AccountId: 011433970860
ContactId: 6e97a98e-3d6a-4e16-bc21-ba1d557d4a97
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 518770 ms
Total Talk Time (AGENT): 236213 ms
Total Talk Time (CUSTOMER): 124678 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/6e97a98e-3d6a-4e16-bc21-ba1d557d4a97_20250121T21:35_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi um my name is [PII], and um I was wanting to check and see where kind of my account stands.
[AGENT][NEUTRAL] In terms of is it active or not?
[CUSTOMER][NEUTRAL] Yes, and um what I need to do um.
[CUSTOMER][NEUTRAL] Like what else is covered?
[AGENT][NEUTRAL] You want to know what's covered on the OK.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, I've I've gotten one payment.
[CUSTOMER][NEUTRAL] Um, but I've had other bills, so I needed to see if I need to submit those.
[AGENT][NEUTRAL] OK. Well, I can definitely help you with your policy and your coverage. And [PII], may I have a good contact number in case we're disconnected and then the policy number?
[CUSTOMER][NEUTRAL] Um, [PII], but I don't have my policy number with me.
[AGENT][NEUTRAL] OK. May I have, um, well, I can look it up with your social?
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So I'm just waiting for the policies to populate here. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is for the cancer policy?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, here it is.
[AGENT][NEUTRAL] And I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Mhm, um, I'm sorry, what did you ask for first?
[AGENT][NEUTRAL] Your date of birth?
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] And it's [PII] and the email is [PII] [PII].
[AGENT][NEUTRAL] Alright, and thank you so much for verifying your information and all the information provided is a verification of benefits, not a guarantee of payment. So I am showing the policy is active. It's been effective since [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And, um, so you wanted to know like if particular wellness benefits were covered or?
[CUSTOMER][NEUTRAL] Well, I'm, I'm having surgery on Thursday, so I needed to see if that's gonna be covered.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What type of um surgery is it?
[CUSTOMER][NEUTRAL] Uh, mastectomy.
[AGENT][NEUTRAL] OK, so for mastectomy, for confinement, the policy would pay up to $50 per day.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] The surgery.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Do you have surgery limited?
[AGENT][NEUTRAL] The surgery would pay up to $25 per surgery.
[CUSTOMER][NEUTRAL] $25.
[AGENT][NEUTRAL] Yes, um, it looks like, OK, so this is a limited benefit cancer policy.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Yeah, that's what it says for um it says surgery per surgery $25. Let me see if this is.
[AGENT][NEUTRAL] It doesn't say per unit. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so yes, that is the amount that this policy will pay towards um a surgery.
[CUSTOMER][NEUTRAL] OK and then what about other bills?
[CUSTOMER][NEUTRAL] Like other medical procedures due to the cancer.
[AGENT][NEUTRAL] Um, it depends. Like, for example, the radiation like if it's treatment, um, if there's radiation, chemo, or immunotherapy, um,
[AGENT][NEUTRAL] Treatment needed, the policy will pay up to $15,000 a year.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] If I don't know if you've used the first occurrence benefit if there is a positive diagnosis, the policy will pay up to $7500 that goes to you.
[AGENT][NEUTRAL] There's um cancer screening benefits, um, the diagnostic testing, and then a follow-up or medical imaging is needed after a positive diagnosis.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And so where would I submit?
[CUSTOMER][NEUTRAL] Things
[AGENT][NEUTRAL] Um, so you can mail it, you can fax it, or you can, um, send it to the online service center. Which one would you most likely use?
[CUSTOMER][NEUTRAL] Um, I was trying to log into the online service center.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And it's saying when I put my information in it says no user was found with the information that was entered.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So let me go on my side and see and.
[AGENT][NEUTRAL] OK, so there's no policy, there's no um online service in our account?
[AGENT][NEUTRAL] Set up so we can set one up together. Um, are you on the website now?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so you'll go ahead and click on new user and then I'm an individual.
[CUSTOMER][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Last name, your full social?
[CUSTOMER][NEUTRAL] Yeah, that's what I've put in.
[CUSTOMER][NEUTRAL] Are there any dashes in the social?
[AGENT][NEUTRAL] No, there's no dashes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And which email address are you using?
[CUSTOMER][NEUTRAL] The [PII].
[AGENT][NEUTRAL] OK, so the um the so it's probably the email address. The email address on file is [PII].
[CUSTOMER][NEUTRAL] OK, let me put that in.
[CUSTOMER][NEUTRAL] There we go, OK.
[CUSTOMER][NEUTRAL] Now it says create your account.
[AGENT][NEUTRAL] OK, there you go. So then once you get to that point, you'll just create your username and password, um, and it'll send you a text message to verify and then you'll everything will start populating up there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well, let me go ahead and try that then.
[AGENT][NEUTRAL] All right. Well, what's, well, did you need the, um, well, are you going to file the claims online or did you need like the mailing address or anything?
[CUSTOMER][NEUTRAL] Oh, I can file them from the online service center.
[AGENT][NEUTRAL] Yes, ma'am. So once everything populates, um, when you get to your dashboard, you'll see like a pop up that says um upload documents or file claim. It's sometimes they we change the wording, so I don't know which one it says now, but um you'll just click on that and then the um you'll follow the prompts to fill out the claim.
[CUSTOMER][NEUTRAL] Oh OK
[CUSTOMER][NEUTRAL] OK, well, I will try that then.
[AGENT][NEUTRAL] All righty. Well, was there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] I think that's it.
[AGENT][POSITIVE] All right. Well, thank you so much for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thank you you too bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.