AccountId: 011433970860
ContactId: 59a34736-0c47-4e2c-8c9e-a1718709860e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 681559 ms
Total Talk Time (AGENT): 191972 ms
Total Talk Time (CUSTOMER): 297382 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/59a34736-0c47-4e2c-8c9e-a1718709860e_20250618T17:55_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, I was calling. I needed to get some explanation on some benefits that I'm, I'm looking at. I've had, um, I don't know what that is. I had, um, some radiation treatments.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I was trying to see how to make a claim on that.
[AGENT][POSITIVE] Great, and who am I speaking with?
[CUSTOMER][NEUTRAL] This is [PII].
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] And [PII], can I get a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] And do you have your policy number with you?
[CUSTOMER][NEUTRAL] Yes, it's uh 909252.
[AGENT][NEUTRAL] Yeah, let me look that up.
[CUSTOMER][NEUTRAL] to stop by.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] serious about me they wanted to check up on me.
[AGENT][NEUTRAL] All right, I was unable to locate you with that policy number. Is it all right if I use your social to search?
[CUSTOMER][NEUTRAL] Yes, uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK and just to verify, I have [PII].
[AGENT][NEUTRAL] [PII] correct?
[CUSTOMER][POSITIVE] Uh-huh. Correct.
[AGENT][NEUTRAL] Alright, give me just a moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Can I get you to verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the address that we have on file?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and you're wanting to know about some benefits on your policy?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I know I had talked to a lady earlier. I mean that was like up in March or something when I was getting ready to take uh radiation.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then she told me just to um
[CUSTOMER][NEUTRAL] After I got through with it, um, then I could do a claim, but what I'm trying to see, she said get a my um benefit summary.
[CUSTOMER][NEUTRAL] And on my benefits on, which is with, I'm with United Healthcare. It listed like I've had 5 radiation treatments at a time, you know.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's listed that way. So I was wondering, do I send in the whole sheet of my benefits?
[CUSTOMER][NEUTRAL] Summary, I do. I just send in the part that talks about the radiation.
[AGENT][NEUTRAL] I would send in your complete summary um because our our claims department will be able to uh to decipher whether or not it can be um.
[AGENT][NEUTRAL] Uh, paid or not, and so I would, I would send the whole thing in.
[CUSTOMER][NEUTRAL] So that's like 15 pages, probably 30 with because it's on back and front.
[AGENT][NEUTRAL] It's a lot of pages.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's quite a few pages for, cause I probably would have to send in 2.
[CUSTOMER][NEUTRAL] Because I took radiation, she told me somebody the benefits is one radiation treatment per month.
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] But my radiation treatment was done all.
[CUSTOMER][NEUTRAL] In one month.
[CUSTOMER][NEUTRAL] I took
[CUSTOMER][NEUTRAL] I think I took one in March and the rest of them were done in April, so I had 16 of them.
[AGENT][NEUTRAL] Yeah, and I am seeing on your policy um that it is per calendar month of treatment that you'll get that benefit amount.
[CUSTOMER][NEUTRAL] Yeah, and the other thing I was, I didn't have to pay because I'm under Medicare and I mean I had to pay out $1000.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Or uh before they would kick in and pay.
[CUSTOMER][NEUTRAL] For my radiation.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So when I started taking my radiation.
[CUSTOMER][NEUTRAL] I had met my deductibles.
[CUSTOMER][NEUTRAL] So once you meet the deductibles, then you're, my insurance pays 100%.
[CUSTOMER][NEUTRAL] So I was wondering.
[CUSTOMER][NEUTRAL] Do I make a claim on that or what?
[AGENT][NEUTRAL] I would submit the claim and I would um whenever you submit the claim if you got any documentations from Medicare saying that they paid or um if you had to pay out of pocket if you have any receipts on paying out of pocket.
[CUSTOMER][NEUTRAL] Yes, it's all, it's all, yeah.
[AGENT][NEUTRAL] It's all out of pocket.
[CUSTOMER][NEUTRAL] It's listed on the, uh, yeah, it's listed on the benefits. That's when I was asking, do I send all the pages in or do I just send the summary page of my benefit because on the summary page it tells how much I how much I had to pay in.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And then, and tell me my deductible is 0. That's on my summary page. But then the other pages I got there.
[CUSTOMER][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] It tells every time I've, I've gone in.
[CUSTOMER][NEUTRAL] To take a radiation treatment, but like I say, it's listed, sometimes it's listed as uh radiation treatment times 5. The next time it'll say radiation treatments times 5, and another one radiation treatments times 5. And then I had, like I said, I had 1 in March.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So do I send in the summary page?
[AGENT][NEUTRAL] I would still send in all of it just to just in case because if should there not be something on that summary page that we need I would hate for you to have to get more information and then send it in again and that'll just take more time.
[CUSTOMER][NEUTRAL] Or do I send.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I would just be safe and then that way at least we have it um and if worst comes to worst you wouldn't need to send all of that in but.
[AGENT][NEGATIVE] Uh, just in case there isn't something on that summary page and we need more information for you, it's just gonna delay the process.
[CUSTOMER][NEUTRAL] Oh, OK, OK, so I can send it in, send you in, uh, the 15, well it'd be about 30 pages because it's in 2 months increments, so.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'll send you the whole 30 pages.
[AGENT][POSITIVE] Yes, ma'am, if you, if you could, that's, that's what I would do just to be safe.
[AGENT][NEGATIVE] Because I don't know what that summary page looks like um, I would hate for for you to tell you just to send that in and then it not be enough information for you.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, I mean, that's fine. I just didn't know if you wanted all those pages. I just.
[CUSTOMER][NEUTRAL] So, uh, that's before I start printing them out and giving them to you.
[AGENT][NEUTRAL] Yeah, yeah, it's it's always safe and then our claims department, everything that you send in um.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] They will, they will review it and look over it and so it's just better to be safe and have all of that documentation there just in case um so hopefully they won't need anything further from you.
[CUSTOMER][NEUTRAL] Oh, OK, OK, I can do that well then um.
[CUSTOMER][NEUTRAL] Do I send it? cause I don't have any, any claims thing, so do you send me a piece of paper or something that I connect with these pages that I need to send you?
[AGENT][NEUTRAL] Um, are you, do you need the claim form?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Is it alright if I email you that claim form?
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And I have the Hotmail account, is that OK?
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] OK, give me just a moment, let me get that ready.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] And should I email it back to you or should I mail it to you?
[AGENT][NEUTRAL] Um, you'll want to mail that back?
[CUSTOMER][NEUTRAL] With your email take? OK.
[AGENT][NEUTRAL] Yeah, uh, because the emails won't be secure, so I wouldn't send that information over through an email. Um, we do have our fax number and our and our um mailing address at the bottom of the form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, but you said mail it to you, so I'll mail it.
[AGENT][POSITIVE] Yes, that's what I would do and let me double check that this is correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right, I just sent that claim form to you. Uh, if you don't see it in the next couple of minutes, I would check your spam, OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll do that.
[AGENT][NEUTRAL] Right. And until then, is there anything else I can help you with?
[CUSTOMER][POSITIVE] That would be all, thanks so much.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] Bye-bye.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] OK.