AccountId: 011433970860
ContactId: 40f5f52c-8df2-4630-a3cd-af1ed652ae47
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 337350 ms
Total Talk Time (AGENT): 148912 ms
Total Talk Time (CUSTOMER): 181372 ms
Interruptions: 1
Overall Sentiment: AGENT=2.2, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/27/40f5f52c-8df2-4630-a3cd-af1ed652ae47_20250127T15:54_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Um, hi, I was calling checking on my claim. Um, it's been out there for a while, um, and we've sent in, uh, several documents. My doctors sent in documents, and I was wondering if you might be able to, to give me an update or help me out on it.
[AGENT][POSITIVE] It would be my pleasure to assist you. Do you have your policy number available?
[CUSTOMER][NEUTRAL] Uh yes, let's see, it's 254-920-6.
[AGENT][NEUTRAL] Thank you. And do you mind verifying your name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Sure. It's [PII], and my birthday is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And can you verify your current mailing address, email, and phone number?
[CUSTOMER][NEUTRAL] OK. The address is [PII], that's in [PII]. My email address is [PII]. Well, it may be my work address. Um, that would be [PII].
[CUSTOMER][NEUTRAL] At uh [PII].
[CUSTOMER][NEUTRAL] And my phone number is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Now Ms. [PII], I am checking your claim for you, and it looks like that they are processing that today.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And your first occurrence benefit is payable. It is will have to go through our audit department because of the amount and then once released.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, that will be sent to your bank account.
[AGENT][NEUTRAL] And that is for the first occurrence benefit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And how long does that take?
[AGENT][NEUTRAL] To go through audit, it could take um
[AGENT][NEUTRAL] Up to a week, they have to audit the claim and make sure that the payment amount is correct.
[CUSTOMER][NEUTRAL] OK, OK, and do you have any idea what that payment amount might be?
[AGENT][NEUTRAL] It looks like that is for your first occurrence benefit.
[AGENT][NEUTRAL] And that benefit amount is $7500. Now of course I won't be able to verify the check amount until it goes through audit.
[CUSTOMER][NEUTRAL] Right, right. OK. Oh good. I can tell the hospital some a little bit of information anyway.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, I would just tell them that it looks like it is um completing the processing stages.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Um, going through the audit department, yeah. Now that's gonna come to you.
[CUSTOMER][NEUTRAL] OK, and it could take up.
[CUSTOMER][NEUTRAL] OK, up to a week.
[CUSTOMER][NEUTRAL] Right. Exactly. Exactly. Yeah, I knew it would come directly to me, and then I'd have to disperse it to the doctors and hospitals and all that good stuff.
[AGENT][NEUTRAL] Oh, that's
[AGENT][NEGATIVE] And all those charges get outrageous, don't they?
[CUSTOMER][NEUTRAL] Yes, they do. And
[AGENT][NEGATIVE] And overwhelming
[CUSTOMER][NEUTRAL] They're continuing to add up, um, in the chemo and, and radiation portion of it now. So, uh, long road.
[AGENT][NEUTRAL] We just, yeah, but you know what, it is amazing what they do now. You know, it's cancer is not like this, the sentence you used to get, if you know what I mean. And um
[CUSTOMER][NEUTRAL] Oh, I know.
[CUSTOMER][POSITIVE] Oh yes. Oh yeah.
[AGENT][POSITIVE] So it's beautiful.
[CUSTOMER][NEUTRAL] Yeah, I'll
[AGENT][NEUTRAL] The treatment that they have, how they can treat it.
[CUSTOMER][NEUTRAL] Yes, I
[CUSTOMER][NEGATIVE] I know. Um I remember in the [PII], my grandfather and I, and one of my aunts had it. And it was, yeah, it was a death sentence, and the pain and everything they went through, just horrible. And now, it's, it's
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] You know, hardly painful. I mean, you get tired and of course, I've got a hoarse voice and everything, but, you know, compared to what they went through.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So.
[AGENT][POSITIVE] It's amazing.
[CUSTOMER][POSITIVE] Yes, yes, yes.
[AGENT][POSITIVE] Well, I certainly hope the best for you. Now, don't forget to continue just to send in your itemized bills for your chemos and, and your um explanation of benefits from your primary insurance for chemos.
[CUSTOMER][NEUTRAL] OK, well,
[CUSTOMER][NEUTRAL] OK. OK. I'll do that. Um, yeah, I've got some bills here that, uh, just go ahead and send in, uh, the bills from the doctors.
[AGENT][NEUTRAL] Yes, ma'am. And you can send it in as you're getting the treatment or if you prefer to wait and send it in all at once. It's whatever your preference is and, you know, how you, how good you feel and can send it in or
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] It's either way.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, OK, I do appreciate that. All right, thank you very much.
[AGENT][POSITIVE] It's been my pleasure. Is there anything else I can help you with, Miss [PII]?
[CUSTOMER][POSITIVE] I think that was it. You were very helpful.
[AGENT][POSITIVE] Well, thank you for
[AGENT][POSITIVE] It's been my pleasure. And if you need anything else, don't hesitate to give us a call. We're here for you, OK?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] All right. Thank you very much.
[AGENT][POSITIVE] Thank you, Ms. [PII]. You have a lovely day and stay warm.
[CUSTOMER][POSITIVE] You, you too. All right. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye.