AccountId: 011433970860
ContactId: 6c554598-833e-4782-a884-8b1e3933fa59
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 847690 ms
Total Talk Time (AGENT): 227939 ms
Total Talk Time (CUSTOMER): 289039 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/6c554598-833e-4782-a884-8b1e3933fa59_20250102T21:54_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII]. I have a question. I've had your policy, cancer policy for a long time. Um, and I did file on it one time when I had skin cancer, but every time I go to the dermatologist and she does a pre-cancerous thing or she cuts something on me, should that bill be sent to you?
[AGENT][NEUTRAL] Not every time. You probably have a diagnostic um testing that's one per year, but I can check for you and make sure.
[CUSTOMER][NEGATIVE] OK, uh, they don't send anything in. I've, I've got to pay. I've got all the bills that I've had over the years.
[AGENT][NEUTRAL] OK. And Ms. [PII], um, may I have a good contact number in case we're disconnected and then your policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me ask what I had sent it to [PII]. That was the last address I have for this, but they said they couldn't find an find it. So I didn't know where to send it to.
[AGENT][NEUTRAL] Yes,
[AGENT][NEUTRAL] Yes, I'll give you the claim's mailing address also. It's no longer [PII], it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, that, that kinda helps me there. OK, you need my policy number?
[AGENT][POSITIVE] Yes, ma'am, and a good contact number in case we're disconnected.
[CUSTOMER][NEUTRAL] OK 461.
[CUSTOMER][NEUTRAL] 070
[CUSTOMER][NEUTRAL] I think it says I see.
[AGENT][NEUTRAL] Oh, that's the policy number?
[CUSTOMER][NEUTRAL] And my num
[CUSTOMER][NEUTRAL] Yes ma'am. What other, there's another number underneath it. It's got two different numbers.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the number underneath it?
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK, 067455-HI.
[CUSTOMER][NEUTRAL] And my phone number is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. So hold on one moment, let me get to your cancer policy because this is for your hospital indemnity.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right. I had both of them.
[AGENT][NEUTRAL] OK, here goes the cancer. Hold on one moment, I'm pulling it up now.
[CUSTOMER][NEUTRAL] OK, that's fine.
[AGENT][NEUTRAL] And Ms. [PII], do you mind if I place you on just a brief hold while I look at the benefits?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Referring
[CUSTOMER][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Claims, this is [PII].
[AGENT][NEUTRAL] Oh, so I just had a whole conversation on you. I'm sorry, [PII], this is [PII] on the care team. How are you?
[CUSTOMER][POSITIVE] I'm good. How are you?
[AGENT][NEUTRAL] I'm doing good. Um, can you help me? I'm trying to quote benefits, but it's an old policy and
[AGENT][NEUTRAL] There's no policy, sir, on on-base. It's just
[AGENT][NEUTRAL] The back files, one has like 85 pages, 20 pages. I'm just trying to see what the diagnostic testing benefit is. Do you know if there's a quicker way?
[CUSTOMER][NEUTRAL] Let me see what's the policy number?
[AGENT][NEUTRAL] It's 76042.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Let me check.
[CUSTOMER][NEUTRAL] A lot of times with those old policies, if they don't have.
[CUSTOMER][NEUTRAL] The certificate, it usually will have uh application or schedule page.
[CUSTOMER][NEUTRAL] But that doesn't.
[AGENT][NEUTRAL] And I tried to look on PIBFT, but I know it's in that base coverage, but I, it doesn't break it down in PIBFT and
[AGENT][NEUTRAL] I don't see a schedule page, so I'm just going through, I'm on, there's 3 back files. I went through the 85 pages.
[AGENT][NEUTRAL] And the 19, I'm about to look at the 42, but I don't see it.
[CUSTOMER][NEUTRAL] Yeah, these are.
[CUSTOMER][NEUTRAL] Tricky when they don't have it, but looking at this one, they have some claims and the claims history that paid.
[CUSTOMER][POSITIVE] The wellness benefit.
[CUSTOMER][NEUTRAL] And it shows $75.
[CUSTOMER][NEUTRAL] Can you see the actual claims and lion?
[AGENT][NEUTRAL] Oh, let me see. Mhm.
[CUSTOMER][NEUTRAL] So like if you, uh, that last one, I mean the the most recent, I guess it's 2013 though, but.
[AGENT][NEUTRAL] Oh, I see the 75 for the wellness.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, so that's what I would.
[CUSTOMER][NEUTRAL] Go based off of if, and again, it's, it's depending on if you feel comfortable with that information it's typically what it is if it's.
[AGENT][NEUTRAL] I'm just gonna get a disclaimer, but uh, but it so but this is at one time a year, right?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, it's always uh one test per calendar year.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Well, I can go with that and um give a disclaimer. I mean, hey, it's not in there.
[CUSTOMER][NEUTRAL] Yeah, exactly, and.
[AGENT][NEUTRAL] And I went through 100 and something pages, well over 100.
[CUSTOMER][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] Yeah, usually if it's there it'll say schedule page or to say application and it's usually those first few pages. If you don't see it, I'll say page 1 through 5. I would just move on to another uh file.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and then I can look back in the claims too and see. I'll do that next time too.
[CUSTOMER][NEUTRAL] Just from my experience.
[CUSTOMER][POSITIVE] Yeah, exactly, yep.
[AGENT][POSITIVE] OK. Well, thank you, [PII]. Sorry about that.
[CUSTOMER][NEUTRAL] No, no, anytime.
[AGENT][NEUTRAL] OK, bye-bye.
[CUSTOMER][NEUTRAL] All right bye bye.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Thank you so much for holding. I'm sorry for that wait. Um, I had to look through a few quite a few pages.
[CUSTOMER][NEUTRAL] I you.
[CUSTOMER][NEUTRAL] I know it's been a long time.
[AGENT][NEUTRAL] But I found it. So it's $75 for your wellness um testing and it's one test per year. So however many you have, um, it looks like the last one was for [PII]. So from then on, um, if you like, you can file one, you know, one per year from [PII] up to now.
[CUSTOMER][NEUTRAL] Oh, I don't.
[CUSTOMER][NEGATIVE] So I, so you're not paying for when I go and then she finds something and she cuts it out. You don't pay for that?
[AGENT][POSITIVE] Well, I mean, you do have a surgery benefit as well, yes.
[CUSTOMER][NEUTRAL] OK, could I just send all the bills and let you go through them and what can be filed? Can not and not throw them out?
[AGENT][NEUTRAL] Mhm, you sure can.
[CUSTOMER][NEUTRAL] Uh, cause I mean, it's hard to talk about it without seeing actually what it is, and I can always get another copy cause I have one myself. But I thought they would designate what it is, but it, it's a dermatologist I go to every year.
[CUSTOMER][NEUTRAL] So I'll just send all these papers. I do have a cover sheet that has my name and everything on it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And yes, ma'am, and do you have a um copy of the cancer claim form?
[CUSTOMER][NEUTRAL] Yes, ma'am, that's what I've got.
[AGENT][NEUTRAL] OK. Oh, and let me give you the new address.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] So it's, oh, let me know when you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, so it's [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Ok, so, so close the office down there or you just um
[AGENT][NEUTRAL] Well, the, we still have the building there, but there, I think it's like 3 people that work there now.
[CUSTOMER][NEUTRAL] Moved everything on.
[CUSTOMER][NEUTRAL] Oh my gosh. OK. Well, I had an address I thought was correct, but obviously I couldn't find it. OK, what was the zip up code?
[AGENT][NEUTRAL] In [PII].
[AGENT][NEUTRAL] Um, so it's [PII], [PII]. Zip code is [PII].
[CUSTOMER][NEUTRAL] All right, got you then.
[AGENT][NEUTRAL] Alrighty, and again, all the information provided was a verification of benefits, not a guarantee of payment. And is there anything else I can help you with?
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] No, that was what I was trying to send, where to send them to and what happens, um.
[CUSTOMER][NEUTRAL] I go back in this month for a checkup cause she had a spot that she did and she's looking at, but I go once a year. So that, that would be my wellness thing.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I don't have anything to do with Medicare, does it?
[AGENT][NEUTRAL] Oh, no, ma'am.
[CUSTOMER][POSITIVE] OK, because I had to do a wellness sometimes on a check on Medicare, so, uh, but they're checking, yeah, yeah, they're checking to see if I have a memory yet I lost it. So, OK, you have a [PII] and thank you very much.
[AGENT][NEUTRAL] 000, I know what you mean. No, ma'am, it won't affect it.
[AGENT][POSITIVE] Thank you, Ms. [PII]. Thanks for calling APL and happy [PII] to you also. Bye-bye.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] OK, no problem.