AccountId: 011433970860
ContactId: 50df05e4-f7fe-4858-a5f5-a0db0bd39a93
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 482420 ms
Total Talk Time (AGENT): 214774 ms
Total Talk Time (CUSTOMER): 140785 ms
Interruptions: 1
Overall Sentiment: AGENT=0.3, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/50df05e4-f7fe-4858-a5f5-a0db0bd39a93_20250124T20:08_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey, how you doing?
[AGENT][POSITIVE] I'm good, how are you?
[CUSTOMER][NEUTRAL] OK, I'm a retired educator.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And I supposed to have a cancer policy with you all.
[AGENT][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] And I need to, I need to know, uh, I go every, I've been going every year.
[CUSTOMER][NEUTRAL] Um, to my oncologist.
[CUSTOMER][NEUTRAL] And I just need to know what kind of benefits do I have?
[AGENT][NEUTRAL] OK, what's your name?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. Yes, ma'am.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], yes ma'am. Uh-huh.
[AGENT][NEUTRAL] OK, what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You don't have your policy number, do you?
[CUSTOMER][NEUTRAL] No ma'am, I really don't uh uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's your address, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and your date of birth and your email address on file?
[CUSTOMER][NEUTRAL] OK, [PII]. Now I don't know, do I have, uh, [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So let's see.
[AGENT][NEUTRAL] So, yes, I do show that you have a cancer policy with us.
[CUSTOMER][NEUTRAL] OK, uh.
[AGENT][NEUTRAL] Since [PII] looks like and I don't show any claims on file for you.
[AGENT][NEUTRAL] And let me look
[CUSTOMER][NEUTRAL] OK, uh,
[AGENT][NEUTRAL] Uh-huh. You were talking about a wellness. Let me look at your policy and see if you have that benefit.
[CUSTOMER][NEUTRAL] OK. I got it.
[CUSTOMER][NEUTRAL] Oh, OK, OK, because I've been going every year.
[AGENT][NEUTRAL] If you do, there is no timely filing limit and you can submit them.
[AGENT][NEUTRAL] Back to your effective date.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Give me a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Still looking.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] All right, so there is a diagnostic and prevention benefit under your policy which states that each calendar year we will pay the indemnity amount shown in the schedule of benefits for each covered person who receives the screening test that is generally medically recognized to detect internal cancer, including but not limited to. And so there's a list here. It's mammogram. So if you had a mammogram, a breast ultrasound, a breast thermography.
[CUSTOMER][NEUTRAL] OK, I was doing the chest X-rays because I had, you know.
[AGENT][NEUTRAL] The chest, OK, that's listed. Chest, chest X-ray is listed.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I, I
[CUSTOMER][NEUTRAL] I cannot. OK, so what I do when I go back to my college and have them to file those for me?
[AGENT][NEUTRAL] Uh, for each year, is it a chest X-ray?
[CUSTOMER][NEUTRAL] I was getting a chest X-ray every year.
[AGENT][NEUTRAL] OK, so, so you're gonna be sending uh a chest X-ray bill or an itemized bill for a chest X-ray for each year?
[CUSTOMER][NEUTRAL] Yes ma'am, uh, I'll get them to do it. I, I, I go back to them in uh June.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And I don't even have, could you, I don't, I don't have a computer. My computer is not working right now. Could you mail me a claim?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Now if you send the claims the itemized we will need an itemized bill.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Or something
[CUSTOMER][NEUTRAL] OK, they can pull it. OK, they can.
[AGENT][NEUTRAL] OK, that shows that you had the test, the date that you had it, where you had it done.
[CUSTOMER][NEUTRAL] OK. Uh-huh.
[AGENT][NEUTRAL] And we can email you, we can mail you out a claim a wellness claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] To the address that you verified.
[CUSTOMER][NEUTRAL] Yes ma'am, uh huh.
[AGENT][NEUTRAL] And.
[AGENT][NEUTRAL] Let's see, do you have any other questions?
[CUSTOMER][NEUTRAL] No, uh, just everything would be where they where they needed to do it for me, right?
[CUSTOMER][NEUTRAL] Everything is on the claim form where they need to fill out everything for me, right?
[AGENT][NEUTRAL] Well, you know what? There is nothing that the doctor needs to complete on the claim form. And so basically.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, I just need to send you those views.
[AGENT][NEUTRAL] Well, actually we've updated our wellness claim form basically when you get this claim form, it's just going to require your demographic information, your name, your date of birth, your address, phone number, things of that nature. Um, I'll give you a policy number if you're in a position to write it down because you'll need that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I am ready I am ready.
[AGENT][NEUTRAL] It's 9 it's 92.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] 99.
[AGENT][NEUTRAL] 82.
[CUSTOMER][NEUTRAL] 929-982
[AGENT][NEUTRAL] Correct, and you can just put that on the top page of one of this claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then basically it doesn't actually require any documents. What it, what it will have on it is that it'll list each test.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, that's covered under the diagnostic imaging test benefit.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you will put a check mark by the test that you're trying to claim. Checks x-ray is on here and then to to the right of it, there's a box for you to put the date that the test was done.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But now you can, you can only put one per claim.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] So that means you, you'll have to fill out a claim for each date each year.
[CUSTOMER][NEUTRAL] OK, OK, just send me one. I can, I can, OK, I can get.
[AGENT][NEUTRAL] 1314. 8 copies, yeah, that'll be fine.
[AGENT][NEUTRAL] And then let's see.
[CUSTOMER][POSITIVE] It worked OK.
[AGENT][NEUTRAL] Uh, that's it.
[CUSTOMER][NEUTRAL] OK, can they send me another cop because I could, uh, on my policy.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh card or something so but ok ok I'm requesting it.
[AGENT][NEUTRAL] You know, we do not issue cards for the cancer policy, but we can issue, we can request a policy certification.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Uh, I'll be mailed out to you.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So we'll mail a policy and then a claim form.
[CUSTOMER][NEUTRAL] OK, you're gonna put the mail you're gonna, you're gonna put that claim form in in the mail to me, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Oh, OK, thank you. OK, OK.
[AGENT][NEUTRAL] And the, and the policy will be mailed as well.
[CUSTOMER][POSITIVE] OK thank you I appreciate that.
[AGENT][NEUTRAL] OK. Any other questions, [PII]?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] No ma'am, that's all I need.
[AGENT][POSITIVE] OK, well thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, you too, OK, mhm.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Mhm.