AccountId: 011433970860
ContactId: 5179734c-6279-4321-bc8a-47072dba0dce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 787109 ms
Total Talk Time (AGENT): 195579 ms
Total Talk Time (CUSTOMER): 297885 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/5179734c-6279-4321-bc8a-47072dba0dce_20250304T19:53_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is so how may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. Um, I've called before and I believe I received all the, the paperwork that I needed, and I wanted to go over, uh, some, uh, got some questions as far as before I submit the paperwork. I talked to, uh, [PII] one time and then I guess I spoke to [PII] again the second time. So this is the 3rd time I'm calling.
[CUSTOMER][NEUTRAL] Uh, what is the address? I've got the, uh, this cancer claim form.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What is the address that I'm mailing this information to? Is it the one that's way down there, the bottom [PII]?
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] Yes, that is correct, Mr. [PII].
[CUSTOMER][NEUTRAL] OK, so it's [PII], [PII]. OK, so that's all right, OK, I got that down. OK dokey. So, I believe I've got, uh, I have my biopsy, I have the MRI.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, some pictures that came with the biopsy and I've got the uh.
[CUSTOMER][NEUTRAL] Basically, what I've been able to receive from the doctors as far as the itemized medical bills, the one that I'm having, uh, I, I guess they're having problems with the insurance is the um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Anesthesiologist.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Um, can I go ahead and submit this and still wait for that information to come?
[AGENT][NEUTRAL] Um, yes, Mr. [PII], you can always submit, um, the claim and just, uh, submit the rest of the documents or the rest of the claim whenever you receive that information. Um, now, may I have a callback number just in case we get disconnected, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, it's uh [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And then I have one more question, uh, they prescribed some painkillers, is that something to submit or is that not needed?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'll have to be looking into your benefits to see if you have benefits from medication. Um, do you have the policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK. I'm ready whenever you are.
[CUSTOMER][NEUTRAL] OK. 4.
[CUSTOMER][NEUTRAL] 454141
[AGENT][POSITIVE] OK, thank you one moment.
[CUSTOMER][NEUTRAL] It's an old one.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, and I need.
[CUSTOMER][NEUTRAL] In fact, I
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] I need to verify your date of birth and mailing address on file.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] In [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] OK, so let me see if it covers medication.
[AGENT][NEUTRAL] Maybe one more minute. I'm waiting on the documents to pull up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, I just received the uh.
[CUSTOMER][NEUTRAL] A copy which I had spoken to uh [PII] on the accident policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Again, I
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's pretty old, but anyway.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Yeah, and this one it's an old policy, so, um, yeah, I'm trying to see if it's gonna be here on the information we have, but uh it is not as detailed, so let me see if I find it.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] OK, there's one more place that I can find it.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] that one.
[CUSTOMER][NEUTRAL] It goes back to [PII].
[CUSTOMER][NEUTRAL] If that would help.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, mm, not exactly. It's just for us it's, it's, um, basically.
[AGENT][NEUTRAL] We need to look for a pamphlet and that's gonna have the information. Um, can I put you on a brief hold? I just need to find that information really quick, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Come on, where
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding, Mr. [PII]. OK, so I found this a schedule of benefits, um, for your type of product, um, and I, I do see some drugs, um, benefits, which is like not exceeding $25 per day. Um, do you know what kind of medication was it?
[CUSTOMER][NEUTRAL] Yes, uh, it was painkillers after the, uh, biopsy, uh.
[CUSTOMER][NEUTRAL] It was the names are here let me get this.
[AGENT][NEUTRAL] So they're not any type of uh drugs uh for to treat cancer. They're just for the pain after the biopsy.
[CUSTOMER][NEUTRAL] No, no, they were right. They were for pain after the biopsy. No, apparently.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so no, no, we're not.
[CUSTOMER][NEUTRAL] OK, so we don't submit those then.
[AGENT][NEUTRAL] No, uh, no, those are not. Only if it's related to drugs for, uh, you know, to treat cancer, yes, but if it's, um, any other than treatment for cancer, no, it will not be payable. Mhm.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, and the other question I have apparently, uh, the oncologist is following up uh with one more report and, uh, the recommendation right now and I guess we have to meet and talk about it as radiation treatment, and that apparently still has to be reported as far as.
[CUSTOMER][NEUTRAL] They're thinking there might be another cancer. I guess that's, that's the bottom line, but uh that doesn't come till another couple of weeks. So that would be submitted at a different time.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] Yes, you can send me that.
[CUSTOMER][NEUTRAL] Since I don't have that information.
[AGENT][POSITIVE] Correct, yes. Mhm.
[CUSTOMER][NEUTRAL] OK, alright.
[CUSTOMER][NEUTRAL] Alright, and, and then the other question I have is on the uh claims form here, it has here Section C, uh non-local transportation. Uh, it was a local uh facility. I don't have to fill any of that stuff out, do I?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] No, that is for mileage, but that's only if you need to get like um chemotherapy, radiation therapy, and you need to travel 5050 miles one way to get that treatment.
[CUSTOMER][NEUTRAL] And I'm
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, no, that, that wouldn't, that wouldn't be OK. I just wanted to make sure I'm about to go ahead and put this into, uh, one of those uh mailing envelopes, and so I just wanted to make sure that I had everything. So actually on the form it's just that section A, section B, and then to make sure that I go ahead and sign the, the second sheet and then the paperwork that I'm, I'm submitting with it. Am I right?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] Correct. Yes, that's correct.
[CUSTOMER][POSITIVE] OK. All right. I appreciate you. Thank you very much. And your name, please?
[AGENT][NEUTRAL] You're welcome. My name is [PII].
[CUSTOMER][NEUTRAL] So, oh, OK, like [PII], like sun, son?
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Mhm, yes, yes, that's correct. Yes. Mhm.
[CUSTOMER][POSITIVE] So, really? OK. OK. Well, I appreciate you, [PII], and, uh, well, uh, I talked to three of you all and all [PII], and yourself have been very helpful for me. And so I'm sending this in the mail now.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome, Mr. [PII]. And if you have any other questions, just feel free to call us back, OK? You may get somebody else, but it's fine.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] All right, OK, OK, yeah, OK, yeah, apparently you all have a lot of folks there.
[CUSTOMER][POSITIVE] Well, I appreciate it. You have a good rest of the day.
[AGENT][NEUTRAL] Oh, that's.
[AGENT][POSITIVE] You as well, and thank you for calling APL. Have a good afternoon. Bye-bye, Mr. [PII]. You're welcome.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Bye bye.