [PII], and I got some questions about how to file and what I need to file a claim. I was just recently diagnosed with prostate cancer.
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] All right. Well, Mr. [PII], it would be a pleasure to assist you with that information. What is a good callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. Thank you. And do you happen to have your policy number available?
[CUSTOMER][NEUTRAL] I, I'm not logged into my computer. I don't have it handy, but I can find.
[AGENT][NEUTRAL] That's right. That's fine.
[AGENT][NEUTRAL] What is that?
[AGENT][NEUTRAL] No, that's fine. I can look it up by your social if that's OK.
[CUSTOMER][NEUTRAL] That's fine [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Let's see, let me get that policy pulled up.
[CUSTOMER][NEUTRAL] Just through the Fort Worth ISD.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] And what is your date of birth and current mailing address, please?
[CUSTOMER][NEUTRAL] November [PII].
[CUSTOMER][NEUTRAL] And [PII].
[AGENT][NEUTRAL] All right, perfect. And do you mind, uh it looks like we might have your school email address on file. Would you like to keep that or change it to your personal account?
[CUSTOMER][NEUTRAL] Um, I know y'all have my school email is on file because I had a hard time initially getting logged in. When I logged in, I I thought I changed it. I guess it didn't change that, yeah, you could change it to my personal one. It's [PII].
[AGENT][NEUTRAL] OK, well, actually that's what we have on file.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I was, I was thinking Charter was an ISD. I apologize.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] No, originally it was originally it was my school address and that's my personal.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] And it would be my pleasure to assist you with information regarding filing a claim.
[AGENT][NEUTRAL] Now, Mr. [PII], what we're gonna need, now I see you do have that active account.
[AGENT][NEUTRAL] On our portal.
[AGENT][NEUTRAL] And under the claims and forms section, there is a cancer claim form.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] It it also has instructions on page one is what's needed to file a claim. We will need the um pathology report.
[CUSTOMER][NEUTRAL] Right?
[AGENT][NEUTRAL] With the diagnosis of cancer.
[AGENT][NEUTRAL] If you had a biopsy, you can send in the bills for your biopsy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I did. That's how they got rid of it but.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. And then if you're going to have any treatments, we would need itemized bills with diagnosis codes as well.
[AGENT][NEUTRAL] For treatment.
[CUSTOMER][NEUTRAL] OK, um, before, OK, before that, I was reading through that and it said something about, before we went through the biopsy, they, I had a CAT scan, I had an MRI, I had multiple PSAs to see the elevations.
[AGENT][NEUTRAL] That you can file for those diagnostic tests as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you just need the billing in the billing or what on those?
[AGENT][NEUTRAL] We would
[AGENT][NEUTRAL] Yeah, we need an itemized bill from the provider that performed those diagnostic tests.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Ah. So we need to.
[CUSTOMER][NEUTRAL] Pathology right and the biopsy, um, you don't need it with um all the billing codes and all on those.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] And when I called earlier, they said it'd be like.
[CUSTOMER][NEUTRAL] Oh, anywhere from
[CUSTOMER][NEUTRAL] 4 to 6 weeks before they get it all.
[AGENT][NEUTRAL] Build out and everything.
[CUSTOMER][NEUTRAL] They, they don't
[CUSTOMER][NEUTRAL] Yeah, they don't, uh, they don't run in a hurry.
[AGENT][POSITIVE] No, they don't, and that's fine. You, um, there's no time frame to submit the claim, so you're good.
[CUSTOMER][NEUTRAL] OK, so all this is covered up, I was a little confused on the actual, on what is covered, is it, um.
[CUSTOMER][NEUTRAL] There's uh looks like there's a one time, once you're diagnosed, there's a one, a one-time payment. Is that correct?
[AGENT][NEUTRAL] Mhm. That is correct. That's upon the diagnosis of cancer. There's, it's called a first occurrence benefit.
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK, and then after that it only looked like he paid just a little bit on on for one.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Of the uh diagnostics is that, was that correct?
[AGENT][NEUTRAL] So you have your screening benefit and then you have a follow-up diagnostic test.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then, um, once you're following the diagnosis of cancer, you have a benefit for up to one test per per person per calendar year. That's after the diagnosis of cancer. So if they do an MRI or PET scan, uh, whatever, you know, after the diagnosis of cancer to check it, you can file for that.
[CUSTOMER][NEUTRAL] OK, so, OK, so we haven't gone that route and I'm meeting with the doctor next week to figure out what our plan of action is.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] On how to tackle this.
[AGENT][POSITIVE] Yeah, you're gonna tackle it and be fine.
[CUSTOMER][POSITIVE] I will because it's not very, it's still called it early so it'll be, I'll be wonderful.
[AGENT][POSITIVE] Yes, sir, that's great.
[CUSTOMER][NEUTRAL] Just a matter of which way we want to go.
[AGENT][POSITIVE] Yeah, exactly. I'm figuring that out, um.
[CUSTOMER][POSITIVE] All right, so I'll make a matter of same information. I'm still waiting on getting all my bills and once I get everything in.
[CUSTOMER][NEUTRAL] The only thing I could really build now is I could send in for the diagnostic because I have those bills the rest of it I'll just have to wait until I get more information.
[AGENT][NEUTRAL] And you can send in your pathology report for that first occurrence benefit.
[AGENT][NEUTRAL] Cause that does not need a bill, we just need that pathology report and the claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that'll get that started.
[CUSTOMER][NEUTRAL] All right, well, I can do that and thank you for your information. I, I saw the form online. I can go in and.
[CUSTOMER][NEUTRAL] Fill that out and then get that mailed in.
[AGENT][POSITIVE] Yes sir and if you have any questions or concerns along the way, don't hesitate to give us a call because we're here to help you any way we can.
[CUSTOMER][POSITIVE] Alrighty, thank you much. You've been very helpful.
[AGENT][POSITIVE] And thank you for calling. It's been my pleasure, Mr. [PII]. I hope you have a wonderful afternoon.
[CUSTOMER][POSITIVE] Hey, thank you.
[AGENT][POSITIVE] Thank you for calling