AccountId: 011433970860
ContactId: 60f0cf4e-12d1-493c-8aaa-fc5229695b1d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 329519 ms
Total Talk Time (AGENT): 150660 ms
Total Talk Time (CUSTOMER): 150108 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/60f0cf4e-12d1-493c-8aaa-fc5229695b1d_20250113T16:27_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi, yes ma'am. I just had a question. Um, I'm new to this, the kind of the cancer insurance, and I'm just trying to kinda understand, um, if when, when do I make a claim? So if, um, I know I'm gonna be having surgery and stuff like that and I've had a biopsy, um, when do I make the claim and how does that work? I'm sorry, I'm just trying to understand it all.
[AGENT][POSITIVE] No problem at all. Do you have a policy with us?
[CUSTOMER][NEUTRAL] I do, yes, ma'am.
[AGENT][NEUTRAL] You're yourself? OK, what's your name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], can I have a callback number?
[CUSTOMER][NEUTRAL] Uh, sure, [PII].
[AGENT][NEUTRAL] May I have your policy number? If you don't have your policy number, I can look you up by your social.
[CUSTOMER][NEUTRAL] Um, let me see, I had it pulled up the other day. Um, my, you can look it up by my social. I don't have it in front of me.
[AGENT][NEUTRAL] Alright, one moment, let me get to that screen. Hold on.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Could you please verify your date of birth, address, and email address, please?
[CUSTOMER][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And my address is [PII].
[AGENT][NEUTRAL] And your email address.
[CUSTOMER][NEUTRAL] Um, I don't know which one they have, probably, um, it would be [PII].
[AGENT][NEUTRAL] Probably work one maybe.
[CUSTOMER][NEUTRAL] [PII] and then my other one is [PII].
[AGENT][NEUTRAL] All right, [PII], thank you so much for verifying that information. So you're wanting to know when is the time that you would need to file a claim um under your cancel policy?
[CUSTOMER][NEUTRAL] So I'm not sure.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So you, you went in and you had the biopsy done and this is for a positive diagnosis of cancer?
[CUSTOMER][NEUTRAL] Yes, ma'am, skin. Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, while I pull up your policy, this is a verification of the coverage and not a guarantee for payment. So skin cancer with um the claim form is online at [PII].
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Once you have the biopsy done from that, you would um send us a claim form, the pathology report, and any itemized billing um dealing with the um skin cancer. With skin cancer, the only thing that is covered under the policy is the surgical portion. So, no anesthesia, no um first time occurrence, none of that other stuff. Transportation, so it's only the surgical part of it. So once you
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Does it cover the biopsy too, the labs or no?
[AGENT][NEUTRAL] Labs are not covered. The biopsy itself is covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so if I, I have my, um, my print out, I have my pass all whatever pass it pass, no, I can't say you know what I'm trying to say.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, but I don't have my bill or my itemized receipt yet. Do I need to wait for that?
[AGENT][NEUTRAL] Yeah, because that's the only way we are able to pay for any of the biopsies or the re the skin cancer removal. So, um you would have to wait until um you receive the itemized billing cause it has to have the procedure codes and that's what we're needing. Mhm.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, so let me make sure I'm understanding. So I could go once I go ahead and I get what I'm sure I'll get my biopsy, um, you know, broken down and the payment and all that, probably in the next month maybe. Um, so if I get that, then I can file a claim and then would I do another one once I have the surgery?
[CUSTOMER][NEUTRAL] Or I would just then
[CUSTOMER][NEUTRAL] I'd already have my claim and then I would just submit like the breakdown of the surgery.
[AGENT][NEUTRAL] OK, so what, so you're saying that you're gonna submit the pathology for the biopsy and then
[AGENT][NEUTRAL] Submit the other stuff later once you.
[CUSTOMER][NEUTRAL] That's what I'm asking. I don't know. Or do I wait until I, do I wait until I have my surgery and then I have my breakdown of my surgery bill and then send it all, like the surgery and the biopsy?
[CUSTOMER][NEUTRAL] The surgery is not scheduled until the end of February.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I, I mean, it's, it's up to you. I mean, to, to be honest, if this was a large benefit, then doing it separate, but because it's not, um, the larger benefit will probably come with the removal and not the biopsy that I, you know, to do it twice, I think, you know, if you do it all at one time.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, OK, so I will.
[CUSTOMER][NEUTRAL] More than likely I'll have my surgery once I get my itemized receipt, then I could submit the claim.
[AGENT][POSITIVE] Yes, I, yeah. Yeah. Is there anything else, [PII] I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, all right.
[CUSTOMER][POSITIVE] No ma'am I appreciate it that clears it up for me.
[AGENT][POSITIVE] No problem. Thank you so much for calling APL. You have a great day. Bye bye.
[CUSTOMER][NEUTRAL] Yes ma'am bye bye.