AccountId: 011433970860
ContactId: 5319336f-dca2-4de3-a007-a492fcf3c0cf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 519717 ms
Total Talk Time (AGENT): 252590 ms
Total Talk Time (CUSTOMER): 162570 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/5319336f-dca2-4de3-a007-a492fcf3c0cf_20250115T21:17_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Could you repeat your name again, please?
[AGENT][NEUTRAL] Sure, my name is [PII].
[CUSTOMER][NEUTRAL] [PII], OK, uh, I'm, I'm in the process of making some claims on my wife's cancer policy. Do I need to send in a, a claim form every time?
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If we have the initial claim form, it is not required to send in a claim form with each claim document.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Uh, my wife's, uh, phone number is [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right, thank you. And what is her name?
[CUSTOMER][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] And last name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] All right. And what is your name, please?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm her husband.
[AGENT][NEUTRAL] All right, thank you. Do you mind verifying your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And what is the current mailing address, please, sir?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you, sir.
[AGENT][NEUTRAL] And then what is a good callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] It is area code [PII].
[AGENT][POSITIVE] All right. Thank you, Mr. [PII].
[AGENT][NEUTRAL] Now I'm showing that the last claim that we had on file for Ms. [PII] was back in [PII], so we will need a claim form with the new claim submission and then it once you if you receive.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, statements or itemized bills, then that can just be sent in without the claim form.
[CUSTOMER][NEUTRAL] OK, so, uh, I think what I have a copy of is it it it the title on is American Public Life Insurance Company, uh, claim that statement is that the form that I need?
[AGENT][NEUTRAL] Yes sir that is the claim form that you need.
[CUSTOMER][NEUTRAL] OK, uh, can, where can I get a copy of this? Can I go to your website?
[AGENT][NEUTRAL] Yes, so there's a claim form on our website at [PII].
[AGENT][NEUTRAL] And that would be the cancer claim form.
[AGENT][NEUTRAL] And do you know Ms. [PII]'s email address?
[CUSTOMER][NEUTRAL] Yes ma'am it is uh.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and the reason I was asking is we do have a portal.
[AGENT][NEUTRAL] Ms. [PII] can create a login and password on that portal and you can upload claim documents online as well. That way you don't have to mail it or fax it.
[AGENT][POSITIVE] And I can give you that side if you would like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, go ahead.
[AGENT][NEUTRAL] It's secured, that's [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And she would just go in as a new user and state that she's an individual with an APL policy and enter her information and create a user name and password.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any, any claim documents could be uploaded online. And is this a, a new cancer diagnosis?
[CUSTOMER][NEUTRAL] Alright. Oh.
[CUSTOMER][NEUTRAL] No, ma'am, uh,
[CUSTOMER][NEUTRAL] We started in [PII].
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] And we went through 23 with the first round of chemos and then.
[CUSTOMER][NEUTRAL] Cancer came back in 24 and we finished up.
[CUSTOMER][NEUTRAL] We just, we just finished up 2 weeks ago with her 2nd round of chemos.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I'm just, I'm trying to get all this stuff together so I can file it.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Now, they were, are probably going, did they do another biopsy to
[AGENT][NEUTRAL] Um, see if that had returned.
[CUSTOMER][NEUTRAL] We're doing a CT scan on Friday.
[AGENT][NEUTRAL] OK, CT scan. OK. So they may want to, and that was prior to, um, let's see, did they do another biopsy prior to your second round of chemo?
[CUSTOMER][NEUTRAL] No, it showed up in the blood work.
[AGENT][NEUTRAL] In the blood work. So they may want the results of that blood work since it's been
[AGENT][NEUTRAL] Over a year.
[AGENT][NEUTRAL] So just kind of be aware that they may request that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And just be sure to, to send in any.
[AGENT][NEUTRAL] Itemized bills, and we will need your explanation of benefits from your primary insurance just as before with the chemo.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, uh,
[CUSTOMER][NEUTRAL] Since you're looking at it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, can you go back to the last claim that I filed in November?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Of [PII]. Mhm.
[CUSTOMER][NEUTRAL] And can you see?
[CUSTOMER][NEUTRAL] Yes, ma'am. And can you see if I turned in.
[CUSTOMER][NEUTRAL] The surgery
[CUSTOMER][NEUTRAL] The surgery bills, the EOBs for the surgery.
[AGENT][NEUTRAL] Let me take a quick look at that for you. Bear with me just one moment.
[AGENT][NEUTRAL] Now once you create that login and password you can actually click on claim numbers and view claim decisions but I'm gonna check this for you, so bear with me just one second, it'll have the dates of service listed as well.
[AGENT][NEUTRAL] Looks like um
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Looks like for [PII] for surgical benefit.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] It looks like it was submitted, however, they're needing the fully itemized surgery bill from the surgeon.
[AGENT][NEUTRAL] With the procedure codes and diagnosis codes. So that was not paid, it is still pending, and there's time to send that in.
[AGENT][NEUTRAL] And the anesthesia benefit will pay according, will be paid according to the surgical in the surgery information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, uh.
[CUSTOMER][NEUTRAL] So we're needing the, the surgeons.
[AGENT][NEUTRAL] The itemized bills, yeah, from the surgeon for 413 23.
[CUSTOMER][NEUTRAL] Out of out of.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you very much.
[AGENT][POSITIVE] Well it has been such a pleasure to assist you, Mr. [PII]. Is there anything else that I can help you with today?
[CUSTOMER][NEUTRAL] What was your name again?
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][POSITIVE] OK, thank you very much. I've, I've talked to [PII], and now you.
[AGENT][POSITIVE] You're just getting us all. See, we're all here to help you.
[CUSTOMER][POSITIVE] All right, thank you very much.
[AGENT][POSITIVE] My pleasure. Y'all have a lovely evening and stay warm.
[CUSTOMER][POSITIVE] You too, thank you.
[AGENT][POSITIVE] Thank you, Mr. [PII]. Take care and thank you for calling APL.
[CUSTOMER][POSITIVE] Take care
[CUSTOMER][NEUTRAL] Alright, goodbye.
[AGENT][NEUTRAL] Bye bye.