AccountId: 011433970860
ContactId: 4629b7d4-78b0-4792-b532-b16a0067940c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 385320 ms
Total Talk Time (AGENT): 163672 ms
Total Talk Time (CUSTOMER): 90429 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/23/4629b7d4-78b0-4792-b532-b16a0067940c_20250523T14:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], this is uh uh I guess it's [PII].
[CUSTOMER][NEUTRAL] And I'm calling in regards to policy number 00730492.
[AGENT][NEUTRAL] OK. And can you verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] And you have a good callback number, Mr. [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then just need your address.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you. And how can I help you today?
[CUSTOMER][NEUTRAL] Well, I've been diagnosed with prostate cancer, so I need to file a claim.
[AGENT][NEUTRAL] OK, let me see.
[AGENT][NEUTRAL] Um, do you have your pathology report?
[CUSTOMER][POSITIVE] Yes, I do.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, that's what we'll need for the, that filing. Um, let me get your policy pulled up real quick.
[AGENT][NEUTRAL] Give me one moment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have any type of treatment plan yet, or is it, are you just in the beginning?
[CUSTOMER][POSITIVE] Just in the beginning, just had a biopsy and that's what came back positive.
[CUSTOMER][NEUTRAL] Did I lose you?
[AGENT][NEUTRAL] No, no, I'm, I'm just, I'm, can you hear me?
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] Generally you can hear some paper rustling or something, but you're very quiet, so.
[AGENT][NEUTRAL] Sorry. I'm just making sure I'm not missing anything on here and seeing what we need first.
[AGENT][NEUTRAL] Let's see. OK.
[AGENT][NEUTRAL] So it looks like I was trying to see if you had a
[AGENT][NEUTRAL] First occurrence benefit.
[AGENT][NEUTRAL] But it looks like, let's see, I'm just seeing treatment.
[AGENT][POSITIVE] Benefits, just making sure I'm not missing anything, um.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, so there's a surgical benefit, there's a hospital confinement benefit, um, and this is not a guarantee of payment. It's basic outline of your policy.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] If you have surgery, there's the surgical benefit plus the anesthesia benefit. So there's both of those benefits.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] There's a radiation and chemotherapy benefit.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Um, you have an ambulance benefit if you needed to, for some reason need an ambulance, transportation and lodging.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] Home health
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I don't see a first occurrence.
[CUSTOMER][NEUTRAL] Uh, but what you're saying.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Can I get a copy of the policy? I don't, I think.
[CUSTOMER][NEUTRAL] I don't know I think I had one, but I, I printed off several years ago, but I don't know that I can find it again.
[AGENT][POSITIVE] Yeah, absolutely.
[AGENT][NEUTRAL] Um, do you want me to mail that to you?
[AGENT][NEUTRAL] Or you, I can email it as well.
[CUSTOMER][NEUTRAL] Uh, can you email it to him? Yeah, yeah, I got an email, uh, [PII].
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. I'll get that emailed over and then basically what happens next is when you get your treatment plan set up, um, once you get that established and start getting treatment, then you start submitting the claims for that. Um, and then basically we would need like an itemization of dates of service that you're seeing, um, the diagnosis, um, the procedure, like the coding for whatever procedure you're getting.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, where the services are rendered, but I'll send you your policy certificate so you can look over that and what's covered. Um, and then if you have any questions, absolutely give us a call back, um, and then we can go through that, but
[AGENT][NEUTRAL] Um, main thing is, once you get your treatment established and start getting treatment, that's when you can start submitting claims for reimbursement.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] OK, I'll send that, I'll send that your way. Give me about 5 minutes and is there anything else I can help with today, Mr. [PII]?
[CUSTOMER][POSITIVE] Sounds good.
[CUSTOMER][POSITIVE] No, that's it. That's, I just needed to talk to somebody so I appreciate it.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Uh huh thank you bye.
[AGENT][POSITIVE] Thank you, bye bye.