AccountId: 011433970860
ContactId: 3c1a11d1-20f2-45a9-8774-0ad794c31fc2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1037790 ms
Total Talk Time (AGENT): 556859 ms
Total Talk Time (CUSTOMER): 332886 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/3c1a11d1-20f2-45a9-8774-0ad794c31fc2_20250516T18:19_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I have several questions.
[CUSTOMER][NEGATIVE] Uh, we have, uh, a cancer.
[CUSTOMER][NEUTRAL] Intensive care coronary care policy. Let me give my uh policy number. My husband has been diagnosed with bladder cancer.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I um.
[CUSTOMER][NEUTRAL] They started with um.
[CUSTOMER][NEUTRAL] MRI CAT scan, found it, did 2 surgeries, scrapings, and now he has uh 6 weeks of chemo. They told him the day before yesterday. Now I want to know.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What to file on this cancer policy. His name is [PII]
[CUSTOMER][NEUTRAL] [PII] date of birth.
[CUSTOMER][NEUTRAL] And the policy number is 748041.
[AGENT][NEUTRAL] OK, and can I get a call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] It's the number we're on right now [PII].
[AGENT][NEUTRAL] All right, ma'am, let me look that up real quick.
[AGENT][NEUTRAL] And what is your uh full name and date of birth?
[CUSTOMER][NEUTRAL] My name is [PII]. Last name [PII], [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And can I get you to verify your address and phone number? Um, I got your phone number, your address and your email.
[CUSTOMER][NEUTRAL] [PII] and my email is all lower case, the initials, the initial [PII].
[AGENT][NEUTRAL] OK, and I'm showing a different number on file. Did you want me to keep that number that we have on here or use this number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEGATIVE] That's no longer valid. It's disconnected. That was a home phone.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do have another number that you could call. It's [PII], but call the [PII] number preferably.
[AGENT][NEUTRAL] [PII] are the last four?
[CUSTOMER][NEUTRAL] Uh, one is one is [PII], the other one is [PII].
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, and you want the one with 32 at the end, correct?
[CUSTOMER][NEUTRAL] My number, yes.
[AGENT][NEUTRAL] OK, OK. I just want to make sure.
[AGENT][NEUTRAL] And you're wanting to know how to file a claim for this particular policy, correct? I just wanna make sure that I'm give you the right information.
[CUSTOMER][NEGATIVE] Right, I don't know, I don't know what eligible to file like all of this out of pocket for all these tests that they're running for cancer, is that?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that uh something I can file?
[AGENT][NEUTRAL] Yes, ma'am. You should be able to. Let me go ahead and check and see exactly based off of your policy.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] I have my policy in front of me, but it's like gobbly books so.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Give me just a moment while I look it up, OK?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK ma'am and you are filing this yourself correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so when you go to [PII] and go on to the claims, you will go to cancer claim form.
[AGENT][NEUTRAL] It will have information for you to complete.
[AGENT][NEUTRAL] Um, I'm double checking on everything that you need.
[CUSTOMER][NEUTRAL] I go to [PII] and I look for cancer claim forms.
[AGENT][NEUTRAL] Yes ma'am and if you want I can even email you that claim form if you would like me to send it to the email I have on file.
[CUSTOMER][POSITIVE] Yes, I would, that would be great.
[AGENT][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] Now I have some forms here, but they are for like my yearly pap.
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] Things like that, you know.
[AGENT][NEUTRAL] Yeah, and if you're filing in in regards to your husband's uh bladder cancer, it'll be a separate claim form. So on that cancer claim form uh that I'm going to email you, it does have a list of everything that you'll need. Um, so you will complete uh sections A through D, um as applicable to his particular type of cancer.
[CUSTOMER][NEUTRAL] It's um
[AGENT][NEUTRAL] Um, let me see if there's anything that you absolutely don't need.
[AGENT][NEUTRAL] Right, so on the cancer claim form it just has information about your husband that you will fill out or information about you that you will fill out information that's section A. Section B will be about your husband because you're filing the claim for him. He will be the patient.
[AGENT][NEUTRAL] See and uh see is only if you guys are going to be transport if you're going to be going uh.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Far away. So if your cancer doctor is near you and his appointments are near you, you might not need to fill that out. Um, you can always fill it out just in case. We might be able to reimburse you for travel. Um, it just depends on your type of policy. I personally would just go ahead and fill it out and if they don't, if they don't bill you, uh, I'm sorry, pay you back for travel, then it's nothing really lost and you tried.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] Um, and then lodging too. So if his cancer doctor is far enough away to where you need to stay at a hotel overnight, that information is in section C as well. If you don't believe that those are needed, um, you would fill out section A and B.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And on the claim form that I'm going to send you.
[AGENT][NEUTRAL] Uh, I want to remind you at the very bottom of the very last page you'll have your policy number you'll need to put your policy number and you will need to sign it. um, if you send in this claim form without the signature, uh, it'll get denied so you wanna make sure it's on a page pretty much all by itself, um, and it has some information for you to sign.
[CUSTOMER][NEUTRAL] Do
[CUSTOMER][NEUTRAL] Do I sign or do we both sign?
[AGENT][NEUTRAL] The signature of the patient.
[CUSTOMER][NEUTRAL] Of the patient because I'm the policy.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Right, it has information specifically for you in section A because you are the insured. Section B would be about him as the patient.
[AGENT][NEUTRAL] But because the claim is going to be for him, you will need him to sign it, and it still has your policy number and everything on there. If you are a representative, you can sign that, um.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And then at the bottom you'll put your um relationship, that's if needed, but um he would be the one signing it because the technically the claim is going for his cancer.
[AGENT][NEUTRAL] On this form, it shows everything that you uh will submit with this claim form.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] If it's me personally, if you think it's relevant, go ahead and send it because we go through all of it. We uh we review everything that you send. So even if you think that it might be, but you don't know for sure, go ahead and send it. Um, and for this claim form, it would be only documents relating to his bladder cancer. Um, I know you said something about your, your mammograms, those would be separate.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Uh, what about, does it tell you like, um, they used to make us give like a hick of HIPA form that had the, the treatment, the date, the doctor, the, does this have to be anything that doctor fills out or is this what I can send in?
[AGENT][NEUTRAL] You should be able to send it in. Um, most people with the cancer forms, they do send them in themselves. Um, really, all you'll need, and it'll say this on the form too, is pathology reports stating that he was diagnosed with cancer, if it was an, an initial one, or if there was any surgeries related to it. Um, it's, it's everything you can get from your doctor, um, if you need to.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Um, since you are doing stuff such as chemotherapy, um, you will want an itemized medical bill from every medical provider that you have. Um, since they give that to you, you should be able to get that and an explanation of benefits or an EOB.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Showing uh that they that it was paid, if it was paid.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEGATIVE] Now, I'm not filing.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] For what Medicare or my primary insurance uh charged me for I'm, I will be filing strictly for out of pocket, which is huge, right?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, you can bring, you can send those bills in so that explanation of benefits through your Medicaid, you can fill those in to show that they part of it was paid if you are going that route, or you can just send the itemized bills that they give you that the doctor's office gives you, and then any receipts.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] See, that's
[CUSTOMER][NEGATIVE] They don't give us an itemized bill, you know, they say, um.
[CUSTOMER][NEUTRAL] Doctor [PII], $350 paid with Visa. That's, that's the extent of what I get. It might say office visit or uh MRI that won't be sufficient, will it?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You will want to ask them specifically for an itemized bill telling them that you are going to be submitting a claim because in some of these instances we need the procedure codes so the itemized bill has the procedure procedure codes that might be something that you have to ask them specifically for and just let them know it's because you're filing a claim for this um it might not be something that they normally give but they can if you ask for it.
[CUSTOMER][NEUTRAL] Yeah, that's what
[CUSTOMER][NEUTRAL] Yeah, are you familiar with monthly charge?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You know what my chart is? You might do that personally. It's online.
[AGENT][NEUTRAL] Through, mhm.
[CUSTOMER][NEUTRAL] And you go and every doctor that there is now, in fact, you can get reports before your doctor gets them on my chart.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] They can tell you everything, but as far as getting it from the doctor, you know, those days are over. Like you said, I'll have to go and ask specifically for that cause I can't send an email off of my chart, I don't guess that has all the.
[AGENT][NEUTRAL] Right, and I've used my chart before and it's very hard because you can't screenshot anything because it's all medical documents. Um, you might not need to drive up there. You can always call them and ask them to mail it to you. That's if you are OK relying on the mail, um, or just say, hey, I'm coming up here on this day for his treatment. Can I get it whenever we get up there? Um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, that
[CUSTOMER][POSITIVE] Yeah, that's probably the easiest thing to do.
[AGENT][NEUTRAL] Yeah, because we need those procedure codes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And you have sent me a form, right? Or you will send me one?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yes, after this call it'll give me, give me about 5 minutes to get it sent over to you. Um, sometimes you'll need to check your spam sometimes our emails go to spam, so just be on the lookout if you don't get it by the end of today, um, around [PII], go ahead and call us back in the morning, um, and we'll see what happened.
[CUSTOMER][NEUTRAL] OK, now I only need to send one claim form and I attach all of the documents to that one form, is that right?
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] I don't need one document for one hospital, another document for the doctor, another document for radiology. I just need one claim. OK, OK.
[AGENT][NEUTRAL] No, ma'am. It's
[AGENT][NEUTRAL] Right, it, and it says on the cancer form too, um, when filing a claim for services, itemized bill from each medical provider, meaning you can file them all under one claim.
[CUSTOMER][NEUTRAL] OK, now you had told me A, B, C, and D. What is on D that I would have to complete?
[CUSTOMER][NEUTRAL] Or did you just tell me A and B and I thought you said D.
[CUSTOMER][NEUTRAL] On the form.
[AGENT][NEUTRAL] It looks like it reads funny, so it, so D isn't actually a form, it just is there to make sure that you read certain law fraud statements on your claim form. There's nothing to fill out in section D. Um, I had to double check that myself, yeah, so.
[CUSTOMER][NEUTRAL] He just
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Section A and B C if you need it for the transportation and lodging. D is just to make sure that you read the fraud statement for your particular state.
[AGENT][NEUTRAL] Um, which, yeah, so it really all you need is that and then he is the one that you will have, it's at the very bottom you'll just need uh your policy number and all that and then that's where you and him will sign it.
[CUSTOMER][NEUTRAL] OK, I think
[AGENT][NEUTRAL] So section E is signing it.
[CUSTOMER][NEUTRAL] I thought you said just
[CUSTOMER][NEUTRAL] I thought you said just he would sign it as the patient.
[AGENT][NEUTRAL] Right, but if you needed to be his personal representative, that's when you would sign it as well.
[AGENT][NEUTRAL] But yes, he will be the one signing it if you have to sign for him say he has he's disabled and he's not able to sign it if you are a representative that's when you would sign it.
[CUSTOMER][NEUTRAL] OK, all right, uh.
[AGENT][NEUTRAL] And it and it explains it on there too mhm.
[CUSTOMER][POSITIVE] Let me ask you something. I, I appreciate you helping me with this and explaining everything. I was really confused. Do you have an extension where if I had a question, since you're familiar with this, I could get back to you or I just, it's just the luck of the draw?
[AGENT][POSITIVE] Um, when you call us and you get the care team or us, uh, we should all be able to help you with this. Now if you want me specifically, they do have, we do have notes that have our names in it, so someone will be able to read all of the notes that I put in there, uh, to know what exactly is going on. Uh, you should be you should be pretty well taken care of with everyone in this group. Uh, we all pretty much we've dealt with these a lot.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] It's, it's horrible that we have to have this, uh,
[AGENT][NEUTRAL] Cancer form, but most of us are pretty well versed in this, so you should be in good hands no matter who you get.
[CUSTOMER][POSITIVE] OK, well thank you again I appreciate it and I'll check my email and the spam as well for the form.
[AGENT][POSITIVE] All right, and if there's nothing else you need from me, [PII], I hope you have a great day and thank you for calling APL.
[CUSTOMER][NEUTRAL] Is there a limit on what how long you have to file?
[AGENT][NEGATIVE] No ma'am we do not have timely filing.
[CUSTOMER][POSITIVE] OK, all right, thank you so much bye bye.
[AGENT][POSITIVE] All right. You're welcome, bye.