AccountId: 011433970860
ContactId: 5f22e026-f416-4be5-98d0-31c55f14ea38
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1635250 ms
Total Talk Time (AGENT): 627647 ms
Total Talk Time (CUSTOMER): 763037 ms
Interruptions: 9
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/5f22e026-f416-4be5-98d0-31c55f14ea38_20250602T20:28_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] that.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Hi, so, this is [PII]. I was calling uh
[CUSTOMER][NEGATIVE] OK. Um, I, I don't know how to go about doing it. My husband was just diagnosed with cancer.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] And I don't know, how do I, I don't know how, how do I go about doing anything right now?
[AGENT][NEUTRAL] OK, I can give you instructions. Do you have the policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Let me see if it's on this paperwork here that I printed out.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] I you.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Insured, what do you need? certificate number? What?
[AGENT][NEUTRAL] The policy certificate number, yes. Uh-huh.
[CUSTOMER][NEUTRAL] What do you need out of here.
[CUSTOMER][NEUTRAL] OK, 02559420.
[AGENT][POSITIVE] Thank you. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Wow
[AGENT][NEUTRAL] OK, and for security, may I have your date of birth, mailing address and email address on file?
[CUSTOMER][NEUTRAL] [PII], [PII]. You may have uh [PII].
[AGENT][NEUTRAL] No, we have the [PII], so we do have that one. OK, and what's the email address on file?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Uh, it's either the [PII] or [PII] now probably [PII] or [PII].
[AGENT][POSITIVE] OK, it's gonna be the last one. OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, OK.
[CUSTOMER][NEUTRAL] No, yeah, something on the back.
[AGENT][NEUTRAL] See where we are.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK, so this will be the first time you're following with us, OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, so, um, yeah, we have several ways of sending claims, um, you can either send it by mail, by fax, or if you register um through our website, you can just upload it online. That will be the fastest way because it comes here automatically and it's put in line to be.
[CUSTOMER][NEUTRAL] I thought about the.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] You know my workshop.
[AGENT][NEUTRAL] Process. Um, also, if you register online, you'll be able to see your policy documents with your benefits and everything that you can uh go ahead and send claim form. You can also get your claim forms and just review and keep records of your history, OK? Um.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Um, when you go to the claim form, it's gonna have a list on the first page with the instructions based on what you're trying to claim. So, um, just an example, if you're trying to claim, um, just like for a surgery, it's gonna ask you for pathology reports, it's gonna ask you for itemized bills, and it's gonna ask you for that, uh, claim form to be filled out. Um, since this is your first time, we are gonna need that pathology report for the first findings.
[CUSTOMER][NEUTRAL] What are you doing?
[CUSTOMER][NEUTRAL] 8.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then just any itemized bills based on what you're trying to claim.
[CUSTOMER][NEUTRAL] OK, so let me see if I can if I go on it. Hold on, let's see, so it's just there.
[AGENT][NEUTRAL] OK. Mhm. Yeah, go ahead, go ahead.
[CUSTOMER][POSITIVE] I wanna, I wanna, I wanna sign on to it.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Understand.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, I know I say in my.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] ATL, oh, maybe I'm getting the ATL.
[AGENT][NEUTRAL] And the website is [PII]. Again, that's [PII].
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Public life, there it is. There's public life.
[CUSTOMER][NEUTRAL] Alright, claims and forms.
[AGENT][NEUTRAL] You're gonna click on sign in to create your account.
[AGENT][NEUTRAL] Click on sign in to create your account.
[CUSTOMER][NEUTRAL] Yeah, hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] yeah.
[CUSTOMER][NEUTRAL] you know.
[CUSTOMER][NEUTRAL] Yeah, I know one time. I got, it came up American Public Life.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So should I do it a different way?
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] This is uh sign in. Hold on, no, no, no, hold on, I found it. OK, log in.
[CUSTOMER][POSITIVE] Awesome.
[CUSTOMER][NEUTRAL] Oh, did I not sign in? I thought I did sign in because I just printed all this paperwork out.
[AGENT][NEUTRAL] Oh, you did? OK, I can check and see if you already signed in. I know we have a change on the website recently made that you need to register again, but I can check and see if it was recent or if it was um.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] [PII], come get this, please.
[AGENT][NEUTRAL] Yeah, it looks like you have registered, um, let me see how far back was that. Um, that was in [PII]. So you need to register again because, um, yeah, we have reset everything. Mhm.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] Alright, let me see, create an account.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] provider wait a minute, the role you best describes you, agency, agent broker.
[AGENT][NEUTRAL] You're uninsured. Mhm.
[CUSTOMER][NEUTRAL] Insurance, OK.
[CUSTOMER][NEUTRAL] Um, my, my brain is does not work right right now insured, OK. Next.
[AGENT][NEUTRAL] Mm, OK, it's a lot.
[CUSTOMER][NEUTRAL] Oh wait a minute, date of birth.
[CUSTOMER][NEUTRAL] Hold on.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Last name.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Let me say a member ID is that the same number I gave you?
[AGENT][NEUTRAL] Uh, no, it's not gonna be the policy number. Um, let me check and see what you have on there. Um.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] It said not policy number it says.
[AGENT][NEUTRAL] Yeah, no, this group doesn't have a um member ID, so you're gonna use the social.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, that's what I got on there.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] I can set up.
[CUSTOMER][NEUTRAL] So leave this site, I guess so.
[CUSTOMER][NEGATIVE] I need my new password. Oh no, you don't. I ain't using that password.
[CUSTOMER][POSITIVE] Oh no, I know what I wanna use.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Putting all of it.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] It's great name.
[CUSTOMER][NEUTRAL] Mm, let's do this.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Wait a minute.la not verified email address.
[CUSTOMER][NEUTRAL] And that my email address.
[CUSTOMER][NEUTRAL] Oh, it says send verification to my email address?
[AGENT][NEUTRAL] Uh-huh, yes.
[CUSTOMER][NEUTRAL] Alright, alright, that's what it is. OK, let me go here.
[CUSTOMER][NEUTRAL] Uh, the day.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, I wanna change my email.
[CUSTOMER][POSITIVE] Agree, I agree, continue.
[CUSTOMER][NEUTRAL] Oh shoot, you done that.
[CUSTOMER][NEUTRAL] OK, so dashboard.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Same verification code again.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I mean
[CUSTOMER][NEUTRAL] What is that?
[CUSTOMER][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Oh here it is.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No when.
[CUSTOMER][NEUTRAL] How are you doing today?
[CUSTOMER][NEGATIVE] I went in there and got that code, but it come back here and it says welcome to the online service and it's just spinning.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh, come on.
[CUSTOMER][NEUTRAL] Create your OSC account I forgot passing.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I'm trying to. I went, I went back there just to go get.
[CUSTOMER][POSITIVE] Oh, thank you, baby.
[CUSTOMER][POSITIVE] I've been hearing them say it's it's very good. My daughter made sandwiches with homemade hamburger buns with barbecue chicken, shredded barbecue chicken and french fries.
[AGENT][NEUTRAL] Mm.
[AGENT][POSITIVE] Sounds good.
[CUSTOMER][POSITIVE] It really is, yes. Homemade bun, homemade barbecue sauce.
[AGENT][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] I'm feeling good.
[CUSTOMER][POSITIVE] I'm talking to the insurance company. She's going, wow.
[CUSTOMER][POSITIVE] Sounds good.
[CUSTOMER][NEUTRAL] That's good too. Oh, come on, what are you doing to me? Your account has been set. OK, now go to dashboard, log in.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Send verification code it's gonna send it again to me.
[CUSTOMER][POSITIVE] Oh I got it. I got it. I think I got what I did wrong.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] They're gonna say how many times do we have to send it so.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Now let's go down here.
[CUSTOMER][NEUTRAL] There it is.
[CUSTOMER][NEUTRAL] It was still there, but it was uh
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] I think it's all on that.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] OK, did I don't do it verify?
[AGENT][NEUTRAL] And.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] Thank goodness.
[CUSTOMER][NEUTRAL] Oh wait a minute.
[CUSTOMER][NEUTRAL] I hope.
[CUSTOMER][NEUTRAL] They took me to the dashboard.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I'll be waiting, you can receive claim status update to by text, OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Verify
[CUSTOMER][NEUTRAL] color
[CUSTOMER][NEUTRAL] Yeah there's like oh.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] The same.
[CUSTOMER][NEGATIVE] No, heck no.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] Yeah it is American public. No, this is the phone call stupid. OK, bye.
[CUSTOMER][NEUTRAL] Resend it.
[CUSTOMER][NEGATIVE] There was an error processing your request this error persist. Please contact customer service.
[AGENT][NEUTRAL] Hey, what, what is happening?
[CUSTOMER][NEUTRAL] A text message with
[CUSTOMER][NEUTRAL] I know. Let me see. It says a text message has been.
[CUSTOMER][NEUTRAL] But the verification code has been sent to your phone, please enter the code here. The code never showed up, so I told it to resend.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Are, are you getting the, the text message with the, with the code or you're getting the code on the email?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, it, it should be the text message and the code.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me go back, close that out.
[CUSTOMER][NEUTRAL] OK, I'm on the dashboard. Let's see what it does here.
[CUSTOMER][NEUTRAL] Would you like to review coverage, you need to access your ID card.
[CUSTOMER][NEUTRAL] I might have to print that out too, OK, so.
[CUSTOMER][NEUTRAL] Let me go back here.
[CUSTOMER][NEUTRAL] I'm not sure. I, I, this is a lot of stuff to, to print out that I printed out to read.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] On the policy.
[CUSTOMER][NEUTRAL] All this money that we're putting out for these.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All these monies that we're putting out for the CT scans and stuff like that.
[CUSTOMER][NEUTRAL] Um, is that gonna be covered? I mean, can we get reimbursed on that?
[AGENT][NEUTRAL] Um, you, you do have medical imaging testing. Um, the certificate is 43 pages long. Now, if you're trying to just look at the benefit.
[CUSTOMER][NEGATIVE] It's been really hard.
[CUSTOMER][NEUTRAL] Yeah, I know. I, I printed it all out.
[AGENT][NEUTRAL] Yeah, yeah, oh.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Yeah, if you want to look just at the benefit, it's gonna be under the schedule of benefits, um, which it has the cancer screening benefits, medical imaging tests. You get two tests per year for $500 each. So that's gonna be um the amount that you get like if he gets like a CT scan or MRI.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Only.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. Well, that, OK, what happened is,
[CUSTOMER][NEUTRAL] We switched uh pulmonologist.
[CUSTOMER][NEUTRAL] So the one that was closer to it, Doctor [PII].
[CUSTOMER][NEUTRAL] Doctor [PII] was looking at the paperwork and [PII] had a couple of nodules in 11 of his lungs. Doctor [PII] didn't do anything about them. He just did uh several CT scans and said, well, if they're not growing, so we're not gonna worry about them.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Well, then when we switched over to Doctor [PII], he requested a a CT scan of the lungs. But now he's got another nodule in his other lung that's like 15 centimeters or something like that.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So Doctor [PII] requested a PET scan.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Just to, you know, to, to see what it shows. And the PET scan was from like the middle of his face down to the middle of his thighs.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's when it picked up the cancer in it at the base of his tongue.
[AGENT][NEUTRAL] Got you. Um, yeah. So this is, um, for what you're telling me, it looks like you're gonna have more than one, screening test because you're gonna have the first initial screening test which is the diagnostic testing and then you're gonna have the follow-up and then you're gonna have the medical imaging. There's a lot, um, you can go ahead and send all the testing that they have done and let us look at it and see what can we pay on it. Um, but he has a lot of benefits. Um.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] The pathology is usually um a surgical benefit.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] OK. Well, we got, well, we got we here too because we're retired.
[AGENT][NEUTRAL] Biopsy. Mhm.
[AGENT][NEUTRAL] Oh, OK. So yeah, this is separate from any other policies you have. So this one will not um we do pay actual charges, but we don't like if they have paid all of it, it doesn't mean that you're not gonna get anything with us because this is a totally different policy so it's not based on that other policy that you have, OK?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, I know, but I need to let WellCare know that I have this policy.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Oh, OK. OK.
[CUSTOMER][NEUTRAL] Because between between you guys and WellCare.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Hopefully, we'll get everything taken care of and not have to pay out anything.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So the first scan though was
[CUSTOMER][NEUTRAL] Would that, well, see, we're going to tomorrow, we're gonna make a trip to the woodlands.
[CUSTOMER][NEUTRAL] To see the, uh, let's see, chemo and radiation. The radiologist.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] And the oncologist. We have 2 appointments tomorrow.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And from there,
[CUSTOMER][NEUTRAL] I know Doctor, I'm Doctor [PII] because we, we got two doctors because because uh there are his ENT.
[CUSTOMER][NEUTRAL] Which is the one that's dealing with the, the cancer in the throat.
[CUSTOMER][NEUTRAL] And then we have Doctor [PII] that is on the.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's gonna do biopsies on the lungs.
[CUSTOMER][NEUTRAL] Now, the actual biopsy is, would probably wouldn't be covered, uh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Maybe unless it's cancer or what? I'd say I don't understand.
[AGENT][NEUTRAL] if, if
[CUSTOMER][NEUTRAL] Just send them in and just see.
[AGENT][NEUTRAL] Um, yeah, you can do that. But basically, this is a cancer policy. So anything that will pay, will pay for positive cancer. Um, now, the biopsies, um, are usually handled as a surgery, especially if it's positive for cancer, that's gonna be under surgical procedure. So it's gonna be based off that benefit of the, um, um, again, if you're looking at the scheduled benefits, it's gonna be listed on how much we pay for surgery.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] For calling from.
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] Um, so it looks like per operation we pay up to 4500 anesthesia, 9000 per lifetime. So, um,
[AGENT][NEUTRAL] You need to send us itemized bills again.
[CUSTOMER][NEUTRAL] It's not really a lot, is it?
[AGENT][NEUTRAL] No, it's not a lot. It is not a lot. Mm. No, you do have an internal cancer first occurrence of 5000 if they did find internal cancer, and that's just a lump sum amount and then it just pays based on the benefits um of the policy.
[CUSTOMER][NEUTRAL] Not really
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] So you do have like cancer screening, which is the ones that we mentioned earlier, the surgical benefits. You have um hospital confinement benefits. Um, let's see, you also have treatment and evaluation consultation. You have $750 for that one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let's see what else.
[CUSTOMER][NEGATIVE] Yeah, with what, what doctors charge now, and no way that that's gonna pay for their consultation tomorrow.
[AGENT][NEUTRAL] Yeah, I know it's a high, high amount, yeah.
[CUSTOMER][NEGATIVE] They're ridiculous.
[AGENT][NEUTRAL] Yeah, it's a lot.
[CUSTOMER][NEGATIVE] And you know what's so stupid.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This, this last month.
[CUSTOMER][NEGATIVE] I've been paying $25 a month for a cancer, another cancer policy for.
[CUSTOMER][NEUTRAL] Well, we're trying to cut back on bills, so what do I do? I canceled that policy.
[AGENT][NEUTRAL] Mhm
[AGENT][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, yeah, I, I know that can happen, yeah, because you, you pay for it so long and then you think that you're never gonna use it and you're like, OK, let me cut some, some down and you don't think that you're gonna ever, ever gonna use it and then something like this happened and I know I have had a lot of calls like that, oh, can we reverse it? Can we do something and once it's canceled, we cannot reverse it unfortunately. But yeah, you, you also have um benefits.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] I know.
[CUSTOMER][NEGATIVE] Right, so I can't call them and get it back.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Oh boy. Have you tried? I mean, there's places that you can, um, um, well, it's hardly, hardly, but you can try. Um, maybe you can talk to them and see if there's any way you can just go ahead and take it back, but, um, you also have radiation therapy which is, uh, you do have $15,000 like if he has radiation therapy, chemotherapy, or immunotherapy, we pay up to $15,000 for a 12 month period. I know it's not a whole lot, but it is something.
[CUSTOMER][NEUTRAL] I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] Um, like you said with the charges nowadays.
[CUSTOMER][NEUTRAL] Well, for a 12 months, 12 month period.
[AGENT][NEUTRAL] You know,
[CUSTOMER][NEUTRAL] You're saying for a 12 month period, but after that, I mean, that's a year, so does it start over the next year?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Oh, it's awesome.
[AGENT][NEUTRAL] Yeah, but it's gonna be 12.
[CUSTOMER][NEUTRAL] Cause he's gonna have radiation and chemo.
[AGENT][NEUTRAL] Yeah, so it's gonna be 12-month period, meaning like, um, just an example, let's say he start getting like um chemotherapy or radiation therapy in July, starting [PII], OK? So we're gonna pay [PII] until [PII], and then that will be a 12 month, 12 month period, OK? And then um we start, we will start again basically on [PII] to the.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What was that other one you were talking about a lump sum of 5, 5000 for what?
[AGENT][NEUTRAL] Uh, internal cancer, that's a lump sum benefit.
[CUSTOMER][NEUTRAL] Internal cancer.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And you're saying that it, it, it's uh.
[CUSTOMER][NEGATIVE] irreversible. Nothing you can do about it? Is that what kind of deal is it? What?
[CUSTOMER][NEUTRAL] Uh huh
[AGENT][NEUTRAL] No, that one is just a one-time lifetime benefit. So once we pay that 5000, it's not gonna be paying again, but that's just a lump sum benefit. So it's basically a one-time check that we send out if he has internal cancer, which for what you're saying it looks like he does have internal cancer. Um, so.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Oh, I pray he don't.
[AGENT][NEUTRAL] Mhm, yeah, if it comes positive, if, if.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Well, he's got it, he's got it in at, he's got it at the base of his boat.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So we just paid for another CAT scan that doctor uh [PII] ordered.
[CUSTOMER][NEUTRAL] With contrast, so we paid a deductible of $250.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Hm.
[AGENT][POSITIVE] Wow.
[CUSTOMER][POSITIVE] WellCare is taken good care of the rest of it. That's why I have to contact WellCare.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And tell them about this policy also.
[CUSTOMER][NEUTRAL] Cause WellCare is paying for that. We paid 250 $250 for it. I could submit it to get the, the money back.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] But I don't, I don't know how it's gonna work with Wellcare. I have to call them.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, you have to just check with them and see, but again, I
[AGENT][NEUTRAL] To us for the or for what you pay out of pocket and just let us look into it. Um, and again, this is a cancer policy so it has to be positive for cancer to get like the highest benefit. If it's not cancerous and you're just trying to get like a benefit for the wellness or diagnostic testing that is not cancerous, you do have a diagnostic testing benefit or follow-up testing benefit.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, it is once per year and it's $75 for the first time diagnostic or $100 for the follow-up diagnostic.
[CUSTOMER][NEGATIVE] No, it's definitely cancer. They've already done the biopsy.
[AGENT][NEUTRAL] And this is if it's not cancer. Yeah, OK. So yeah, if the biopsy came back that it is cancerous, then yes, um, it will be um under that benefit of $500 benefit. Now, we cannot guarantee anything over the phone, but you can always submit the claims, let us look at it and see if it's something that we'll cover, OK?
[CUSTOMER][NEUTRAL] It's squamous cell carcinoma.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, I'll look at this uh site and see if I can.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I'm trying to look at the card and the kind of print out a card for it.
[AGENT][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] But anyway, I'll look at the site. I'll call WellCare. I'll go ahead and start a claim.
[CUSTOMER][NEUTRAL] And I'll submit those paperwork for you to look at.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And also the, the diagnosis.
[AGENT][NEUTRAL] Yeah, the pathology report is gonna be really important for the first time, OK? So just um reminder to send in that with the claim form, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right. You're welcome. Is there anything else I may help you with today? Any other questions or concerns?
[CUSTOMER][POSITIVE] Thank you so much. You've been awesome.
[CUSTOMER][NEUTRAL] No, but if I ever have to call back, I wish I got you again.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Well, you can always ask for me. My name is [PII]
[CUSTOMER][NEUTRAL] What did I say?
[CUSTOMER][NEUTRAL] I can ask who are you?
[AGENT][POSITIVE] Yes, you can.
[CUSTOMER][POSITIVE] Oh great.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] You have
[CUSTOMER][POSITIVE] No, I'm I'm OK right now.
[AGENT][POSITIVE] You OK? OK. I, I hope, hopefully I'll help you. You're welcome and I hope the best, OK? Have a good day.
[CUSTOMER][POSITIVE] Thank you so much, so.
[CUSTOMER][POSITIVE] All right. Have a blessed day.
[AGENT][NEUTRAL] Yes ma'am bye bye.
[CUSTOMER][POSITIVE] Great bye.