AccountId: 011433970860
ContactId: 413129c9-ab51-43bc-b789-81a99d78e0f9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 886119 ms
Total Talk Time (AGENT): 420546 ms
Total Talk Time (CUSTOMER): 262871 ms
Interruptions: 10
Overall Sentiment: AGENT=0.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/413129c9-ab51-43bc-b789-81a99d78e0f9_20250624T20:06_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes ma'am, I was just checking back on the uh on a claim to see if I have any um.
[CUSTOMER][NEUTRAL] Claims that I could uh claim for um well this claim.
[AGENT][NEUTRAL] OK, so you're wanting to check a status for a wellness claim?
[CUSTOMER][NEUTRAL] Well, I wanna see if I have any uh open uh if I have a a claim process a claim or if I've already used up those dates. I think you only get one a year.
[AGENT][POSITIVE] OK, yes, ma'am. I can help.
[CUSTOMER][NEUTRAL] This was uh through [PII] Independence? OK.
[AGENT][NEUTRAL] I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] This is [PII], and I wanna say this is for last year because I don't think y'all y'all with BISB anymore.
[AGENT][NEUTRAL] OK, and [PII], what is your last name again? I'm so sorry, did you say [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, [PII], thank you. And Miss [PII], what's a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And do you have your policy number?
[CUSTOMER][NEUTRAL] Uh, I have this policy number on this letter, so I'm guessing it's the same thing 02076718.
[AGENT][NEUTRAL] OK, thank you so give me just a couple of moments please to get your information all pulled up and I will have to verify your information first for security.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And also any information that's provided for you would be a verification of benefits and not a guarantee of payment, so just a moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] What, you put that back there in?
[CUSTOMER][NEUTRAL] Oh, cause I just went back down like.
[CUSTOMER][NEUTRAL] You need me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so first off, Miss [PII], if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] OK, thank you and your home mailing address.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. The phone number that is on file for you is the same as the one that you provided for me, so that is your best contact number, is that correct? OK.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then lastly, your work email, Ms. [PII], and this does appear to be your work email.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] My work email is um [PII].
[AGENT][NEUTRAL] OK, thank you. All right. So give me just a moment to um
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah, I was just saying if there's any available claims I didn't process.
[CUSTOMER][NEUTRAL] I mean
[AGENT][NEUTRAL] Alright, so just a second.
[CUSTOMER][NEUTRAL] And I may have did one last summer, I'm not sure. I said, well, let me just double check.
[AGENT][NEUTRAL] OK, so I'm first looking at the policy number that you gave me, but I don't believe there were wellness benefits on this particular policy. So that's, this was your hospital indemnity plan, but let me check on, I'm trying to pull that information up to look at it.
[CUSTOMER][POSITIVE] Oh OK yeah I think I'm OK.
[AGENT][NEUTRAL] From what I can tell, it does not have wellness benefits or screening benefits, but I just wanna double check that.
[CUSTOMER][NEUTRAL] OK, cause I had it. I did them before. I did actually did one last summer, so I was just checking to see if I had any, if I use them all, yes, the wellness exam wellness.
[AGENT][NEUTRAL] Right, yeah.
[AGENT][NEUTRAL] Yes, so on this policy, right, but on this part you had different policies with us. You had more than one type of policy. Right. So this one, there were not any wellness benefits on it. Let me, I'm just gonna have to look at each one of them.
[CUSTOMER][NEUTRAL] Oh, OK, so it's the wrong one. OK.
[AGENT][NEUTRAL] OK. And so then last year up until [PII], you also had your cancer policy.
[AGENT][NEUTRAL] So that one should have a wellness benefit on it, but let me double check that one for you.
[AGENT][NEUTRAL] OK, so I, let's see. So I do see that you did file Ms. [PII] for your preventative under your cancer policy for [PII]. It was filed in April for data service of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So that was the one that did go through or didn't cause I have the letter send one of them, I guess I had 2 minutes. OK.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, it did.
[AGENT][NEUTRAL] Yes, ma'am. That one did, that one did process. That claim was actually processed in almost a year, [PII], yes, and [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh-huh, cause then she's the one I get them like in May or June, so that's when I try to file them cause I, I use it to get, so I'm up to date. I don't have any other dates.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Right, we
[AGENT][NEUTRAL] No, ma'am. That would be, yes, ma'am. That benefit was used for that policy for last year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I know my husband had it, but I don't know if he's ever used any of his. If I could check his, he's right here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] If there's anything he could uh claim.
[CUSTOMER][NEUTRAL] Did he have claims.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Now we don't have a claim on file for him under your policy.
[CUSTOMER][NEUTRAL] No, I think he has, maybe he has his own. I thought he was with me, um.
[AGENT][NEUTRAL] No, he's on your policy, but we don't have any claims.
[CUSTOMER][NEGATIVE] I have to put off
[CUSTOMER][NEUTRAL] Oh yes ma'am, that's what I'm saying do you have an available dates that he could submit if he had any?
[AGENT][NEUTRAL] For him.
[AGENT][NEUTRAL] Uh, this latest policy isn't was in effect from [PII].
[AGENT][NEUTRAL] Under your cancer policy?
[CUSTOMER][NEUTRAL] OK, and do
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was policy number 2.
[CUSTOMER][NEUTRAL] OK, if he had any
[AGENT][NEUTRAL] Oh, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Oh, go ahead.
[CUSTOMER][NEUTRAL] So if he had anything that he could send in from [PII], could he submit one for uh each year?
[AGENT][POSITIVE] Correct. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, what, what kind of things could he use?
[AGENT][NEUTRAL] If it was part now.
[AGENT][NEUTRAL] OK, just a moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, now let me see. I'm not.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK. I need to place you on just a brief hold because I'm not sure if there are benefits for him. This policy that you have with us was was specific to ovarian and cervical cancer screenings.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK. Well that
[AGENT][NEGATIVE] Um, it doesn't, I'm not seeing any any benefits for
[CUSTOMER][NEUTRAL] OK, well I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well like wellness, uh, for men.
[AGENT][POSITIVE] Right. Correct. Right.
[CUSTOMER][NEUTRAL] OK, cause I told before it was like um X-rays or
[CUSTOMER][NEUTRAL] Uh, with the men, the men, uh, what's that other one, the men have that type of thing. It was something. She called out a few of them, but.
[AGENT][NEUTRAL] The PSA prostate, prostate cancer.
[CUSTOMER][NEUTRAL] Prostate check for prostate, X-rays, um.
[AGENT][NEUTRAL] Yes, ma'am, but this one, right, this policy though, this latest policy that you have with us, it does not show that it had benefits for those types of tests. It just has other tests or screening approved by the United States Food and Drug Administration for the detection of ovarian cancer.
[CUSTOMER][NEUTRAL] OK, so he doesn't have a a policy like have with the with when you call in for the uh wellness, any type of wellness exam.
[AGENT][NEUTRAL] Not that I'm seeing. I'm double checking a few things for you.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Cause I know they switched to a different company now, it's not um this one, but I know back then he did have it. He had the he had the ATL.
[AGENT][NEGATIVE] No, that's great. It's not with us.
[AGENT][NEUTRAL] Yes, ma'am. He was covered under this cancer policy with you. He was. Uh-huh.
[CUSTOMER][NEUTRAL] And a lot of times when I was so, OK.
[AGENT][NEUTRAL] But it just, as far as the benefits on that specific policy, so let me look at another policy that you had before that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so on the policy, and again, Miss [PII], any information I'm providing is a verification of benefits and not a guarantee of payment, but on the policy that you will have with us from
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], that coverage did have the different test on there. Uh, the scope was broader than just for.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Female.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And let me see if.
[AGENT][NEUTRAL] Yes. So on that policy, things like, you know, a colon cancer, blood test, prostate, a PSA test, flexible sigmoidoscopy, colonoscopy, virtual colonoscopy.
[AGENT][NEUTRAL] Chest X-ray, a hemacult stool specimen.
[AGENT][NEUTRAL] A serum, excuse me, serum protein electrophoresis, or that's a blood test for myeloma.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Those would have been, you know, some of the cover benefits under that policy. So, he could still solve.
[CUSTOMER][NEUTRAL] Oh, OK, so you had it. OK.
[AGENT][NEUTRAL] So if he had any of those tests, right, then you would, what you would need to do.
[CUSTOMER][NEUTRAL] So he would have to get a copy of it.
[CUSTOMER][NEUTRAL] He had some blood tests, uh, OK.
[AGENT][NEUTRAL] It would have to be specifically for cancer to detect internal cancer screening.
[CUSTOMER][NEUTRAL] So but uh.
[CUSTOMER][NEUTRAL] Oh, only not just a, a blood test for just regular labs for, uh, say for instance di diabetes test or anything like that.
[AGENT][NEUTRAL] No, ma'am. No, ma'am, this is a, these blood tests were specific on the ones that are listed had like, it says colon cancer blood test, which is a CEA.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got you, OK.
[AGENT][NEUTRAL] Or a prostate-specific antigen blood test, that's the PSA test.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So a colonoscopy, would it work?
[AGENT][NEUTRAL] colonoscopy that was done as a screening, that is one of the tests listed that could be reviewed.
[CUSTOMER][NEUTRAL] Uh-huh, I'm OK.
[CUSTOMER][NEUTRAL] He did do a colonoscopy. When he did a colonized last summer or this year?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Now, if it was before, now if it was after [PII], it would not.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It would, it wasn't on your most recent policy. So, if he had any of those tests that I just went over with you between [PII], then yes, ma'am, he could still file his wellness claims on those.
[CUSTOMER][NEUTRAL] OK, after [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, I'll check and see. OK.
[AGENT][NEUTRAL] Cause I don't have it, I don't see anything on file for him for those years.
[CUSTOMER][NEUTRAL] I'll check it
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Under and that policy number that you had for that period of time was 1211.
[AGENT][NEUTRAL] 646.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well I'll take a look. I'll check in and see what his date was if it was within that range.
[AGENT][NEUTRAL] OK. Well, is there anything else, Miss [PII] that I could try and help you with?
[CUSTOMER][POSITIVE] OK, well thank you so much.
[CUSTOMER][POSITIVE] No, ma'am, that'll be all. Thank you.
[AGENT][POSITIVE] OK. Well, thank you for calling APL and I hope that you have a very nice evening.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.