AccountId: 011433970860
ContactId: 6367c3e3-1a2d-44fb-bf5e-9615e00b062c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 497890 ms
Total Talk Time (AGENT): 245282 ms
Total Talk Time (CUSTOMER): 284089 ms
Interruptions: 4
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/6367c3e3-1a2d-44fb-bf5e-9615e00b062c_20250313T14:48_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] 98
[CUSTOMER][NEUTRAL] Oh, I was just checking. I know on my wellness, uh, in the past when I file, it's on PSAs, I think. I, uh, also get checked by my thyroid doctor every 6 months and they check my thyroid, uh, blood test, the T3, the T4, uh, because I had cancer of the thyroid. Is that also qualify, uh, that blood test for the thyroid?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Do you have your
[AGENT][NEUTRAL] I can check that for you. Do you happen to have your policy number available?
[CUSTOMER][NEUTRAL] Uh, let's see, uh, I've got a few policy numbers here. I'm not sure which one it is, uh.
[AGENT][NEUTRAL] Just give me a, I can pull it up by any of those policy numbers.
[CUSTOMER][NEUTRAL] Oh, OK, uh, let's try 2558315. That was effective [PII]. How come the policy numbers change every year, huh?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Because it could be because they change a benefit. If a benefit changes, then you're gonna get a new policy number.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Alright, well that's the one from [PII], so I don't know if that's still current or not.
[AGENT][POSITIVE] That is, you did good.
[CUSTOMER][NEUTRAL] I mean, I pay every
[CUSTOMER][NEUTRAL] Yeah, I mean, I pay every month. It's automatic deductions from my checking account, but, um, I was just curious because in the past I've done PSA, but
[AGENT][POSITIVE] No, you did good. That is the active color.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have, you know, the thyroid should count too, I would think.
[AGENT][NEUTRAL] Well, I'm gonna check on that for you. I do need to verify your information. Do you mind verifying your name, date of birth, and current mailing address?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure. [PII]
[AGENT][NEUTRAL] And what is your current mailing address and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth [PII].
[AGENT][NEUTRAL] All right. Thank you, sir. What about your email and phone number?
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][POSITIVE] Perfect. Now that is um
[AGENT][NEUTRAL] We just want to
[AGENT][NEUTRAL] Verify you are who you are.
[AGENT][NEUTRAL] And try to protect your information. That's why we do that. So I know it gets old and it's a lot to verify.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] There's a lot of qualifications done by it.
[AGENT][NEUTRAL] I know.
[AGENT][NEUTRAL] But we do, um, want to protect your information so we do need to make sure.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] That um you are who you are. We don't want to give any information to somebody, you know, there's so many bad people out there in the world, right?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, yeah, I'm not one of them.
[AGENT][NEUTRAL] I know, I know you're not. I'm not saying you are, but we want to protect you from those who are.
[CUSTOMER][NEUTRAL] I'm a retired teacher. I had to pass background checks and everything.
[AGENT][NEUTRAL] Oh, yeah, you did, didn't you? What, what grade did you teach?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, well, I finished the last 4 years of high school, but before that it was kindergarten, so I went from the little ones to the big ones.
[AGENT][POSITIVE] Oh my goodness, you made a job, didn't you?
[CUSTOMER][NEUTRAL] Oh yeah, I think the little ones were smarter, they were like a sponge. The older ones, oh good, a lost cause.
[AGENT][NEUTRAL] Uh, yeah, my daughter's a high school teacher, so I, I get it.
[CUSTOMER][NEUTRAL] Oh yeah, I'm sure she has horror stories too.
[AGENT][NEUTRAL] It's, it's hard and
[AGENT][POSITIVE] Yeah, bless them, but it, I, I bless the teachers in the world, that's all I have to say.
[CUSTOMER][NEUTRAL] Mm, made them put their phones in a shoebox and they didn't touch them until we needed them, otherwise you'd never get their attention.
[AGENT][NEUTRAL] Right. She has a, a cellphone gel too, in her room.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] So mm mm, phones don't work here.
[AGENT][NEUTRAL] Hm, I am looking at your policy, Mr. [PII], and
[AGENT][NEUTRAL] It does show.
[AGENT][NEUTRAL] I'm looking at the benefits and do you have our active online account because if you do.
[CUSTOMER][POSITIVE] Yeah, I'm on it right now um.
[AGENT][NEUTRAL] You, you can click on your policy number.
[CUSTOMER][NEUTRAL] But I thought I'd call you because I don't.
[CUSTOMER][NEUTRAL] What's that?
[AGENT][NEUTRAL] I'm sorry, you can click on your policy number and it will show you all your benefits covered on your plan.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Getting your oops, there has been an error.
[AGENT][NEUTRAL] No, try that again.
[CUSTOMER][POSITIVE] Uh, you're experiencing technical difficulties. Oh, wonderful.
[AGENT][NEGATIVE] Oh, OK. That's not nice.
[CUSTOMER][NEUTRAL] That's why I'm calling because it made me call because I was trying to look it up. And like I say, in the past, I've always done a PSA for the wellness, but of course, Medicare only pays once a year for that, so I can't do that until after June. Um, but the thyro and I even get a Cysto, you know, but that's in December, once a year for the bladder cancer I had in the past.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Right. So it is a cancer screening test.
[CUSTOMER][NEUTRAL] Anyway, um, but I just got a, yeah.
[AGENT][NEUTRAL] That's covered.
[CUSTOMER][NEUTRAL] Um, and the thyroid, I mean, she's screening me every year just to make every 6 months actually, just to make sure it doesn't come back.
[AGENT][NEUTRAL] Right. And it's just a 23 and uh T3 and T4 blood work?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look at this claim form.
[AGENT][NEUTRAL] You know, now all you have to.
[CUSTOMER][NEUTRAL] I can't believe it'd be any different than a PSA, yeah.
[AGENT][NEUTRAL] Let's see, hang on just a second.
[CUSTOMER][NEUTRAL] And I did print screens off my chart, but it doesn't show, it just says Welcome [PII], it doesn't show my address, and I think you're gonna need that, right?
[AGENT][NEUTRAL] So actually now for filing a wellness claim, you only need to complete the wellness claim form.
[CUSTOMER][NEUTRAL] Oh OK you don't need to send backup information?
[AGENT][NEUTRAL] No, no, sir, not anymore. We have updated that to make it easier and
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEGATIVE] Yeah, because in the past you denied me because I was missing like a page or something. It's like, come on.
[AGENT][NEUTRAL] Right. No, no, it's just a claim form. That's all you have to complete.
[CUSTOMER][NEUTRAL] Yeah, alright, um.
[AGENT][NEUTRAL] And you can do it online and it's the wellness claim form. If you want to submit that and then you know your wellness benefit is only one for one screening per year.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, right, right, right. Oh, I understand, yeah.
[AGENT][NEUTRAL] But if you, if you want to submit that, I would submit it and let them review it to see if it's covered, either that or your PSA, whichever one you want to submit.
[CUSTOMER][NEUTRAL] Yeah, I mean, the PSA I won't do until after June, but I figured that's why I'm calling. I said, certainly the thyroid that I get checked would be comparable. It's pre-screening for cancer. Hopefully it won't come back. Um, I can't see why it would be any different, but I didn't want to go through all the motions and get rejected.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right. Now then, uh, but I, you know, if there's ever any question if something's covered, submit a claim for it. In this case, all you have to do is complete the claim form. Now that the um
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, how do I get it? I do it here. How do I get it to it from here, uh, claim forms. There it is.
[AGENT][NEUTRAL] So you can go to the claim forms and it's gonna be on page 3 of the list of the claims forms under the well list.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, I'm on my phone.
[CUSTOMER][NEUTRAL] File claims online, sign in to register.
[CUSTOMER][NEUTRAL] Uh, OK, alright, I'll figure it out.
[AGENT][NEUTRAL] Yeah and on that claim form it's not a listed uh.
[AGENT][NEUTRAL] Screening, but it does say other wellness test, and you can put those dates, what those tests are if it's not listed on the claim form.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] Let them review it and see if it's payable.
[CUSTOMER][NEUTRAL] All right, let me see what I can do.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] My pleasure to assist you, Mr. [PII]. Anything else I can help you with?
[CUSTOMER][NEUTRAL] Well, let's just hope all this is not in.
[CUSTOMER][NEGATIVE] For nothing.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Oh, I could just see it now rejected. It doesn't qualify like what.
[AGENT][NEGATIVE] Well, we don't like to, we don't like to reject claims either. We feel rejected when we can't pay them.
[CUSTOMER][NEUTRAL] I think it's only $50 right? I think my policy is $50. OK. All [PII]. Thank you.
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] My pleasure, Mr. [PII]. I hope you have a wonderful day and thank you for teaching all those young folks.
[CUSTOMER][NEUTRAL] All right, bye bye.
[AGENT][POSITIVE] Making a difference. Take care. Bye-bye.