AccountId: 011433970860
ContactId: 6c847514-6c5a-45be-b435-65db10b87bb2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 317019 ms
Total Talk Time (AGENT): 159104 ms
Total Talk Time (CUSTOMER): 132181 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=1.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/6c847514-6c5a-45be-b435-65db10b87bb2_20250124T20:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling Eli [PII]. How can I help you?
[CUSTOMER][POSITIVE] Howdy, my friend. How are you doing and Happy, happy Friday.
[AGENT][NEUTRAL] I'm doing OK, and you?
[CUSTOMER][POSITIVE] Oh, I'm doing OK.
[AGENT][POSITIVE] It's almost regular season. I had to laugh when you said that.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh, yeeha.
[CUSTOMER][POSITIVE] I really am. I'm just really a good old cowgirl at heart.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] What you got?
[CUSTOMER][NEUTRAL] I got policy number 256-6030 for [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And he had a biopsy yesterday and wants to know the surgical benefit. I told him, of course, it would only be payable if it comes back a positive diagnosis, but he wants to know the exact amount for that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, biopsy that he could get paid because he had to pay $500 yesterday.
[AGENT][NEUTRAL] Oh I better tell him exactly my um what's his callback number?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, you can send them through.
[CUSTOMER][POSITIVE] Alrighty well have fun and I hope you have a great weekend.
[AGENT][NEUTRAL] You too.
[CUSTOMER][NEUTRAL] Let me, let me get him on the line. Thank you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Mr. [PII], thank you for your patience. I have [PII] on the line and she's going to assist you further, and you have a wonderful weekend.
[CUSTOMER][POSITIVE] You too, ma'am. Thank you. Bye-bye.
[AGENT][NEUTRAL] Hi, Mr. [PII]. This is [PII] um on the cancer team. The rep stated you had a question um regards to a biopsy you had done yesterday.
[CUSTOMER][NEUTRAL] Yeah, uh-huh, they was checking, uh, my, the prostate here I had cancer.
[CUSTOMER][NEGATIVE] And I had to put the whole payment was $2000. I put $500 down and I set up a payment plan with them and I won't know nothing I think till Thursday or Friday with my, if I had it, I didn't have it. So what all do y'all pay up on stuff like that there?
[AGENT][NEUTRAL] OK. So, um, it all depends on if it comes back as a positive diagnosis. Um, so if it's a positive diagnosis, um, then there's a portion that we pay, but as far as how much we pay, that's gonna be harder determine because the way we pay is based off of the procedure codes and um what the charges are.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, um.
[AGENT][NEUTRAL] But as far as other than that, I mean, if you have surgery done, um,
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] After that, or any kind of.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] Chemo or anything like that, then, then that's covered as well up to a certain amount.
[CUSTOMER][NEUTRAL] Oh, to a certain amount if I have this positive. So if it's not positive, everything is still on me to pay that bill and everything right.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So it's only covered and what it's positive it pays a certain amount of money.
[AGENT][NEUTRAL] Yes, so as far as the biopsy itself, because it's considered as a surgery, um, like I said, if it's positive, then it pays a portion of
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, for the, the surgery that they've done and they say if they recommend you to get chemotherapy or radiation done or immunotherapy, as long as it's a, it's a covered um drug.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] This policy pays up to $20,000 per 12 month period for that.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I just put the, if I have to go to chemo and everything.
[AGENT][NEUTRAL] Yes, sir. um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] It also covers like if you have to have like any any imaging or diagnostic testing as well.
[CUSTOMER][NEUTRAL] Well, I did do a diagnostic test.
[CUSTOMER][NEUTRAL] Back here and before I got this though, I didn't have this then.
[AGENT][NEUTRAL] Um, when did you do the, because your policy didn't start until, um, it just started this month, so it wouldn't cover if you had anything done before January.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, yeah, I did from that, so don't go won't cover that. OK, the only thing for this year that it will cover.
[AGENT][NEUTRAL] Correct. Yeah, cause the policy just started.
[AGENT][NEUTRAL] Yeah, so anything after January the first of this year, since that's when the policy started.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'll just have to wait and see, but I got the information I have to fill out. I printed out yesterday. If I did have so I will send this back.
[CUSTOMER][NEUTRAL] This is castor playing for.
[AGENT][NEUTRAL] Yeah, so when
[AGENT][NEUTRAL] Yes, so when you get the, um, because we're gonna need the PAT report. So when you um find out from the doctor, um, I mean, if it's positive, um, like I said, we, you would just um obtain the path report and you can send that in with that claim form um and we can go from there.
[CUSTOMER][NEUTRAL] OK, only if it's positive not negative negative, I'm right.
[AGENT][NEUTRAL] Correct, cause if you, I mean, if you if it's negative, then, I mean, like say when you send it in, um, it just won't be covered because I mean, it's, it's negative.
[CUSTOMER][POSITIVE] Has to be positive for it to come.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][POSITIVE] OK, well, thank you, ma'am.
[AGENT][NEUTRAL] No problem, Mr. [PII]. Was there anything else that I can help you with today?
[CUSTOMER][POSITIVE] Oh, no, that was it. Thank you.
[AGENT][POSITIVE] Alright, thanks for calling you have a wonderful day.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.