AccountId: 011433970860
ContactId: 32c97185-9580-4723-89c9-63b741357542
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 541799 ms
Total Talk Time (AGENT): 296863 ms
Total Talk Time (CUSTOMER): 205886 ms
Interruptions: 5
Overall Sentiment: AGENT=0.5, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/32c97185-9580-4723-89c9-63b741357542_20250326T19:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Yes, you may. I'm calling about benefits, um, I wanna make sure that I have benefits.
[CUSTOMER][NEUTRAL] Um, my name is [PII], and it would be with the Duncan Valley Independent School District.
[AGENT][NEUTRAL] OK, ma'am, um, I can check to see if you have any active policies with us. Can you please give me your social security number and that will pull in anything that you have with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, I'm gonna look that up real quick.
[AGENT][NEUTRAL] OK, Miss [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your address, phone number, and email address that we have on the policy for you, ma'am?
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Uh, phone number [PII] and I believe the email you would probably have is [PII].
[AGENT][NEUTRAL] Uh, it looks like I have, um.
[AGENT][NEUTRAL] A personal email. Yes, that's it.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. Let me make sure I write it down this time.
[AGENT][NEUTRAL] Yes, ma'am. That's
[AGENT][NEUTRAL] Yes, ma'am. OK, let me look real quick.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] You do have an active cancer policy with us.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And can you explain to me what they cover?
[AGENT][NEUTRAL] So, and this is just to verify your benefits. It's not a guarantee of payment. If you're ever diagnosed with cancer.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It has um.
[AGENT][POSITIVE] A treatment benefit.
[CUSTOMER][NEUTRAL] I was not
[CUSTOMER][NEUTRAL] I was not my husband was.
[AGENT][NEUTRAL] OK, let me see if he's on this policy.
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] What is your husband's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let's look.
[AGENT][NEUTRAL] OK. So it has, um, you have treatment benefits. You have an internal cancer first occurrence benefit. So if the cancer is
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, let me write that down, treatment benefit.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You have, um,
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] And in
[CUSTOMER][NEUTRAL] You say in treatment benefits and what what is the other one?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Internal cancer first occurrence. So, uh, the first occurrence.
[AGENT][NEUTRAL] Benefit
[AGENT][NEUTRAL] If he's ever diagnosed with internal cancer is $5000. It's paid one time.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then there's also on this policy, a heart attack and stroke.
[AGENT][NEUTRAL] First occurrence writer.
[CUSTOMER][NEUTRAL] OK, he hasn't had no.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then it is
[CUSTOMER][NEUTRAL] He hasn't had either one of them.
[AGENT][NEUTRAL] OK. And then you also, um, if for any reason you're not with the school district, you have the option to take the policy with you and pay for it on your own if you ever leave the school district.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, OK, so what I'm dealing with now, my husband's been diagnosed with prostate cancer.
[AGENT][NEUTRAL] Yes ma'am, OK.
[CUSTOMER][NEUTRAL] And I need to know what I need to go from here, not only that he um.
[CUSTOMER][NEUTRAL] And his work they just.
[CUSTOMER][NEGATIVE] On Friday they told him they couldn't accommodate him because it's kind of crippling with it right now.
[AGENT][NEUTRAL] Yes, ma'am, I understand. OK. So, um,
[AGENT][NEUTRAL] On the
[AGENT][NEUTRAL] On this policy, you're gonna need to file a claim for him and let me tell you how to do that.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] You can go into our online service center, you sign up for that. Let me give you that website.
[CUSTOMER][NEUTRAL] I'm OK.
[AGENT][POSITIVE] It is secured, S E C U R E D.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] If you wanna talk to me I was trying to take a message and get information I can do that.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] AM public.
[AGENT][NEUTRAL] When
[AGENT][NEUTRAL] Yeah, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII] you're gonna go in um as the first time you're gonna sign up as a new user.
[CUSTOMER][NEUTRAL] OK, uh huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then the second option is you're an individual with an APL policy.
[AGENT][NEUTRAL] And then you're gonna choose your username and password for the website for the online service center. It's a direct portal to your policy so you can actually uh see your uh policy uh copy of your policy there on that site too if you wanted to read over it.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But when you go when you go in, you're going to go to claims and forms, you're gonna click on that for your cancer policy. That first page of the claim form is a cheat sheet that tells you exactly what you need to send in with your claim.
[CUSTOMER][NEUTRAL] Oh OK OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] One more
[AGENT][NEUTRAL] But I will tell you, one of the most important things is to send in the pathology report that shows that he's, yes, you'll need to send that in. That's what's gonna tell that he's been diagnosed with cancer. Um, you'll need any itemized statements with diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Pathology.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If he's had surgery, you'll need the operative report.
[CUSTOMER][NEUTRAL] Well this is the thing about it he's been diagnosed and then one doctor said, OK, he needs $700 right now to come back in and I guess do something procedure or something so I didn't know how that works. I was like, OK, let me see if I got an insurance that will cover some of these fees.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, you do have a, a cancer policy. Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now, if the doctors wanted to call and verify benefits on the policy, we can do that too.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So they can go ahead and see him or whatever. OK.
[AGENT][POSITIVE] They can call in and um just ask for eligibility and benefits and we can give the eligibility and benefits for.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. Mhm.
[AGENT][NEUTRAL] The policy.
[CUSTOMER][POSITIVE] OK, good, good.
[AGENT][NEUTRAL] Over the phone to them.
[CUSTOMER][NEUTRAL] And what did you show that the policy went in effect so I can tell him that.
[AGENT][NEUTRAL] Yes, ma'am. Your effective date is.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, that's plenty I mean that's uh.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] It ain't like it's a brand new policy and that's what she asked me. I was like, no, I don't think so. I've been working a long time. OK.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, you, you tell her it's, it's a policy that was taken out through your school district that it's a group plan.
[CUSTOMER][NEUTRAL] A group plan that's what I need to hear because I remember that word too. OK, OK, well you've answered a lot of questions for me so let me get on top of them and go ahead and call and um.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Well, you're
[CUSTOMER][POSITIVE] If they need to call for eligibility and benefits they can to keep this treatment going and everything.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, well thank you so much for helping me. I'm just new to it, but I'm trying to stay strong.
[AGENT][POSITIVE] All right. You're very welcome, Miss.
[AGENT][POSITIVE] Yes, and if you ever, right, and if you ever find that you need more help with anything, always feel free to pick up the phone, Ms. [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK I sure will mhm thank you so much all right bye bye.
[AGENT][NEUTRAL] OK. All right.
[AGENT][POSITIVE] You're welcome. You have a good day and thanks for calling APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm