AccountId: 011433970860
ContactId: 41b79510-520f-419d-b849-41003e6c61e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1317119 ms
Total Talk Time (AGENT): 532212 ms
Total Talk Time (CUSTOMER): 344520 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/18/41b79510-520f-419d-b849-41003e6c61e8_20250418T16:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling ATL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm a member through Power ISD.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] Um, last year, I, well, not well, yeah, last year in February, I was diagnosed with um a breast cancer, and I did all my treatments, my surgeries and stuff, and I never turned in a claim.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there a limited time to do that?
[AGENT][NEUTRAL] Um, no, uh, we don't have timely filing limit for claim. Um, do you have the policy number so I can check your policy and see where you're at with the policy?
[CUSTOMER][NEUTRAL] That's one thing. I don't have any, I don't have any of my information for this. I have it written somewhere, but so much paperwork, I don't.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I don't remember where I have it.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, no problem. Um, all right. Let me have a callback number just in case we get disconnected.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] OK. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And let me see if I can find your policy. One moment.
[AGENT][NEUTRAL] And you said uh [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] All right. And um for security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] OK. Uh, date of birth is [PII].
[CUSTOMER][NEUTRAL] Mailing address is [PII]. And email is [PII].
[AGENT][NEUTRAL] Yes. Um, well, we have the ISD. Is that OK?
[CUSTOMER][NEUTRAL] Yes, is that one [PII] that goes to you at 4 ID.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, that's what we have. Thank you. Alright.
[AGENT][NEUTRAL] I see you had the policy since [PII] and this is the most recent one,
[CUSTOMER][NEUTRAL] Let me, let me write that down. Uh, you said September.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] What was that? [PII]?
[AGENT][NEUTRAL] First of [PII].
[CUSTOMER][NEUTRAL] Oh, [PII] of
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] What year?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] Uh-huh. Now, prior to that one, you did have another one. so it looks like the other one was from [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, OK, OK, so it was.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] Mhm. So, um, yeah, I'm not sure when um they found the um the cancer, but yeah, I can go ahead and give you both policies and you can just put it on, uh, you know, the one that corresponds to that date of service. Um, but, um, we're gonna need a pathology report. Also, we need the claim form and any item. OK, sure. Yeah. Let me know when you're ready. OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, let me write that down. Let me write that down.
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] Mythology report.
[AGENT][NEUTRAL] Mhm, pathology report for the first findings, and we need the claim form, which you can find on our website at [PII].
[CUSTOMER][NEUTRAL] And what else?
[CUSTOMER][NEUTRAL] 91.
[CUSTOMER][NEUTRAL] OK. The pathology report, the first line.
[CUSTOMER][NEUTRAL] The claim form, OK?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And any itemized bills that you have.
[AGENT][NEUTRAL] And the claim form is gonna have instructions on the first page. Um, it's gonna give you instruction based on what type of service you're trying to claim. So you just go down the line and see which ones that you're trying to claim and based on what you're trying to claim it's gonna ask you for additional documents.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] This is done through where?
[AGENT][NEUTRAL] OK, uh,
[CUSTOMER][NEUTRAL] Where I get my claim forms and stuff.
[AGENT][NEUTRAL] Um, you get your claim forms through our website at [PII]. Again, that's [PII]. Um, yes, yes, and if you want to register, you can upload the claim electronic. If you want to register online, you just click on sign in.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. Mhm.
[AGENT][NEUTRAL] And it will take you to a page where you can register. If not, you can send the claim by fax or mail. The information is in the claim form.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEGATIVE] I have to do all the paperwork, the doctors and all that. Don't do it.
[AGENT][NEUTRAL] No, they don't do it, um, because this one is gonna be more than likely a reimbursement done to you based on the benefit. So, uh, you will have to submit the claim if you want a reimbursement. If you want us to send any payments directly to the provider of service, then they can go ahead and send in the claim directly from the provider of service. But if it's uh due to any kind of reimbursement, then you will have to submit your claims.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, the, for this year.
[CUSTOMER][NEUTRAL] I have also been um diagnosed with uh thyroid cancer. That would have to be a different one, right?
[AGENT][NEUTRAL] If it's a separate cancer from the, yeah, yeah, it looks like it's gonna be a separate uh cancer from the uh from the breast one. So, uh, that will be another pathology report. So you will send the first um pathology report of the first findings, which is gonna be the breast one, and then you're gonna send the pathology report for the thyroid, and that's gonna be the first finding of that type of cancer. So it's two separate cancers, OK?
[CUSTOMER][NEGATIVE] And I'm gonna have surgery on that.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So yeah, it is two separate benefits. Um, let me go ahead and um check really quick and see what are your benefits to know if you can send, if you can request that from the provider instead of going through all the paperwork yourself. um, but let me check the benefits because that will give me a little bit more information on if it's gonna be paid to you or to them.
[CUSTOMER][NEUTRAL] Yeah, cause getting all that paperwork together.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I think it's just too much. I mean, so many appointments here and there, doctor visits, and I just think it's too much, but.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Well, it's not gonna pay for all everything, um, so let me just go ahead and narrow it down so you can send what is payable, OK? Um, let's see. OK, so you have.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is there any way you could email that list to me or something?
[AGENT][NEUTRAL] Mhm, I can, yes. Um, I'll go ahead and send the copy to you as well. But yeah, um, and this is not a guarantee of payment, just a verification of uh benefits, Ms. Go you. And it looks like you do have like benefits for, um, you have a lump sum benefit for the first time they found, uh, they found the internal cancer.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] This time, this one is just a one-time benefit, which is $5000. Um, that one will be paid directly to you, so you'll have to send that one. So that will be through the pathology report and the claim form. That will be that benefit, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, quick question. The pathology, pathology report, is that from the surgeon or whoever uh diagnosed? Like, for example, my, my breast one, would that be like the
[CUSTOMER][NEUTRAL] The person that did my, my mammogram would be the doctors.
[AGENT][NEUTRAL] More than likely it's the doctor that, it's the doctor that, I don't know if they did a biopsy, but it's gonna be the doctor that found, uh, yeah, that found the, the cancer. Um, they're the ones that will have that, yeah, pathology report. Mhm.
[CUSTOMER][NEUTRAL] I'm not familiar with
[CUSTOMER][NEUTRAL] Yes, they did.
[CUSTOMER][NEUTRAL] OK, OK, OK, that sounds OK.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK, so you do have that.
[CUSTOMER][NEUTRAL] All right. Well, if you will just narrow it down to me and uh email it to my uh personal email.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Personal, OK, let me have that personal because I don't have the personal. I only have the ISD so go ahead with the personal one more time so I can write it down.
[CUSTOMER][NEUTRAL] Please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The personal is my last name, [PII]
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] No, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I'm gonna go ahead and send this certificate information which on um let me see which page is this, page 23 is gonna have the schedule benefits which that's what we pay. So you, you need to only send information about the things that we pay. You don't have to send everything. So if you see something that you have.
[CUSTOMER][NEUTRAL] And that would be on page 23 you said?
[AGENT][NEUTRAL] Page 23 of the booklet I'm gonna send you, OK? So if you don't mind holding for me, I'm gonna go ahead and send this email to you right now just to make sure you get it, OK? Um, do you mind holding for me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me ask you one quick question. Um, do I have to make, is it gonna be the same, um, policy numbers for, for both years because you said I had [PII] and [PII].
[AGENT][NEUTRAL] Uh-huh, yes.
[AGENT][NEUTRAL] Mhm. Correct. It's gonna be different numbers. That's why I said I can go ahead and provide both of them to you and you can send in the information based on that year. Um, let me go ahead and give you these. Um, the one that I'm sending the paperwork on is gonna be the most recent one, which I think is gonna be the same benefit. I can check the old one just to make sure it is the same one, OK? Uh, now, the old one, and the policy number is 242.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 549.
[CUSTOMER][NEUTRAL] 242.
[AGENT][NEUTRAL] Mhm. 5493.
[CUSTOMER][NEUTRAL] 549
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, that's the first one which is the old one.
[CUSTOMER][NEUTRAL] 242-549-3, which is 2023.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] 23, mhm correct.
[CUSTOMER][NEUTRAL] 2023. OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the new one is going to be 254.
[CUSTOMER][NEUTRAL] 254
[AGENT][NEUTRAL] 1364.
[CUSTOMER][NEUTRAL] 1364.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh, this is 2024, correct?
[AGENT][NEUTRAL] Correct. Yes. Mhm. And um I'm gonna go ahead and check, make sure that it's the same benefit and if, if it's the same benefit, I'm just gonna send one certificate which is gonna be the new one, but it's gonna be the same benefit for both. If I see the benefit in the past is different, then I'll go ahead and send both of the documents, OK? So if you don't mind holding for me, let me check on that first and then let me go ahead and send that email to you, OK?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me Miss [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. You want to check and see if you received that email with the information?
[CUSTOMER][NEUTRAL] Let me check really quick.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK. I got an email saying thank you for contacting us.
[CUSTOMER][NEUTRAL] Uh, attachment.
[CUSTOMER][NEUTRAL] Do I need to click on the [PII] to see? OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah, you need to click on the uh attached um PDF.
[CUSTOMER][NEUTRAL] Yes. Uh, yes, it's asking me for username, password.
[AGENT][NEUTRAL] Um, no, the.
[CUSTOMER][NEUTRAL] Do I need to create one?
[AGENT][NEUTRAL] No, you, you should not be able to, uh, no, we should not ask you for that. Um, go ahead and click on the APL policy certificate on the attachment in the top.
[CUSTOMER][NEUTRAL] OK, hold on.
[CUSTOMER][NEUTRAL] Let me see, let me go back.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mm mhm.
[CUSTOMER][NEUTRAL] Your business click here to share a review.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, right here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Mm, well, all the certificate, it gives me.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] APL.
[CUSTOMER][NEUTRAL] Yeah, I've got a couple of pages there.
[CUSTOMER][NEUTRAL] Yeah, I think it's that book that you were talking about.
[AGENT][NEUTRAL] OK, so, um, if you go to page I believe it was 23.
[AGENT][NEUTRAL] Yeah, 23.
[CUSTOMER][NEUTRAL] 23, I believe you said AC.
[AGENT][NEUTRAL] Mhm. 2.
[CUSTOMER][NEUTRAL] 1821 22.
[CUSTOMER][NEUTRAL] Uh 23. I see 23.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, do I go by that this list right here then?
[AGENT][POSITIVE] Yes, uh-huh, that's gonna be your benefits.
[CUSTOMER][NEUTRAL] Mm mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it's for both of them?
[AGENT][NEUTRAL] Yes, it's the same benefit. I checked the old one and the new one is the same benefit. Mhm.
[CUSTOMER][NEUTRAL] OK. Oh, OK.
[CUSTOMER][NEUTRAL] So I got it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, right. OK.
[AGENT][NEUTRAL] Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Anything else besides?
[CUSTOMER][NEUTRAL] No, I was just wondering about all this because, you know, going through all the process of everything, I hadn't had a chance to send you guys anything and I was just hoping it wasn't like a limited time or something.
[AGENT][NEGATIVE] No, and there's no timely filing limits.
[CUSTOMER][NEGATIVE] OK. Now, on um this one that I'm barely starting on this process, cause I was just diagnosed. I need to go to my speech and then the surgery.
[CUSTOMER][NEUTRAL] Um, would you suggest that it be easier if I mail you things or email you things as I get them?
[AGENT][NEUTRAL] You can do that.
[CUSTOMER][NEUTRAL] Or just ask for reports.
[AGENT][NEUTRAL] Um, you can do that. You can go ahead and, and just send the information as you get them or you can wait and just send a big um packet at one time. Um, but if you go through the benefits and see that it's something like, um, of the benefits that you have that you need to send in like just an example. If for this new cancer, you're, you, they did an MRI or a CT scan or something like that and you're trying to get that benefit, then you'll go ahead and send just for that. So you don't have to send.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Just everything because um like office visits and stuff like that are not covered so um yeah, I don't want you to just get all that information and send it because it's gonna be a lot. So just based on the benefit that you're trying to, you know, get from the policy which is gonna be the ones listed on that page, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All righty. Well, thank you so much for your help and uh I guess I'll be in touch with you guys.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK. Well, yes, uh, if you have any questions or concerns, just feel free to call us back, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes, ma'am. Thank you so much. You have a great day.
[AGENT][POSITIVE] You're welcome. You as well, and thank you for calling ATL. Bye bye.
[CUSTOMER][NEUTRAL] Yes, ma'am. Bye-bye.
[AGENT][NEUTRAL] No