AccountId: 011433970860
ContactId: 759acc6c-b289-4d0c-9c2f-bc89c386af49
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1079099 ms
Total Talk Time (AGENT): 254184 ms
Total Talk Time (CUSTOMER): 509507 ms
Interruptions: 7
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/759acc6c-b289-4d0c-9c2f-bc89c386af49_20250219T16:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL this is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, hi, [PII]. My name is [PII]. I have a basic question. Um, um, I'm a, I was a beneficiary for my brother who had insurance with you for American Public Life, I believe it's a cancer care.
[CUSTOMER][NEUTRAL] Um, insurance, APL.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, he passed away in August and I've never followed up on it. Um, I called one time right after, but you guys said you guys didn't receive the faxes that came that we sent. However, I have the, um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have the claim form, a protective health information form. I, I have copies of some things, but anyway, um, I had requested his um place of, of treatment to, uh, fax everything to you while I was a durable power of attorney. However, he's passed away, so I don't know how to get my hands on what you guys needed to complete these, these claims.
[AGENT][NEUTRAL] OK, um, I can help you with your claims questions. Can you please uh give me your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then can you spell your first name for me please and your last name?
[CUSTOMER][NEUTRAL] Yes, [PII] Last name is [PII]
[AGENT][NEUTRAL] OK, and then what is your brother's name and policy number?
[CUSTOMER][NEUTRAL] Um, [PII], that's [PII] Last name is [PII] A. Policy number, I believe there was two, there was a new policy, um, new policy 91 of 23 change, no loss in coverage. Hold on, I'm reading my, my notes here. It says um.
[CUSTOMER][NEUTRAL] Um, policy for APL ID is 242-6917. Group number is 1829.
[CUSTOMER][NEUTRAL] 6
[AGENT][POSITIVE] OK, thank you so much for that information.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look up the policy real quick.
[AGENT][NEUTRAL] OK, and can [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Yes, it's um [PII], I believe.
[AGENT][POSITIVE] OK, thank you very much.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, let me look at the notes on this policy real quick so we can see where we might be as far as the claim.
[AGENT][NEUTRAL] It's
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][NEUTRAL] Yes ma'am, I'm looking at the policy notes real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] I apologize. All right.
[CUSTOMER][NEUTRAL] It's OK. You were cutting out a little bit, so.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Uh, yeah, my phone's been acting kind of crazy this morning. The weather outside is terrible, so I think that has something to do with it. um, now when did you report, uh, you said you reported a claim back in August, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, yeah, he passed away in August and I called in, I don't know, like in September, I think, and there were two policy numbers. Um, I remember they told me there were two policy numbers. I have another one as well, the 242-6917, and then there was another one originally 02078422.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me look at the other policy because the only one, the only thing I show on the on this number that you gave me was uh where you send in your power revenue, so let me look and see if there's something on the other policy for you.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, we also sent in the beneficiary form.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We faxed that on, um.
[CUSTOMER][NEUTRAL] In July, on [PII] we faxed it.
[CUSTOMER][NEUTRAL] We fax it with a copy of the durable um power of attorney.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so you're still wanting to file claims on this policy for the dates of service when he was active, is that correct?
[CUSTOMER][NEGATIVE] Right, right. Because he never did. So I was the one covering all that for him, but I've been pretty much mourning all this time and just didn't wanna do anything.
[AGENT][NEUTRAL] Um, on the policy. OK. All right.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] And now I've got stuff coming up, so I figured he could, he could use all that, you know.
[AGENT][NEUTRAL] Yes ma'am, I understand.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I took care of him for the last 4 years. I just can't believe he never filed any claims.
[AGENT][NEUTRAL] So what
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, especially since he had such a good policy, um, what I'm going to do since we don't have any claim information at all, I'm first going to refer you to our website, um, let me give you that number.
[AGENT][NEUTRAL] It's
[CUSTOMER][NEUTRAL] OK, hold on, let me write this down. Hold on please.
[AGENT][NEUTRAL] Oh, the website address, yes.
[CUSTOMER][NEUTRAL] OK, I can't find a piece of paper when I need one, and I'm in an office. Does that make any sense? I'm in my office. Hold on please.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Like that work bags I've got all kinds of stuff that um here we go I got it.
[CUSTOMER][NEUTRAL] OK, so what is the website for though?
[AGENT][NEUTRAL] So you can get the claim form.
[CUSTOMER][NEUTRAL] Do I have to do everything online? OK. Well,
[AGENT][NEUTRAL] You
[CUSTOMER][NEUTRAL] I had one. I, I have the claim forms here. Let's see protective health. This is an authorization to disclose. I don't know what that is.
[AGENT][NEUTRAL] Oh, you do?
[CUSTOMER][NEUTRAL] So it's got his name.
[AGENT][NEUTRAL] That's a HIPAA authorization.
[CUSTOMER][NEUTRAL] OK, so we signed that and then we got um.
[CUSTOMER][NEUTRAL] Hold on, where's all my stuff at? I got too many things on my desk.
[CUSTOMER][NEUTRAL] Then we have the um
[CUSTOMER][NEUTRAL] Instructions to change beneficiary form. We have that we faxed that on [PII] with the durable power of attorney.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Hold on, cause I have folders for everything separately cause I know that I did it. I had, I had his medical provider fax things over, but apparently, one of your representatives told me that you guys never got it.
[CUSTOMER][NEUTRAL] So, um, it was, it was Texas Oncology that faxed medical records on [PII].
[AGENT][POSITIVE] Correct. I'd, right.
[AGENT][NEUTRAL] OK, so I do not see anything that has been submitted for claims at all. Um, what that's why I wanna refer you to the website because you'll have to fill out a claim form to submit the claims and then all of the.
[CUSTOMER][NEUTRAL] Right, but I have, I have this and we did submit it, ma'am. We did submit it. We submitted it on [PII], a cancer claim form that I completed from him on July, um, on [PII], he signed it, but we sent it out on [PII], OK? And that was, I listed on their chemo surgeries, radiation, or any immunotherapy. He signed it and we faxed that over as well. Um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I went, I went to the Texas oncology.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And requested them to fax everything to you guys and I was able to do all that because I was his durable power of attorney however, now he's deceased, so I don't know how that works. I don't know if if you guys have to request it because if I go in there and request anything, I don't even live there to begin with. I live in [PII], OK, so if I go in there and request anything, they're not gonna give it to me. My brother is deceased, so my, my durable power of attorney is out the window.
[AGENT][NEUTRAL] So what's your
[AGENT][NEUTRAL] OK, so what I'm gonna do is I'm gonna send in a request for somebody from the cancer claims department to give you a call back and instruct you on what your next steps are.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, wonderful.
[AGENT][NEUTRAL] OK, it's gonna be a brief hold while I get that request in for you.
[CUSTOMER][POSITIVE] Wonderful, yeah, I don't.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're very welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK Ms. [PII], I have that request in with some good notes for the claims department and they should be calling you back within the next 24 hours to advise you as to what step you need to take next, OK?
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and, and I do have also, I hadn't, I, I kept, I, I kept copies of everything I faxed and I also have um the fax that went out to you guys um.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, we, American Public Life, yeah. I have the form that, um, he signed for all his medical records to be sent to you guys, and that was, that was requested on, um.
[CUSTOMER][NEUTRAL] What day was this? Let me see, we faxed this.
[CUSTOMER][NEUTRAL] This fax was [PII] as well.
[CUSTOMER][NEUTRAL] And it was and we took this directly to um.
[CUSTOMER][NEUTRAL] It was a disclosure protected health information release form. American Public Life, um, we took it to the cancer center.
[AGENT][NEUTRAL] OK, all right, and we didn't.
[CUSTOMER][NEUTRAL] Sure did and he signed it and
[CUSTOMER][NEGATIVE] Yeah, and we left that there we gave them this form and for them to um and they, they fax and mail we requested both fax and mail and um apparently um you guys didn't get anything.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Correct. um, yes, I do not see anything coming from the facility itself. When the claims examiner calls you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right, because they couldn't give them to us. Mhm, right, apparently they couldn't give them to us there because we went up to the medical record department at the cancer center and they said that um they would, they would, they would mail and fax everything over with this form, this disclosure form.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Right, I understand that. um, please let the claims examiner know all of the documentation that you have to be able to obtain medical records so that they know that you have everything in order, um, when they call you back and then they can advise you on your next steps as to what to do for the medical records or if they can request them. I'm not sure, but we'll, we'll get you some help for, for sure.
[CUSTOMER][NEUTRAL] So I don't know.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because at this point,
[CUSTOMER][NEGATIVE] I know that they're not gonna help me.
[CUSTOMER][NEUTRAL] I think I, I was told that once I'm sorry, something went down wrong.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I was told that once the um the individual is deceased, um, the durable power of attorney is out the window so I can't request anything at this point.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Right. And let them know that, but do let them know that you have signed um medical release forms and HIPAA forms um that he signed before he passed away.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So medical release forms and HIPAA forms.
[CUSTOMER][NEUTRAL] OK. Yeah, and also the beneficiary forms. I have that as well. Um.
[AGENT][NEUTRAL] OK, yes.
[CUSTOMER][NEUTRAL] I guess it's time for me to get back on this because what happened was, I was, uh, we were trying to get everything in order and he passed. So, um, we didn't get the will signed. We, uh, he made, he was trying to make me be the beneficiary for everything so I could handle all his business. Well, now everything's coming back on me and um
[CUSTOMER][NEUTRAL] I have put this all aside due to family members.
[CUSTOMER][NEGATIVE] But now it's like I have to jump on it again, you know, I had just paid for everything, but now bills are coming at me that he owed. So it's like I need to handle this, you know, I can't let what everybody else thinks or does affect me and keep doing what I was supposed to do for my brother. So yeah.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] All right. So, somebody should be calling me then, right? Within 24 hours, you said? All right. All righty then. I will wait for that phone call. Thank you so very much and you've been very helpful. Thank you.
[AGENT][NEUTRAL] Yes. Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Yes, this birthday.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. You have a blessed day and thanks for calling APL.
[CUSTOMER][POSITIVE] Thank you you as well bye bye.
[AGENT][NEUTRAL] Bye bye