AccountId: 011433970860
ContactId: 79cb5f68-8ff6-4247-8ea4-fb7e1df03b04
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 386890 ms
Total Talk Time (AGENT): 173283 ms
Total Talk Time (CUSTOMER): 177232 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/79cb5f68-8ff6-4247-8ea4-fb7e1df03b04_20250522T20:23_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], this is [PII] on the care team. I wanted to get your input on this claim that I'm looking at. Um, I think, what's your last name?
[AGENT][NEUTRAL] Boys.
[CUSTOMER][NEUTRAL] Oh, OK, who's [PII]?
[AGENT][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] is that [PII] or [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII], that's it. OK, well, maybe you can help me though. This one's kind of funky because we're looking at a cancer claim and it's not, uh, let me give you the policy number if you don't mind.
[AGENT][NEUTRAL] Certainly, go ahead.
[CUSTOMER][NEUTRAL] 247-709-0.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This is one of the
[CUSTOMER][NEUTRAL] [PII]'s customers, so I know he's one of our heartbrokers, um, trying to help her out and figure out what we can do, um.
[CUSTOMER][NEUTRAL] Uh, OK. So, so her husband's been recently diagnosed with a leukemia. OK. And so we have a note in there that we need the pathology report, but because it's leukemia, which is a blood cancer, there is no pathology report, like they don't do tissue. They only determine the cancer by way of a blood test.
[CUSTOMER][NEUTRAL] Um, which is what she submitted.
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] Sorry about that, um, [PII], what's that policy number again? I couldn't pull it up. 02.
[CUSTOMER][NEUTRAL] 0, uh 247-709-0.
[AGENT][NEGATIVE] That's what I put in it's not coming up.
[AGENT][NEGATIVE] Could be, you know, something's wrong with my lion one of them spinning around and I opened another one and now it's giving me some funky message.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEGATIVE] Yeah, I'm not, it's not moving for me.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Bear with me for just a moment let me see if I can open another window. I don't know what's going on with it.
[AGENT][NEUTRAL] I'm getting a weird message saying some kind of internal error.
[AGENT][NEUTRAL] Session was timed out so.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] I don't know what's going on, sorry.
[CUSTOMER][NEGATIVE] And we, yeah, I've had problems here and there with line too sometimes it's funky.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well they're doing there's a lot of behind the scenes stuff going on too so.
[AGENT][NEUTRAL] I guess that's understandable.
[CUSTOMER][NEUTRAL] I know, yeah.
[AGENT][NEUTRAL] OK, I got it. [PII], right?
[CUSTOMER][NEUTRAL] Yep, and it's for [PII].
[AGENT][NEUTRAL] For part two, yeah, OK.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Just wanted to get your opinion on this because it's not, so it's leukemia and it's blood cancer, so it's not an actual like tissue pathology report that diagnosis the cancer. It's the flow cytometry, which she attached. So basically how she explained it is.
[CUSTOMER][NEUTRAL] You know, he went in, they did a bunch of lab work.
[CUSTOMER][POSITIVE] You know, he came back with abnormal lab work, blood work, and then this flow cytometry is the one that is the definitive.
[CUSTOMER][NEUTRAL] Says, yes, you've got leukemia.
[AGENT][NEUTRAL] I'm pulling up the documents.
[CUSTOMER][NEUTRAL] So it's not
[CUSTOMER][NEUTRAL] Not an actual pathology report of tissue, it's a blood.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Test that is the, you know.
[CUSTOMER][NEUTRAL] The final test that determines, you know, definitively this is.
[AGENT][NEUTRAL] Like what stage or?
[CUSTOMER][NEUTRAL] Oh, sorry, uh, page.
[CUSTOMER][NEUTRAL] Uh, it's page 7.
[AGENT][NEUTRAL] Well, now, [PII] has a note in here this, this morning, she called the patient. Phone insured, it will sign claim form, no answer. Insured needs to submit pathology or blood specimen report that first diagnosed the cancer. So she did reach out and try to contact the patient regarding this, and that was [PII]'s note on the claim. When I pulled up the claim documents, she's got a sticky note on there. So she's saying that that's what's needed.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, so there's another blood specimen uh test, I guess then that.
[AGENT][NEUTRAL] That's what she's saying, the blood specimen report that first diagnosed the cancer.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, I'll see then if she can. It's just the member was saying that this is the one that actually says yes he's got the CLL, whereas the other ones are just saying abnormal abnormal we need to.
[CUSTOMER][NEUTRAL] You know, look further or whatever so I'll see if she has.
[AGENT][NEUTRAL] You said.
[AGENT][NEUTRAL] Right. And then she's got another note on here actually just at [PII], new patient lymphoma clinic, newly diagnosed with chronic lymph uh lymphocytic leukemia needs a pathology report for that first diagnosis diagnosis of cancer.
[AGENT][NEUTRAL] So there's
[CUSTOMER][NEUTRAL] OK, I'll see if she can send the other. I don't see the sticky note. Where's the sticky note?
[AGENT][NEUTRAL] I pulled up the claim documents associated with that claim that was processed, the 36045997.
[AGENT][NEUTRAL] Which was uh
[AGENT][NEUTRAL] Latest claim number.
[AGENT][NEUTRAL] I pulled up the documents in OnBase and and when you pull it up that way you'll be able to see the sticky notes if you do it from the hyperlink and lion, it doesn't show you those notes and sometimes you have to search for them if they're available but I've noticed this the screen is a little wonky.
[AGENT][NEUTRAL] So when I wanna look at the documents I go to Onase and pull it up by that mail number because then you can see the whole picture and you can also put it in by it it's also if you're looking just like for an FYI if you're looking for like an email inquiry or something like that, any uh any documents that we might have received, you can look at them through Onase by putting in just the policy number and it'll bring up all the documents attached to that uh to that policy number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK perfect well I didn't know that. No wonder I can't see it. Well, I'm gonna have to look um.
[CUSTOMER][NEGATIVE] What are you talking about? I don't see what you're talking.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK perfect. OK, I'll let her know to submit the original lab work um and then we can go from there. OK, thank you so much. I appreciate you.
[AGENT][POSITIVE] Yeah, and that's right. No problem, anytime, [PII].
[CUSTOMER][POSITIVE] OK thanks bye.
[AGENT][NEUTRAL] Alright bye.