AccountId: 011433970860
ContactId: 6ecaffc3-44a5-4dc3-8b1f-ef749ff9e716
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 657640 ms
Total Talk Time (AGENT): 336418 ms
Total Talk Time (CUSTOMER): 183797 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/6ecaffc3-44a5-4dc3-8b1f-ef749ff9e716_20250624T22:45_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I was trying to sign up.
[CUSTOMER][NEUTRAL] I have um.
[CUSTOMER][NEUTRAL] This plan through my job.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] Uh, cancer or something.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And so I was needing to do.
[CUSTOMER][NEUTRAL] Another colonoscopy?
[CUSTOMER][NEUTRAL] And they consider a diagnostic?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So is that something I can file?
[AGENT][POSITIVE] Yeah, definitely.
[CUSTOMER][NEUTRAL] Or that you guys will pay for?
[AGENT][NEUTRAL] I can I can definitely get that pulled up to verify, but I know most of our cancer policies do have that um considered as a wellness benefit, uh, under the diagnostic, so I can get that pulled up and verify. Um, I'm so sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] First name is [PII].
[CUSTOMER][NEUTRAL] Last name [PII], [PII]
[AGENT][POSITIVE] OK thank you and then uh can I go ahead and get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then do you have your policy number?
[CUSTOMER][NEUTRAL] Where would the policy number be? Is that my medical number or?
[CUSTOMER][NEUTRAL] Is that
[AGENT][NEUTRAL] Um, typically, it would begin with a 0, a 1, or a 2.
[CUSTOMER][NEUTRAL] I'm trying to
[CUSTOMER][NEUTRAL] No, I'm trying to log in and I'm verifying my email right now maybe it'll be on there.
[AGENT][NEUTRAL] It should um I can also start using your social if that's easier.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, there we are, and then, uh, [PII], just gonna verify some information really quick. Uh, can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And can I get your um mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Perfect. The last thing I need is the email address we've got on file for you. uh, looks like it's through your employer.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] OK, perfect. Thank you so much for verifying all of that. OK, give me just a moment, let me go ahead and get this policy pulled up and we will take a look.
[AGENT][NEUTRAL] OK. So, yes, you do have the benefit for uh diagnostic testing.
[AGENT][NEUTRAL] So I will go ahead and verify um yes, there we are. Uh, colonoscopy is listed as a coverage diagnostic test. So that would be, um, you can claim up to 1 per calendar year and that pays a $50 benefit. Uh, now, if it does require a follow-up I'm sorry?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That what?
[CUSTOMER][NEUTRAL] It pays a what? I didn't hear you.
[AGENT][NEUTRAL] Oh, I'm sorry, um, so, uh, one test per calendar year can be claimed, uh, that pays $50 per test.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, if it does require a follow up diagnostic test, then that would be an additional $100 benefit.
[CUSTOMER][NEUTRAL] So that's what I pay or that's what you pay me?
[AGENT][NEUTRAL] Oh no, no, no, that's our benefit amount that's the benefit amount we would pay.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] $50?
[AGENT][NEUTRAL] Yes, under your cancer policy.
[CUSTOMER][NEUTRAL] You said
[CUSTOMER][NEUTRAL] OK, so I'm confused. They're quote they quoted me a price.
[CUSTOMER][NEUTRAL] And it's gonna be way over $4000 so you're saying you'll pay $50?
[AGENT][NEUTRAL] Sure, so this
[AGENT][NEUTRAL] Yeah, this isn't, uh, this is a supplemental coverage. This isn't a major medical plan. Um, this is simply a cancer supplemental plan.
[CUSTOMER][NEGATIVE] So you, you don't pay them.
[CUSTOMER][NEUTRAL] Is that what you're saying?
[AGENT][NEUTRAL] Right, you would file that claim with us and we would, uh, pay $50 per test per calendar year.
[CUSTOMER][NEUTRAL] $50.
[AGENT][NEUTRAL] Yes, that's the diagnostic testing benefit for this policy.
[CUSTOMER][NEUTRAL] OK, I
[CUSTOMER][NEUTRAL] So I guess I don't even know what I signed up for then.
[AGENT][NEUTRAL] If you'd like, I can send you a copy of this policy so you can kinda review those benefits.
[CUSTOMER][NEUTRAL] OK, so what is this?
[CUSTOMER][NEUTRAL] Considered. That's uh.
[AGENT][NEUTRAL] Right, it is a supplemental cancer policy, and I did just look for good measure, and this is the only policy that you have with us. Uh, so if you do have additional policies, I would get with your employer to see who those might be through, um, but again, this is predominantly going to be for the treatment of cancer. Uh, the only other benefits that are outside of that is you do have um a lump sum benefit, uh, in case of a heart attack or stroke.
[CUSTOMER][NEUTRAL] What is
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then of course, the cancer screening benefit rider which was additional and that does include the diagnostic testing benefit.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Everything else would be if there was a positive diagnosis of cancer and treatment for that.
[CUSTOMER][NEUTRAL] OK, so this diagnostic is.
[CUSTOMER][NEUTRAL] You, you would pay more if there was treatment?
[CUSTOMER][NEUTRAL] Other than just $50 is that what you're?
[AGENT][NEGATIVE] No, no, no.
[AGENT][NEUTRAL] Um, depending on what it was, uh, so that's its own benefit. That is again, like a preventative, uh, benefit for, you know, obviously cancer screening, um, screening for cancer.
[AGENT][NEUTRAL] So, um, that would be that benefit on its own. Now, if there was a positive diagnosis of cancer, there are separate benefits for, you know, uh, radiation, chemo, immunotherapy, hormone therapy, uh, if there was a mastectomy. Um, there's also a lump sum, um, internal first cancer first occurrence benefit. So there are other benefits, but they would be, again, related to treating cancer.
[CUSTOMER][NEUTRAL] Well this that's what this follow up is for.
[CUSTOMER][NEUTRAL] It's because they found something and now I have to have.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you actually get a positive diagnosis of cancer? Like did they do a uh biopsy?
[CUSTOMER][NEGATIVE] But I'm so confused as to what.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] They did OK all right well that definitely uh changes things. I'm so sorry for the confusion. I thought you just meant an actual.
[AGENT][NEUTRAL] Like you just went to do a routine kind of checkup, um, OK, so in that case, let's see, and I will go ahead, uh, before I forget, do you want me to go ahead and send this policy to you so you do have it for your records you can kind of see through, uh, dollar amounts and such.
[CUSTOMER][NEUTRAL] Yes, I was gonna log in here.
[CUSTOMER][NEUTRAL] When I log in, can I see all of that too?
[AGENT][NEUTRAL] You should, but I can still go ahead and email you a copy if you'd like.
[CUSTOMER][NEUTRAL] If I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] OK yeah do you want me to just send it to this uh email address that we've got on file for you uh through your employer?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, OK, I will go ahead and get that sent now um.
[AGENT][NEUTRAL] Give me just a moment.
[AGENT][NEUTRAL] OK, so that being said, um, of course that diagnostic testing benefit on its own, that is what it is.
[AGENT][NEUTRAL] So to get your other benefits, especially if you're going to be receiving regular treatment uh for this, um, we would first need that pathology report. So where they first um discovered the positive diagnosis of cancer, uh, we would need that sent to us. Once we receive that and it's been processed, then you would get that lump sum benefit amount. Um, if you'll give me one moment, I'm gonna finish sending this and then I will see how much that is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So that is $10,000. Is that lump sum?
[AGENT][NEUTRAL] And then if you do you know, is it kind of too soon, do you know if you're going to be receiving a radiation or chemo or anything like that?
[CUSTOMER][NEUTRAL] At this point it's just I have to do the colonoscopy every year.
[AGENT][NEUTRAL] Oh, OK, so I see, OK.
[CUSTOMER][NEUTRAL] That's what I was saying.
[CUSTOMER][NEUTRAL] They took it out.
[AGENT][POSITIVE] Go ahead, I'm so sorry.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Yeah, they removed it and then they went back in and did another and took out more and now I have to do this every year.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I see. OK, so just the colonoscopy on its own would just fall under that diagnostic testing benefit. So that would just be that $50 benefit.
[CUSTOMER][NEUTRAL] Yeah, and that's why I was saying the it's costing over 4000 so I guess I didn't get a.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] So $50 go.
[AGENT][NEUTRAL] I'm sorry for the confusion. It is, yes, that's for any um diagnostic testing benefit, um, and that could be, you know, I know you said you have to get that every year, um, but it could also be for a mammogram, a Pap smear, uh, things like that as well.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Well those are free every year.
[AGENT][POSITIVE] Oh that's good OK yeah.
[CUSTOMER][NEUTRAL] I get one of those
[CUSTOMER][NEUTRAL] Yeah, but
[CUSTOMER][NEUTRAL] This colonoscopy, the insurance will only pay for them every 10 years.
[AGENT][NEUTRAL] Oh, I see.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] And so in between the 10 I have to pay for.
[CUSTOMER][NEUTRAL] It so I thought that's what this type.
[AGENT][NEUTRAL] Oh, yeah.
[CUSTOMER][NEUTRAL] I thought that's what this type of insurance would be, no?
[AGENT][NEUTRAL] Not for a specific.