AccountId: 011433970860
ContactId: 7d9bf26b-2b79-4102-b5c7-7d1c4d7d2750
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 673320 ms
Total Talk Time (AGENT): 253289 ms
Total Talk Time (CUSTOMER): 235529 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/7d9bf26b-2b79-4102-b5c7-7d1c4d7d2750_20250220T23:21_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL this is this is [PII] how may I help you?
[CUSTOMER][NEUTRAL] Yes, I have a question. I am with the school district and I have a.
[CUSTOMER][NEUTRAL] I guess the low plan of cancer um coverage with you guys and I've been on the web.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] I said, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I I've been on the website and I'm trying to look at like what exactly is covered. Can you tell me is, is any kind of I saw that with uh I don't even oh gosh I've looked at so many times now I'm looking at I feel like I've been reading a different language um I know that with one of the.
[AGENT][NEUTRAL] Oh yes.
[CUSTOMER][NEUTRAL] I think it was one of the [PII] things that it was only internal cancer like skin cancer was not covered is that with all of the policies?
[AGENT][NEUTRAL] No, ma'am. Each um policy can be different. Can I get your name and your callback number and I can um also read through the policy with you and see.
[CUSTOMER][NEUTRAL] I guess with
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, yes, my name is [PII]
[AGENT][NEUTRAL] OK, and Miss [PII]
[CUSTOMER][NEUTRAL] When me and my cell is.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] That's OK, go ahead.
[CUSTOMER][NEUTRAL] Phone number is [PII].
[AGENT][NEUTRAL] OK, and then what is your policy number, please?
[CUSTOMER][NEUTRAL] My what?
[AGENT][NEUTRAL] Your policy number?
[CUSTOMER][NEUTRAL] I, I don't even know where I would find that. I have, I don't have a card or anything. I'm just on our benefits plan with the school district, so I don't even know where I would find that. I just have the.
[AGENT][NEUTRAL] OK, I can.
[AGENT][NEUTRAL] I can look it up with your social security number if you'd like to give that to me it'll pull your policy in for us.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] 79
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me pull up your policy.
[AGENT][NEUTRAL] OK, Ms. [PII], can you please give me uh your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then also for security reasons we'll need to verify your address, phone number and email address that's on the policy.
[CUSTOMER][NEUTRAL] OK, the address is [PII].
[CUSTOMER][NEUTRAL] And then you said phone number?
[AGENT][NEUTRAL] Yes, the number you gave me, is that, uh, your cell phone number?
[CUSTOMER][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] Is that also a good number to call you back on if we get disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, and then one last verification can you give me your email address? It looks like I have your work email.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much, Ms. [PII]. Let me pull in your policy.
[AGENT][NEUTRAL] And see what it reads as far as internal and skin cancer.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Have you been, um,
[AGENT][NEUTRAL] Diagnosed
[CUSTOMER][NEUTRAL] Yes, I had gone in for a routine, um, just screening with the dermatologist that I do every year and they found a spot on my head that they biopsied and it came back that it was that it needed to be removed so that I'm scheduled to do that procedure and that's why I'm wondering if this policy can help me cover any of the cost of that.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Did they give you the name? Did they name it?
[CUSTOMER][NEUTRAL] The, I believe it's a it was a basal cell.
[AGENT][NEUTRAL] Basal cell, OK.
[AGENT][NEUTRAL] Alright, let me keep looking.
[AGENT][NEUTRAL] It's a big policy.
[AGENT][NEUTRAL] I haven't seen anything yet about skin cancer, but I'm not all the way through it yet, but I'm going to keep looking. Um.
[AGENT][NEUTRAL] OK. So it did, they did do, like you went in and they, did they do a cancer screening on you because you do have a screening benefit.
[AGENT][NEUTRAL] For diagnostic testing.
[CUSTOMER][NEUTRAL] OK, yeah, and.
[CUSTOMER][NEUTRAL] So I, I went in and they just did like where they just did the screen and when they were looking at my head, the dermatologist found a spot that then she did a scrape and they sent out for a biopsy.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What I might do.
[AGENT][NEUTRAL] I go ahead and transfer you on over to the uh cancer department.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claims where they actually read the test and the claims that come in.
[AGENT][NEGATIVE] And they might be able to help better because I'm like you, I'm not seeing anything.
[AGENT][NEUTRAL] Other than
[AGENT][NEUTRAL] Internal on this policy, but I don't wanna tell you the wrong thing if there might be something in here that they'll be able to notice that we can't um but I'm reading it the same way that you, you did.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, because I saw the internal and then I saw unless it was a melanoma at a certain depth and I was like that didn't apply so then I was like OK I just need to ask.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, yes, OK, well I'm gonna go ahead and transfer you on over to the cancer claims department and let somebody over there, uh, advise on this policy as to and let let you explain to them what you had done and see if this policy will help with anything, OK?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] OK, thank you so much for your help.
[AGENT][POSITIVE] You're welcome miss [PII] you have a blessed day and thanks for calling APL it's gonna be a brief hold.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Calling APO, this is [PII]. How may I assist you today?
[AGENT][NEUTRAL] Hi [PII], this is [PII]. I've got an insured on the phone. Her name is [PII], and she's been diagnosed with cancer. She had a, well, not diagnosed internal cancer, but we've been reading over her policy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, first, let me give you her policy number. It's 2527823.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And she's been verified and the number she's calling from is a good callback number.
[AGENT][POSITIVE] She had a spot on her head.
[AGENT][NEUTRAL] That they scraped and it came back cancer and she has to um have it removed.
[CUSTOMER][NEGATIVE] So basically skin cancer.
[AGENT][NEUTRAL] And we're reading where, yeah, basically skin cancer. But then there's a part in the policy that says it has to be so deep and so wide, and, and I wanted her to talk with you guys because the cancer um
[AGENT][NEGATIVE] They just confused me and the way the wording is, it's very confusing for me and I wanted to just.
[CUSTOMER][NEUTRAL] Well, basically, um, that means that um
[CUSTOMER][NEUTRAL] If it's so deep and um then it could be considered internal cancer, but we wouldn't know until we get the pathology report. And the best rule of thumb when you get calls like that is
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So just let them know that they need to submit the pathology report for a review with the examiner and that kind of like gets.
[CUSTOMER][NEUTRAL] You know, not get off the hook, but we just can't process over the phone and we just can't tell them, yes, this is what it's gonna be because we don't have eyes on the pathology report. So basically that's what I'm gonna let her know. But just if you have any, any future calls like that, like we just can't, we can tell them what the policy says and that once we get the um pathology report and review it, then we'll know further.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] I thank you [PII]. Thank you so much for teaching me that because I've been sitting here trying to figure it out with her because you know you want them to have help, but I mean.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yeah, exactly, yeah.
[AGENT][POSITIVE] Thank you, I appreciate you. All right you too bye bye.
[CUSTOMER][POSITIVE] Yeah. OK. Have a good day.
[CUSTOMER][NEUTRAL] Mhm.