AccountId: 011433970860
ContactId: 74fa70dd-43d1-468e-ae46-435fe392bf6b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 701280 ms
Total Talk Time (AGENT): 392108 ms
Total Talk Time (CUSTOMER): 287490 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/74fa70dd-43d1-468e-ae46-435fe392bf6b_20250310T16:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, I called earlier and I forgot to ask another question about something. My name is give me a sec. It's uh [PII], and my account number is 2,566,030.
[AGENT][NEUTRAL] OK, I'm sorry that was 256-6030?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, um,
[AGENT][NEUTRAL] Let's see and then really quick if you don't mind, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK appreciate it and you did say this was [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then can I get a uh excuse me, I'm just gonna verify some information really quick um can I get your date of birth please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII], ZIP [PII] [PII].
[AGENT][NEUTRAL] Perfect. Last thing I need is the email address we've got on file for you. Uh, looks like it might be through your employer.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] Alright appreciate you verifying all of that uh what kind of questions did you have for me?
[CUSTOMER][NEUTRAL] OK, they told me I know I gotta start my radiation treatment, I think next week or the week after, but they also got to do hormonal treatment too. So does that would that cover that too, the hormonal treatment.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] All right, let's see.
[AGENT][NEUTRAL] OK. You did say uh radiation and what was the other kind of treatment? I'm sorry.
[CUSTOMER][NEUTRAL] Hormonal treatment, I could take a shot once a month I take the pills. I'd rather take the pills.
[AGENT][NEUTRAL] OK, I'm not super familiar with you said hormonal?
[CUSTOMER][NEUTRAL] Hermonia is a, is a shot you can take once a month from me or a pill once a month, so the cancer won't come back.
[AGENT][NEUTRAL] Oh, I think I know what you're talking about. Um, do you know how that's spelled by chance?
[CUSTOMER][NEUTRAL] I sure don't. She had me.
[AGENT][NEUTRAL] I was gonna see if that was I don't, um, you know if that's, um, considered a prescription jug.
[CUSTOMER][NEUTRAL] Yes, but I can take a shot once a month for me. I'm gonna they wanna take a shot. I'll take a uh take a, take the medication as prescription.
[AGENT][NEUTRAL] OK, let me see. Give me just a moment.
[CUSTOMER][NEUTRAL] Hormonial or hor hormones or something like that to take to keep the cancer from coming back.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's something they wouldn't administer that in the office, right? They would just give that to you, you would administer it yourself?
[AGENT][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] No, if I go out, they would have missed him if I go see them.
[AGENT][NEUTRAL] OK, but as long as it is considered a prescription medication. OK, so you have prescription um coverage under this policy. So I'd imagine it would just fall under that because it doesn't specify, you know, particular. Um, so per prescription, you have a benefit of, it's a $50 benefit towards any prescription.
[CUSTOMER][NEUTRAL] But if I take the pill, I gotta take the pill myself.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So do I need to call them and uh give my information in case I do cause they said I have to have that so they can get in contact with y'all some sort of way.
[AGENT][NEUTRAL] Sure, yes, um, I would always recommend seeing if they would file the claim on your behalf uh it really does depend on the provider sometimes they will sometimes they won't um if for some reason they won't, you can still file the claim yourself, but I would certainly see if they would just to save you that trouble.
[CUSTOMER][POSITIVE] OK then, so I'm gonna call them today then and uh give me your phone number so they can talk to y'all.
[AGENT][POSITIVE] Yes, so your policy number and then yes, we'd be more than happy to speak with them.
[CUSTOMER][NEUTRAL] OK, and another thing was, if I do get approved, I think I've seen somewhere they give the $20,000 I guess y'all pay up to $20,000 a year for my stuff.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For the um radiation and uh yes. So radiation, chemotherapy, and immunotherapy are all kind of in one bucket, and that's per 12 month period. So that would start as soon as you receive treatment. So the date that you first start, uh, it would pay up to that 20,000 for that 12 month period. And then if you have to continue it this time around next year, that would replenish. So it would be that additional 20,000.
[CUSTOMER][NEUTRAL] OK, because I know uh.
[CUSTOMER][NEUTRAL] I do have the chemo treatment that's for 9 weeks. They told me that. And I don't know how long those medications I have to keep taking.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] They didn't, they didn't specific sound. I can take a shot once my toe or take the pill.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So I got to give y'all the information.
[AGENT][NEUTRAL] That's fine. I mean, or they can if that's gonna be easier if they're going to give us a call anyway, uh, they can go ahead and just let us know all that we could kind of communicate that with them.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and what else I was gonna ask you, uh.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Now, I got another medical insurance for the school just so like when I go see the doctors and stuff like that there.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] They pay so much. So whatever let go that's the part y'all will pay.
[AGENT][NEUTRAL] Um, I'm not sure how, uh, your other coverages would work outside of this one. This one pays a set dollar amount regardless of other coverages that you have.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK then, well I appreciate you, ma'am. Let me call them right now so I can give y'all, I'll let information over to them.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] Absolutely did you have any other questions for me?
[CUSTOMER][POSITIVE] Thank you man.
[CUSTOMER][NEUTRAL] Now, will I get anything? I've seen some like get like $5000 lump sum or something like that. I don't know how true that is.
[AGENT][NEUTRAL] With the first diagnosis, yes. So, um, have you sent us a pathology report yet?
[CUSTOMER][NEUTRAL] Uh, like an itemized billing and all that stuff.
[AGENT][NEUTRAL] Um, the, uh, pathology report, so initially it'll be when they did like a, OK, yes, so, um, once that's.
[CUSTOMER][NEUTRAL] Oh yeah I've been did that.
[CUSTOMER][NEUTRAL] Come when they did when they did the cancer treatment on me the first time out the cancer treatment, they did the biopsy.
[AGENT][NEUTRAL] Right. So the first, uh, diagnosis of cancer, yes, with the biopsy. So once we have that and it's been processed, OK. So once it completes processing, then yes, you will get that $5000 lump sum benefit.
[CUSTOMER][NEUTRAL] Yeah, I've been at that.
[CUSTOMER][NEUTRAL] OK, that's why I sent y'all back here back in January.
[AGENT][NEUTRAL] Um, let's see. I don't show that we've received anything for January. I've got.
[AGENT][NEUTRAL] Something that we just received on the [PII] that is still being processed, so it's not completed processing it, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's out of my billing.
[CUSTOMER][NEUTRAL] And then y'all got the other stuff too. That was the itemized billing we sent to y'all [PII], [PII] is when I send all that off to y'all.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I'm not showing that it was the pathology report that we received, so that might need to be resent to us.
[CUSTOMER][NEUTRAL] So with prostate
[CUSTOMER][NEUTRAL] OK then, what I did, I went to see them on the [PII] again. I gotta go see them on the [PII], but I did go see them last week, and they gave me, that's what I tell me what do y'all need that billing for the radiation treatment? That's pathology thing as well too, so I will need that.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, so first thing we would need before anything else is going to be that pathology report, um, and then with the chemo or radiation, we need those itemized statements, um, showing those procedure, diagnosis codes, but for chemo and radiation, we also need um a copy of the primary explanation of benefits. So showing what your, um, major medical paid, but that's only for chemo treatment. Anything else, we don't need that.
[CUSTOMER][NEUTRAL] So you need the one I got last week from the radiation doctor and the one that showed that I do have, that was diagnosed with cancer.
[AGENT][NEUTRAL] The first diagnosis of cancer, yes.
[CUSTOMER][NEUTRAL] I know that's the one I sent. I sent in some in February. I know that much.
[AGENT][NEUTRAL] Well, I see that we received some, but I'm not showing that it was the pathology report.
[CUSTOMER][NEUTRAL] And that was
[CUSTOMER][NEUTRAL] OK, your problem is not showing up, but that's what I did though.
[AGENT][NEUTRAL] And if it's easier if it's easier, um, they, the, uh, physician or the provider can send that to us as well. We have a fax number, um, they're more than welcome to send it to us if that's easier.
[CUSTOMER][NEUTRAL] OK, I do the, OK, the bookkeeper lady, she, uh, when I took my stuff, when they gave me all this stuff when I was diagnosed with it and they did the, you know, to find out I had cancer to show where I was at.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's the paper I'll send y'all in February.
[AGENT][NEUTRAL] They said they sent it to us?
[CUSTOMER][NEUTRAL] The pathology also he.
[CUSTOMER][NEUTRAL] No, I sent it in February.
[AGENT][NEUTRAL] Oh, OK, yeah, I'm not showing that we received that.
[CUSTOMER][NEUTRAL] I said what.
[CUSTOMER][NEUTRAL] Yeah, I'll send a bunch of stuff over to y'all. [PII], pull up some.
[AGENT][NEUTRAL] Well, now and again.
[AGENT][NEUTRAL] Yes, so I see some, uh, that we received [PII], but then I also see one but, um, [PII], and now that one is still processing, so I don't see what that one is, so maybe that's it.
[CUSTOMER][NEUTRAL] There you go, that's it.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, the one, the first one was for.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Like you said, the pathology was sort of showing that I did have, I was diagnosed with cancer. The one you saw from the the [PII], that was from the uh the uh the itemized bill they wanted for.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let's see, give me just a moment. Let me verify that for the [PII]. I just wanna make sure that that's.
[CUSTOMER][NEUTRAL] Definitely. OK. Now,
[AGENT][NEUTRAL] We got that.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, so.
[AGENT][NEUTRAL] We would need
[AGENT][NEUTRAL] OK, so for these notes from this one, we would need your past medical history, so we had mailed out a form. If you haven't gotten it already, you should be getting that soon in the mail um.
[CUSTOMER][NEUTRAL] I did that already.
[AGENT][POSITIVE] You did awesome OK cool sorry about the confusion so yes once we have that sent back and that's been processed, this should be all good to go.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] That's all that that that medical thing that was all with that uh itemized bill that was in there with that too.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Perfect. OK, well, I think we're good to go then. I'm sorry about that confusion.
[CUSTOMER][POSITIVE] So you're good to go and everything right now, right, for them to find yourself in the next week.
[AGENT][NEUTRAL] Looks like it, yes, so that information, um, from [PII], it has been received and is in line for processing, um, and so once that's completed, um, then you should receive that lump sum benefit amount.
[CUSTOMER][NEUTRAL] If I'm approved for it right.
[AGENT][NEUTRAL] I mean, as long as we've got that diag the positive diagnosis of cancer with that uh pathology report, um, then yeah, you, there's no, yeah, you should be fine.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So that's [PII]. I know it someday y'all see that. I thought it was [PII], but it was [PII]. Yeah, y'all got all that and then the.
[AGENT][NEGATIVE] Well, that might have been when we did receive it, depending on how it was sent, it could have taken a while for it to actually have gotten to us.
[CUSTOMER][NEUTRAL] And that's when they called me back and said they needed an itemized billing and uh something when I would see them again, so I sent them all that.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, yeah, I think we're good to go for now. If you wanted to give us another call, um, sometime this week to check on this claim, um, then it should be done here in a little bit. It should be completed processing I'd say maybe by Wednesday, so you could give us a call back, kind of check on that, make sure it's all good, uh, and then we can let you know if for some reason there's anything additional that we need.
[CUSTOMER][NEUTRAL] I got all that already.
[CUSTOMER][NEUTRAL] OK then.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, so I'm gonna go ahead and call them so they can send you the rest of that stuff over as well too.
[AGENT][POSITIVE] Yes sir sounds good.
[CUSTOMER][NEUTRAL] Hold on let me get y'all fax number for y'all. Hold on let me get your fax number.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] I'm gonna have the fax number.
[AGENT][NEUTRAL] OK, that fax number is 877.
[CUSTOMER][NEUTRAL] That that, go ahead.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][POSITIVE] 942 3. All right, thank you, ma'am.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] You are very welcome. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, it was this I can get them call and send the rest of this stuff over when all he told me about that. OK then.
[AGENT][POSITIVE] Sounds good.
[AGENT][POSITIVE] All right well thanks for giving us a call. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too, ma'am.
[AGENT][POSITIVE] Thank you. Bye bye.
[CUSTOMER][NEUTRAL] OK