AccountId: 011433970860
ContactId: 84a52bdd-065c-4ac7-aaac-1a4bae361f0f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 531630 ms
Total Talk Time (AGENT): 244674 ms
Total Talk Time (CUSTOMER): 120625 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/84a52bdd-065c-4ac7-aaac-1a4bae361f0f_20250227T14:24_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yeah, my name is uh [PII]. I was checking the status of my paperwork.
[AGENT][POSITIVE] OK, I'm sure I can assist you with things. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And may I have the policy number?
[CUSTOMER][NEUTRAL] 256.
[CUSTOMER][NEUTRAL] 6030.
[AGENT][NEUTRAL] Thank you. And I need to verify your date of birth, mailing address and email address.
[CUSTOMER][NEUTRAL] OK, date of birth [PII] email.
[CUSTOMER][NEUTRAL] [PII]. [PII].
[AGENT][NEUTRAL] OK, we have the 905 North Buckley. Is that correct?
[CUSTOMER][NEUTRAL] Yeah, OK, I'm sorry, 905 no I broke it. Yeah, I had a PO box too, yeah, that's right, yes sir.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] 970.
[AGENT][NEUTRAL] And this is a claim for the cancer?
[AGENT][NEUTRAL] Policy.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Um, let me see, looks like um the last thing we received was on [PII] and it was processed [PII]. Um, let me check and see what's the decision. Let me pull these papers. One moment.
[CUSTOMER][POSITIVE] OK, take your time.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Do you mind if I put you on a brief hold while I go through it?
[CUSTOMER][NEUTRAL] Go ahead, ma'am.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding and being patient for me, Mr. [PII]. OK, so it looks like we sent a request for medical records from Doctor [PII] and this was, um, sent out on the [PII]. So we're waiting for the um.
[CUSTOMER][NEUTRAL] Uh, yes, yeah.
[CUSTOMER][NEUTRAL] OK, let me put you on 2 ways so you can tell them what you need.
[AGENT][NEUTRAL] Or the right, OK.
[CUSTOMER][NEUTRAL] Let me call and put them on 2 on 2 way ma'am.
[CUSTOMER][NEUTRAL] Hold up.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me have the call so you can tell them what all you need. I'm gonna go to a billing department.
[AGENT][NEUTRAL] Oh well we send the letter.
[CUSTOMER][NEUTRAL] And they can tell you, and you can tell them about you.
[CUSTOMER][NEUTRAL] To them, I mean.
[AGENT][NEUTRAL] Yeah, we send a letter requesting medical records, so the medical records already been requested. We're waiting for for it to be received.
[AGENT][NEUTRAL] Um, I'm not sure if that goes to the sender.
[CUSTOMER][NEUTRAL] Oh, so y'all sent to me then.
[AGENT][NEUTRAL] Yes, we did send a mail indicating that we needed uh the medical records and we send out your authorization for that information.
[CUSTOMER][NEUTRAL] OK, I got this. I need to fax it back to you, but, but I just need to sign the paper and that's it.
[AGENT][NEUTRAL] No, uh uh, no, you, you, you don't have to do nothing right now. We're just waiting for Doctor [PII] to send us the medical record. So if you just want to call them and just verify that they received the letter and to see when they're gonna send the records, you can do that. But right, you don't have to do anything. We already sent that information. You already signed that paper when you send us the claim form, the claim form has that authorization.
[CUSTOMER][NEGATIVE] Instead it back to y'all.
[AGENT][NEUTRAL] Um, so we went ahead and send out together with the request for the medical records. So right now, you don't have to do anything. Like I said, if you wanna call just to make sure they receive the letter requesting the medical records, you can, but right now we're just waiting for that, OK?
[CUSTOMER][NEUTRAL] OK, call them, see if they receive the medical records that y'all send for my cash insurance policy, right.
[AGENT][NEUTRAL] A request, yes, if they have received a request for the medical records and see when they're gonna send it if you wanna do that, you can.
[CUSTOMER][POSITIVE] OK, thank you, ma'am.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] So it take like 1415 more days I hear from y'all again.
[AGENT][NEUTRAL] We will have to wait until they send the medical records, and that's why if you want to call to make sure they receive that letter, or probably it's a little bit too soon because it's regular mail, um, you can call and see and see how long it takes for them to send the medical records back to us because once we receive the medical record, we'll go ahead and reprocess the claim, OK?
[CUSTOMER][POSITIVE] OK, thank you, ma'am.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] Oh, and what this claim I get, well, uh, OK, let me ask you another question. Say for instance, I have to stay in the hotel because they got 9 at 9 weeks, so safe friends I stay in the hotel for like a week.
[CUSTOMER][NEUTRAL] Out of each month up there just for like.
[CUSTOMER][NEUTRAL] Uh, 7 days. How much do y'all pay for that? I have to pay that in my own pocket.
[AGENT][NEUTRAL] OK, was this for uh radiation, chemotherapy, or yeah, radiation treatment. OK. Um, let me check your benefits really quick, one moment.
[CUSTOMER][NEUTRAL] Yeah, yeah, radiation treatment.
[AGENT][NEUTRAL] And this is not a guarantee of payment, just a verification of your coverage as a disclaimer.
[AGENT][NEUTRAL] And let's see, um.
[CUSTOMER][NEUTRAL] You don't think I ask you another question too.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for lodging, we cover $100 per day, up to 100 days per person per calendar year.
[CUSTOMER][NEUTRAL] OK, so if I go for like 9 weeks, I can't be at this only $900 right?
[AGENT][NEUTRAL] Yes, yeah, because it's a per day benefit amount. Mhm.
[CUSTOMER][NEUTRAL] OK, another question I wanna ask you.
[CUSTOMER][NEUTRAL] OK, another question I'm gonna ask you if my driving back and forth up there, do I have to keep my receipts and make copies of them and send them to y'all?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] For the gas mileage, but
[AGENT][NEUTRAL] Yes, yes, uh, for the fare, you need to just save all that information. We only pay for the mileage. Um, so it has to be, um, 50 miles going one way or if you're traveling by bus or plane or anything like that, you just need to keep that record.
[CUSTOMER][NEUTRAL] OK, then.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] When it's, it's 50 miles, it's 56 miles going one way and 56 miles coming back, so it's 106 miles.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, yeah, so long as it's 50 miles or more going one way. Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] So call them and see if they get that letter from y'all y'all mail out to them on the [PII].
[AGENT][NEUTRAL] On the [PII], correct, mhm.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Mr. [PII]?
[CUSTOMER][NEGATIVE] Oh, so you said every time I stay in the hotel every day y'all feel, so I have to keep, so I pay then y'all just pay me back.
[AGENT][NEUTRAL] Correct, yes. You just need to keep the receipts and you need to send us a copy of the receipts for those. Um, and again, the benefit amount is per day, up to 100 days per covered person per calendar year and that's $100 per day.
[CUSTOMER][POSITIVE] OK, thank you, ma'am.
[AGENT][POSITIVE] You're welcome. Thank you for calling ATO. Have a good day.