AccountId: 011433970860
ContactId: 6f7c3730-aef0-405b-a10f-41937937d4b7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1267640 ms
Total Talk Time (AGENT): 396874 ms
Total Talk Time (CUSTOMER): 717876 ms
Interruptions: 6
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/6f7c3730-aef0-405b-a10f-41937937d4b7_20250603T21:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], how are you? This is [PII].
[AGENT][NEUTRAL] Hi so how are you?
[CUSTOMER][NEUTRAL] I'm good, I'm good. Oh, I'm not that good, but I'm OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm trying not to cough. OK, um, I have a member on the line that it looks like she spoke to you earlier about a pathology report, and she just uploaded some documents, but it, it is not a pathology report, it's just a report that they was not able to find a pathology report. So she's wanted to know what else could she send?
[CUSTOMER][NEUTRAL] Um, and I see she spoke to you the last time.
[AGENT][NEUTRAL] OK, um, what's the policy?
[CUSTOMER][NEUTRAL] Um, the.
[CUSTOMER][NEUTRAL] It's 247.
[CUSTOMER][NEUTRAL] 70
[CUSTOMER][NEUTRAL] 90.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Glaser.
[CUSTOMER][NEUTRAL] It is for the husband.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, I was just gonna say I don't remember speaking to this person.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] No, I don't think I talked to her, but now she's asking, she uploaded, uh, a pathology, but it's not the pathology report, is that what you said?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, correct, yeah. It's like a request for pathology, but, um, the request uh for the pathology was kind of denied saying that they didn't find a pathology. So that's why she sent in basically a letter.
[AGENT][NEUTRAL] OK, I'm gonna pull up that mail.
[AGENT][NEUTRAL] And see what the
[CUSTOMER][NEUTRAL] Yeah, it's the last one she's sending just now.
[AGENT][NEUTRAL] The the 7:50. OK, alright.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] Oh boy, 68 pages holy moly.
[AGENT][NEUTRAL] On that one.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] I'm pulling it up now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK looks like she last spoke to.
[AGENT][NEUTRAL] [PII] and then before that it was [PII].
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] All right, [PII], OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Need the pathology report that first diagnosed the cancer, she submitted new patient office notes.
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] I'm waiting for it to load. Sorry, my on base has been terrible today.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] I mean, really terrible. Earlier it froze up on me completely.
[CUSTOMER][POSITIVE] Oh, trust me, everything is.
[AGENT][NEGATIVE] I had to restart
[CUSTOMER][NEUTRAL] I know.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, so
[CUSTOMER][NEGATIVE] I know, I know. So, today's been one of those overseas days, and it's been terrible.
[CUSTOMER][NEUTRAL] The online service center, all the changes and everything and everybody going cuckoos about it.
[AGENT][NEUTRAL] Yeah, right.
[AGENT][NEUTRAL] OK, so they're telling them they're telling her on this request that they don't have any records?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That's exactly what they're saying.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] That supposedly the records are together with the blood work, with the lab results, which
[CUSTOMER][NEUTRAL] Mm, usually that's not the pathology report. That should be something different.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] There has to be some sort of and what's.
[AGENT][NEUTRAL] So now she's wanting to know what she can get or what I'm sorry, what was her question? What should she do now?
[CUSTOMER][NEGATIVE] So, basically, basically, uh, she's saying that that's all she can get and then there's nothing else she can get. So what else could it be done? Do we still need that or that's gonna be sufficient, which I don't think this is gonna be sufficient at all.
[AGENT][NEUTRAL] No, because it's telling us there is no records, but there, did she request it from the correct place?
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] I mean,
[CUSTOMER][NEGATIVE] She, yeah, she's saying that she did. Um, that's who did the um find cancer.
[CUSTOMER][POSITIVE] [PII] is the one that found the answer.
[AGENT][NEUTRAL] And do we know if she tried to contact them? But she's sure they had, they, she didn't have a pathology or she doesn't know?
[CUSTOMER][NEUTRAL] Mm mm mm.
[CUSTOMER][NEUTRAL] Um, she said that she don't have a pathology report, that that's why she sent that request for that pathology report to be sent to her, and that's what she got in return. So, um, she's just confused on what else, uh, how she's gonna get that to us when she cannot, she don't have, they don't have one and she don't have one and.
[AGENT][NEUTRAL] She's
[CUSTOMER][NEUTRAL] It doesn't seem to be one.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Well, there has to be because according to this, it says the first diagnosis cancer new patient office visit note for 35 and lab results for 35 indicates it was newly diagnosed. So where did they diagnose that from? I, that's why we need the pathology.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm. Maybe if you send it to her like that, maybe she will get it and maybe I don't know, I don't know.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and she's been everything's been verified and I'm speaking with the policy holder, right? [PII]?
[CUSTOMER][NEUTRAL] Yeah. Yes.
[CUSTOMER][POSITIVE] Yes, Ms. [PII]. Yes, yes, I do have Ms. [PII]. I fully verify her. Yes.
[AGENT][NEUTRAL] Everything's verified and that's her phone number um listed [PII].
[CUSTOMER][POSITIVE] Yes, that is correct. Yes. Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You can go ahead and transfer, yeah. Thank you so.
[CUSTOMER][NEUTRAL] OK, you ready for her?
[CUSTOMER][POSITIVE] OK, thank you. Here she comes. You're welcome. Hi, good afternoon.
[AGENT][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Thank you for holding and being patient for Ms. [PII]. I got Ms. [PII] on the line. She's in the claims support team, and she's gonna assist you from here.
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][POSITIVE] You're welcome have a good afternoon.
[AGENT][NEUTRAL] Think so.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Hi Miss hi Miss [PII]. Hi, can you hear me OK?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello? OK, good. My name is [PII]. I'm on the, I'm on the claim support team.
[CUSTOMER][NEUTRAL] I can.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, and so I'm looking at the paperwork now. So it looks like um we needed a pathology report for the new diagnosis. Um, and apparently you submitted a request for those records and they're telling you there's none available?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I can tell you why.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The reason and I and I had this conversation before.
[CUSTOMER][NEUTRAL] Because the diagnosis is leukemia.
[CUSTOMER][NEUTRAL] The pathology report is embedded in the lab tests that I, the blood work test that I submitted with the initial claim, and there is a test in that first piece of paperwork that I sent up, the test called the flow cytometry. Flow cytometry is how leukemia is diagnosed.
[CUSTOMER][NEUTRAL] There isn't uh, there isn't a tissue test. It's a blood test. And so, like if you Google how is leukemia determined, it will say flow cytometry blood work is the determination for the malignancy. And so there was a flow cytometry test done.
[CUSTOMER][NEUTRAL] Originally, uh, with his primary care doctor.
[CUSTOMER][NEUTRAL] And that test showed.
[CUSTOMER][NEUTRAL] Leukemia, he was referred then to an oncologist in the on, on um March, uh, I forgot the date, the [PII], I think in March. He saw the primary care doctor in February and then the oncologist in
[AGENT][NEUTRAL] [PII] I think mhm yeah.
[CUSTOMER][NEUTRAL] Um, March, and she ran the, the flow cytometry test again.
[CUSTOMER][NEUTRAL] If you look at the clinical notes from the.
[CUSTOMER][NEUTRAL] Uh, oncology visit that day, you'll see in there.
[CUSTOMER][NEUTRAL] Malignancy, uh, it, it, it says malignancy on her clinical notes. And if you look at the blood work from the both blood works, both blood work, the flow cytometry test have notes from the pathologist. Now I'm with you.
[CUSTOMER][NEUTRAL] I, I, there is nowhere on the pathology notes where it says malignancy. All it has is all of the markers, the blood markers that identify that it's.
[CUSTOMER][NEUTRAL] Leukemia.
[CUSTOMER][NEUTRAL] And then on the itemized billing statement that I and and she asked me for that which is fine I I got the itemized billing statement and I uploaded that.
[CUSTOMER][NEUTRAL] On the top line of that itemized billing statement, it says.
[CUSTOMER][NEUTRAL] Um, highlighted the, um, leukemia diagnosis, but there, there just isn't a.
[CUSTOMER][NEUTRAL] I know what you're looking for. I, I filed claims for my sister's cancer, and I know exactly what you're looking for. It just is that there's no tissue sample. So there isn't a tissue pathology.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because there is no all, all, um, matter of fact, the doctor, the oncologist, the day that we met with her, the oncologist said everything that is done with leukemia is done with the blood. It's the only cancer that's monitored 100% with blood work.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][POSITIVE] And apparently he is right.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I don't know what else to send you. I, I'm, I'm not sure what else I can.
[CUSTOMER][NEUTRAL] I can um.
[CUSTOMER][NEUTRAL] I can provide you to show you that um.
[CUSTOMER][NEUTRAL] That's, you know, that that's, that's what it is.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So let me, I'm, I'm right now, I'm just reviewing through all the pages that were sent in and I find exactly what you're telling me, the flow symptom flow cytometry.
[CUSTOMER][NEUTRAL] Right, if you look on the, uh, understood, yeah, if you look at the um itemized billing statement that I sent up that I sent up.
[CUSTOMER][NEUTRAL] Do you have access to that?
[AGENT][NEUTRAL] Uh, I'm looking through the documents now, so just bear with me. My system's been a little bit slow today, so I do apologize. That's what part of the, uh, issue was before she transferred your call over to me is that I was trying to locate the documents and I have to pull them up separately and my system's been a little uh.
[CUSTOMER][NEUTRAL] Oh, I see. OK. Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Right, right. No, no worries.
[AGENT][NEGATIVE] A little less cooperative for some reason today.
[CUSTOMER][POSITIVE] No worries.
[CUSTOMER][NEUTRAL] And if you look at, uh, if, if you're looking through the list that I uploaded, there is one test that shows flow cytometry from 35.
[CUSTOMER][NEUTRAL] And the results that are there say indication for ordering absolute lymphocytosis.
[CUSTOMER][NEUTRAL] And then blood interpretation, it says CB5 positive B cell lymphral proliferative disorder.
[CUSTOMER][NEUTRAL] And then it and then it goes through a whole bunch of.
[CUSTOMER][NEUTRAL] Medical terminology under the comments section.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] But it the that that showing the expression of the CD 19 and 20, all that differential, all that gobbledygook, that all means that it was positive.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, and then also if you look that that's the, the, you know I'm I'm because I've kind of studied these because I know what you're looking for if you look at that itemized billing, the one from 35.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Uh huh that's what I'm looking at now.
[CUSTOMER][NEUTRAL] The look at the itemized billing from yeah, from 35, so you'll see at the top where it says service date, diagnosis code, chronic lymphatic leukemia B cell, not having achieved remission remission, but then if you also look on there, it also shows, where's it at? The um.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The name of the pathologist. I thought the pathologist was on here. The Doctor [PII] is the oncologist.
[CUSTOMER][NEUTRAL] Oh, [PII], do you see that on the 2nd page?
[AGENT][NEUTRAL] Yes. The cytopathology and it's a charge for, yeah. Mhm.
[CUSTOMER][NEUTRAL] OK, when
[CUSTOMER][NEUTRAL] Right, OK. That [PII] is the pathologist.
[CUSTOMER][NEUTRAL] If you go back and look at the flow cytometry test.
[CUSTOMER][NEUTRAL] You'll see the notes from the flow cytometry pathology division are signed by
[CUSTOMER][NEUTRAL] Uh, the [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's, that's as close as I can get to helping you out cause I don't, I, I, and again, I made the request because I thought, well, maybe there's something else that they have in their medical records department. That's why I sent that pathology request. And that's what I got back was there is no pathology because it, there is no.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] It's blood work. It's in the lab tests.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Is there anything else that I can provide that, that, that will help you?
[AGENT][NEUTRAL] Let me, um, if you don't mind, I'm gonna um just place you on a brief hold. What I'm gonna try to do Miss [PII], is I'm gonna reach out to the um.
[AGENT][NEUTRAL] Adjuster that process the claim and I'm just gonna check and, and uh let her know what you're telling me and see if she has a moment to just review what you uh sent in on those other documents before of course that um last document that tells us that there is no pathology. So if you don't mind, um, or would you prefer that I call you back?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, it, it may take a while because again, you sort of have to piece this together, but, you know, because, because of the fact, like I said, you have to find Doctor [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Notes in the flow cytometry so you gotta look through multiple forms if you guys wanna call me back that's perfectly fine and it's the end of the day you can call me tomorrow.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so let me do a little bit and investigate and check in with her and we'll see what um what she can recommend if we can't use what we do have currently um so and I'll reach back out to you once I um you know kind of [PII] if that's OK and the best number to reach you, Ms. [PII], I have is [PII].
[CUSTOMER][NEUTRAL] That's correct. And do you know when you call me, I know it'll be an [PII] number, will it say APL on it? Do you know or American Public Life?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't believe so. Sometimes it comes up, um, and, and I noticed that, uh, when I'm calling out when I'm dialing out, um, sometimes it comes up it's like a unknown number and it might throw you into the voicemail automatically if you have your phone set to that, um.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Well, that's why I was asking because I, I don't, yeah, I don't wanna miss your call and, and I get so many spam calls that when it's an [PII] number I don't unless there's an identifier on it to tell me what it is and even then that half the time that's a lie but but um yeah I'll I'll try to answer and I'm assuming you'll call me tomorrow because I think you guys are probably getting ready to go home.
[AGENT][NEUTRAL] It should
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, I'm actually here a little bit later this evening. Now whether that adjusters on my schedule or not, I'm not sure. um, but so, so I will either call you back um here in a little bit once I um have her review it for me, um, or it will be tomorrow.
[CUSTOMER][NEUTRAL] Understood OK.
[AGENT][NEUTRAL] And um can I just place you, let me, let me place you on a brief hold real quick and let me check something, OK? Just one moment.
[CUSTOMER][POSITIVE] OK, perfect. And.
[CUSTOMER][NEUTRAL] Sure. Yeah.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Hi, you've reached [PII]. I'm not available right now. Leave me a message and I'll give you a call back. Thanks. Have a great.
[AGENT][NEUTRAL] OK, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Are you there? OK, so it's gonna come up kind of like an unknown number, but it should be it it might have a weird prefect so that's what I'm saying it's probably going to put me into your voicemail um if you don't answer so um if that should happen I'll leave a voicemail and I'll leave you a callback number that you can reach me on.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] OK, and are you calling from [PII] or from [PII]?
[AGENT][NEUTRAL] Well, it should, it's probably gonna come up as unknown. Um, I'm actually I'm remote so I'm actually in a completely different state and I know it used to come up under [PII] City but it's changed um, they've rerouted our phones and we went to a new phone system last year too so like I said it's a little bit like I said it comes up just kind of unknown and it may be like a 833 prefix or could be just a a different but it doesn't always come up under [PII] or [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Right, right, right.
[CUSTOMER][POSITIVE] OK, and I apologize. Will you tell me your name one more time?
[AGENT][NEUTRAL] Absolutely, it's [PII]
[CUSTOMER][POSITIVE] [PII], got it. OK, thank you and I appreciate your help and let me know what else I can help you guys find.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Certainly Ms. [PII], and we appreciate your patience and did you have any other questions at this time?
[CUSTOMER][NEGATIVE] No, and, and I was gonna say I, I know this sounds really, really stupid but um while I was on the phone with the cancer claims person before, while she put me on hold, I, I googled.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] How, how is, what is the pathology for
[CUSTOMER][NEUTRAL] Um, CLL and it came up flow cytometry. So like it tells you, if you Google it, it tells you that that's the determination for whether or not you have leukemia. That's, that's, I mean, that's what Google tells you.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Not that, not that Google is always right, but, um, you know, but she said, no, that's not enough, and I was like, OK, but now I, I, I think it probably is right. So, um again, check it out and just call me back when you can, [PII]. Thank you.
[AGENT][NEUTRAL] You're welcome, Ms. [PII], and I'll be sure to give there that information as well, OK?
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][POSITIVE] All right, thank you, bye.
[AGENT][POSITIVE] Alright, I'll talk to you shortly thank you have a great evening.