AccountId: 011433970860
ContactId: 85dd26a8-1c55-4248-864c-38a3ebb13643
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 680690 ms
Total Talk Time (AGENT): 220473 ms
Total Talk Time (CUSTOMER): 254439 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/02/85dd26a8-1c55-4248-864c-38a3ebb13643_20250402T14:49_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Uh yes, uh.
[CUSTOMER][NEUTRAL] Excuse me, what did you say your name was?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK, OK, I am uh calling because I received a check from you guys.
[CUSTOMER][NEUTRAL] And this is for [PII].
[CUSTOMER][NEUTRAL] And um.
[CUSTOMER][NEGATIVE] [PII]'s deceased, so I can't catch it. I gotta send it back.
[AGENT][NEUTRAL] OK. Yes, you can do that. May I have your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Maybe.
[CUSTOMER][NEUTRAL] Um, his wife and beneficiary.
[AGENT][NEUTRAL] OK. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. Um, do you have the policy number by any chance?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, let me see, I don't think you have it in the.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] No, you don't have it on here. I got the letter saying that you received my information that's all I have on here.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I don't have it
[AGENT][NEUTRAL] OK, bear with me just a second. Let me see if I can find them so I can tell you exactly what to do. OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then I also need.
[CUSTOMER][NEUTRAL] Um, does that cover the big stack of bills that I sent you from the hospital?
[AGENT][NEUTRAL] I'm not sure. I have to look at the policy.
[CUSTOMER][NEUTRAL] It didn't say anything about it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, one moment. May I have the address?
[CUSTOMER][NEUTRAL] I have that.
[CUSTOMER][NEUTRAL] Yes, um,
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And that's the address we have on file for him, the [PII].
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] You said the first name was [PII]?
[CUSTOMER][NEUTRAL] OK, I have a, I believe this is the number that you want right here.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It's 00.
[CUSTOMER][NEUTRAL] 457.
[CUSTOMER][NEUTRAL] 182.
[CUSTOMER][NEGATIVE] And it's for cancer.
[AGENT][NEUTRAL] OK. Um, just for security, may I have your date of birth? I, I do see you listed here.
[CUSTOMER][NEUTRAL] Yeah, mine is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let me check that.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] gonna be a minute I'm waiting on the documents, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I think the second stack has something on the bottom that said for me to sign for beneficiary or something like that and I signed it under [PII]. I mean it's [PII] and I filled out all of it.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] So I don't know if that's all or.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Are they still
[CUSTOMER][NEUTRAL] So they're still working on it because it was a big pile. It was almost like a rim of paper.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It was a lot.
[AGENT][NEUTRAL] OK, so it looks like we're missing a pathology report.
[CUSTOMER][NEUTRAL] There
[CUSTOMER][NEUTRAL] There wasn't the very first one on there?
[AGENT][NEUTRAL] I will have to check with them because I, I, I don't see those documents. Those are viewed by the examiner, the person who processed the claim. I can only see what they're requesting, which is that's what they're saying that they need a pathology report, um, see.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But OK, does, uh, it doesn't say anything on the, the stack of papers that I sent.
[AGENT][NEUTRAL] For the first diagnosis OK.
[AGENT][NEUTRAL] That is the information.
[CUSTOMER][NEUTRAL] Because I think like, I mean, it was a lot.
[AGENT][NEUTRAL] Yeah, um, yeah, I'm not really sure because like I said, I don't, I don't look at those papers. I'm looking at the paper or the information that the examiner or the person who processed the claim put in the system.
[AGENT][NEUTRAL] And based on that information, it looks like um she just need the pathology report of first diagnosis of cancer. Um, also we need explanation of benefits for chemotherapy.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Surgery in hospital stays.
[AGENT][NEUTRAL] Um, but I can do.
[CUSTOMER][NEUTRAL] Yeah, they were all in there.
[AGENT][NEUTRAL] Yeah, what I can do is get uh either get an examiner to call you back or try to get one in the line. I don't know which one would you like.
[CUSTOMER][NEUTRAL] Uh, can you try to get one on the line for me?
[AGENT][NEUTRAL] Um, sure, yes, let me see if I can get 11 moment.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning and thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], how are you? This is [PII].
[CUSTOMER][NEUTRAL] I'm fine thanks how are you?
[AGENT][NEUTRAL] I'm good, I'm good. Um, I have a, um, wife of a member on the line. He, he has passed away and she's trying to do all her, the claims and everything. We have received the death certificate. Um, but it looks like um she's stating that she sent all the information that we're requesting. I went over the EOB and asked her for everything we need, but she is saying that she already sent all that information that we're just overlooking.
[AGENT][NEUTRAL] Um, so I don't know if you can assist her, and it is a big file, so.
[AGENT][NEUTRAL] I'm not sure if you can do that now. Yeah, it's uh 457182.
[CUSTOMER][NEUTRAL] OK, what was the policy number?
[AGENT][NEUTRAL] But I did tell her that um I, we can give her a call back after, but she said she wants to speak to somebody.
[AGENT][NEUTRAL] So we you.
[CUSTOMER][NEUTRAL] OK, and did you verify the name of the insured and date of birth?
[AGENT][NEUTRAL] Yes, uh-huh, it is for [PII], but I got Miss [PII] on the line because [PII] has passed away.
[AGENT][NEUTRAL] And do you need the callback number?
[CUSTOMER][NEUTRAL] Uh yes, please.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And she's also asking about why the check was sent out on [PII]'s name if there's any way they can change it to her name. So I don't know if you can answer that as well for her, OK.
[CUSTOMER][POSITIVE] OK, good.
[CUSTOMER][NEUTRAL] OK. Yeah, it's hard because we hadn't received the death certificate on
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Our end uh let's see.
[AGENT][NEUTRAL] Yeah, we have.
[AGENT][POSITIVE] Yeah, we have some. We probably got it after.
[CUSTOMER][NEUTRAL] OK, uh, yes, so I'll just let her know that that she can send it back to us.
[AGENT][NEUTRAL] Mhm. Yeah, I think that's what I told her that she, she can send it back to us, but just in case because that was her first question, um, but yeah, I told her that more than likely she will have to send that. OK, so let me put her through. Thank you.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] Thank you for holding and being patient for you, Ms. [PII]. I got Ms [PII] on the line. She's in the claims department, OK? She will assist you from here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you for holding, Ms. [PII], and yes, how can I help you today?
[CUSTOMER][NEUTRAL] Uh, who am I speaking to? What's your name?
[CUSTOMER][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] [PII]? OK, um, alright, I got a check from you guys, uh, for $75.
[CUSTOMER][NEUTRAL] OK, and it's sent to my husband, and on the report that I sent with all the pathology reports and everything, I guess you all missed the death certificate. He's no longer with us. He's deceased.
[CUSTOMER][POSITIVE] OK, yes, ma'am, and I'm so sorry to hear about that.
[CUSTOMER][NEUTRAL] Uh yes, so if you would like, you can, you can send us back that check and then we can void it and then we can go ahead and reissue a separate check um let me just take a look here just to verify if we have a beneficiary on file, um.
[CUSTOMER][NEUTRAL] Just to be sure that whenever we do reissue the check we reissue it in the correct name.
[CUSTOMER][POSITIVE] OK, I do apologize for that.
[CUSTOMER][NEUTRAL] But did you not see the, see the paper where it said he was gone?
[CUSTOMER][NEUTRAL] The death certificate, is it not in there? Yes, ma'am. I do see that we, we did receive the the death certificate. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and all those papers, there was not a, because there's a list of things here that says that you didn't get, and they were all in that package which was about as big as a rim of paper.
[CUSTOMER][NEUTRAL] All of this was in the report. All of that was in there.
[CUSTOMER][NEUTRAL] With the date and the amount and everything.
[CUSTOMER][NEUTRAL] was in there, but they said that you didn't get one.
[CUSTOMER][NEUTRAL] OK, sure, bear with me just a moment and I'll take a quick look at look at that for you, OK?