AccountId: 011433970860
ContactId: 76523340-22ef-4dc6-ba61-33b3a6de8120
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 763460 ms
Total Talk Time (AGENT): 314475 ms
Total Talk Time (CUSTOMER): 396204 ms
Interruptions: 3
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/76523340-22ef-4dc6-ba61-33b3a6de8120_20250408T16:15_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh yes, ma'am. Uh this is [PII] and I have a, a cancer with a writer on it policy. Um, I have a question. Um, do you need my information before we start, I guess.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am. Ms. [PII], can you please give me your callback number first just in case the call is dropped or disconnected, I can call you back.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Thank you. And then what is your policy number?
[CUSTOMER][NEUTRAL] OK, my oops, OK.
[CUSTOMER][NEUTRAL] I just had it up.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] I'm sorry. I just had it up and um sometimes it's hard, OK, the policy number is
[AGENT][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] 02088763
[AGENT][NEUTRAL] OK, let me look that up real quick, Miss [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I've got you pulled up right now um I'll need for you to your policy, can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Uh yes, not uh uh [PII].
[AGENT][POSITIVE] Oh thank you.
[AGENT][NEUTRAL] And what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] I'm sorry, you said the address and.
[CUSTOMER][NEUTRAL] What else did you need?
[AGENT][NEUTRAL] Your address, email and um phone number that we have on the policy.
[CUSTOMER][NEUTRAL] Oh, my email.
[CUSTOMER][NEUTRAL] [PII] and then my email is [PII].
[AGENT][POSITIVE] Thank you very much for verifying your policy for me. OK, so you're calling today because you have questions, how, what questions do you have?
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK, um, I, my husband passed away in January. He's been on the on the policy for a long time, and I am trying to file some things, claims on him, but I'm just now getting back, you know, and when I go in to, um,
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] You know, sign in, um, to try to pick, you know, I, I guess I'm going to be filing a wellness claim, but it will not let me pick him because it says that he's, you know, he's, he's no longer on the policy, which
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] You know, he isn't because he's passed away. So how do I file those?
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Uh, you can file it, um, you can send it by fax. I can give you the fax number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Or if you wanted to send it in by mail, let me give you the mailing address.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so there's not gonna be, I don't have fax, um, I mean, I'm retired so I don't have a fax number, so there's no way to do it electronically. I'm gonna have to mail it all in, is that correct?
[AGENT][NEUTRAL] Right. Since he's no longer active on the policy, you'll have to mail it in.
[CUSTOMER][NEUTRAL] Uh, OK.
[AGENT][NEUTRAL] OK, and the, um, that's OK. The claims mailing address is [PII].
[CUSTOMER][POSITIVE] OK, I'm sorry.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] 0
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII] OK.
[AGENT][NEUTRAL] Yes, and that's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] OK.
[CUSTOMER][NEUTRAL] OK. So, oh man, that makes it a lot harder, doesn't it, to do that because of the fact that um um there's nothing electronically. So, um, in that case, when they have questions, are they gonna call, are they gonna contact me by email? Or am I, is this all going to be through the mail?
[AGENT][NEUTRAL] It's gonna be through the mail um now there is a way let me see, there may be a way you can go in and click claims um and forms in the online service center and then click on your policy that you have and you won't be able to pull up information on him because he's lapsed from the policy but you may still be able to file the claim.
[AGENT][NEUTRAL] And just put his name on all the information.
[AGENT][NEUTRAL] That you need to file you can try it that way before having to mail everything in.
[AGENT][NEUTRAL] Since the policy is still active.
[CUSTOMER][NEGATIVE] OK, because this just because this goes down.
[AGENT][NEUTRAL] Under your name
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so I'm going down where you're saying file claims online, sign in, register, OK. Other ways to to claim fa, documents, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Or mail. And so it says download and complete the appropriate form.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] You're saying, I'm sorry, can you repeat what you tell me to do once I go to the forms.
[AGENT][NEUTRAL] You're gonna fill out all of his information. Um, he is part two on the policy.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So you'll fill out all of his information on the claim form and you should still be able to send it through the online service center and when they see his name rather than yours they'll understand that it's for part two and it's for claims that happened before his passing when he was still active on the policy.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I'm going to print out those for what you're saying is probably print them out.
[CUSTOMER][NEUTRAL] And fill them out.
[AGENT][NEUTRAL] Yes, and then upload them.
[CUSTOMER][NEUTRAL] And then go back.
[CUSTOMER][NEUTRAL] Just upload them under um after I've signed in just where it says up I'm sorry, go back to where it just says upload files, upload documents do that. OK, OK, I may try that and see just it's just a pain to go.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Yeah try that and see if it works for you.
[AGENT][NEUTRAL] And then what you can do is if you're doing it today, uh, give it 24 hours and call us back and let's make sure that we received the claim just to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 00.
[CUSTOMER][NEUTRAL] OK. I'm, I'm, I'm sorry, I lost, do you hear me?
[AGENT][NEUTRAL] OK, my phone glitched for a minute. I apologize, yes, I can hear you, but give it 24 hours and.
[CUSTOMER][NEUTRAL] Can you hear me?
[CUSTOMER][NEUTRAL] Can you hear me OK?
[AGENT][NEUTRAL] I can now yes ma'am, um, give it 24 hours and call back and let's just make sure that we received it from the online service center so you could just call in and say I'm just checking to make sure you received my claim on part two.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right. OK. And when you say part two, that's
[AGENT][NEUTRAL] And we'll, we'll double check it.
[CUSTOMER][NEUTRAL] That part two is just referring to my husband, right? That part 2 means.
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, you're part 1 and he's part 2.
[CUSTOMER][NEUTRAL] OK, well, I might try that.
[CUSTOMER][NEUTRAL] OK, OK, well I may just do that and start off with, with that and see um see what it does and then um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I know some of it I'm, I'm not sure like he had a heart attack, but how I'm going to file that claim, um.
[CUSTOMER][NEUTRAL] I, I know they talked about it in the hospital that um at some point, I don't know that they pinpointed the exam, uh when he came in, if it happened after he got there, or if it happened right before he got there, when the heart attack happened. But I'm not sure how I'm going to uh put back up for that. And, and, you know, I don't, I'm not sure if I'm gonna have to have
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] A statement from the doctor, um, going through and I don't know if doctor reports are gonna have that.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, um, so what you'll need to do is on the claim form that first page is a good cheat sheet that tells you everything you need to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So you look at the cheat sheet the that first page and they'll tell you what you need to to turn in with.
[AGENT][NEUTRAL] Um, I know you're gonna need your itemized statement that has the um procedure codes and diagnosis codes. You'll need that from the facility, the hospital.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I'm pro I mean, I don't think any of that shows up on all my insurance stuff. I guess I'm gonna have to.
[CUSTOMER][NEUTRAL] Go back to the hospital and ask them for that possibly.
[AGENT][NEUTRAL] Yes, ma'am. Yes, ma'am. Now, if you file this on your uh regular insurance, you can get the explanation of benefits from your primary insurance carrier. They may send that to you and it also tell everything that's been done.
[CUSTOMER][NEUTRAL] OK, I know. OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Maybe I can dig deeper into that. I, you know, I just don't know. I, it seems like I glanced through that one time, but I don't know that it had, I can't remember having diagnosis codes and doctor notes and all that stuff. I don't, I don't remember it having, having that on that part. So, um,
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Anyway, I will, I will just start with that and see. I know if he was in the hospital for his heart, I know we had two ambulance calls, which I know to file that, and he was in intensive care, and then the step-down intensive care, and I guess that would show on the explanation of benefits that the heart attack portion uh is gonna be the tricky one, I guess.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, that's um where the uh itemized statement comes in because it will have the diagnosis and the procedure codes.
[CUSTOMER][NEUTRAL] OK. Procedure codes on the heart attack. I'm not sure how that works. Anyway, I will, I'm sure I'll be calling back to figure out some of this stuff, but um anyway, OK, I will, I will start with that and see if I can't get it this uploaded at least to get it started.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes ma'am and then um in the online service center if there's any um addition.
[AGENT][NEUTRAL] It will send you uh.
[AGENT][NEUTRAL] Messages to let you know if there's anything else we need. It also will send you a message, a confirmation number to show that the claim was received too as soon as you submit it you should get a confirmation number also.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, OK, so that may be how I'm gonna know they got it, but I will, that makes sense because that's what I've done on my other stuff I've seen that on my other stuff so OK well I will start with that. I just thought, OK, it's not letting me letting me put his name so I wanted to make sure.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, ma'am. Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. All right. Well, Miss [PII], is there?
[CUSTOMER][POSITIVE] Thank you so much for your help.
[AGENT][POSITIVE] Oh, you're so very welcome and if you find that you get stuck or you need more help just please pick up the phone and call us, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] All right. You have a wonderful day, Miss [PII]. Is that all I can help you with before we go?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, well, you take care and thanks for calling APL.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Bye-bye, ma'am.