AccountId: 011433970860
ContactId: 8707642b-c081-4ddb-8a7f-ca79a9de83b3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 699570 ms
Total Talk Time (AGENT): 345234 ms
Total Talk Time (CUSTOMER): 337932 ms
Interruptions: 6
Overall Sentiment: AGENT=0.6, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/8707642b-c081-4ddb-8a7f-ca79a9de83b3_20250514T14:08_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Uh yes ma'am. I was calling. I'm trying to get logged in on um online and I'm having some issues and give me this number.
[AGENT][POSITIVE] OK. I can try to assist you. Yes, ma'am.
[CUSTOMER][NEUTRAL] Like how
[AGENT][NEUTRAL] And your name is?
[CUSTOMER][NEUTRAL] My name is [PII]
[AGENT][NEUTRAL] And Miss. [PII], do you have your policy number?
[CUSTOMER][NEGATIVE] I do not, not in front of me, no.
[AGENT][NEUTRAL] OK, give me a moment.
[AGENT][NEUTRAL] And if you don't mind, what's your social?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And verify your date of birth, mailing address and email address for me.
[CUSTOMER][NEUTRAL] 4
[CUSTOMER][NEUTRAL] OK, [PII] date of birth, um, is my date of birth. Uh email is [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, and [PII] or I might have another email address on there.
[AGENT][NEUTRAL] No, that's the one we have. And it gives, uh, when you enter the information, or are you putting in your social or you're trying to use your policy or where you don't have your policy number?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So when you're
[CUSTOMER][NEGATIVE] Yeah, OK, well, it just says pass I put forget password and then it gave me this number it wouldn't let me do anything.
[AGENT][NEUTRAL] OK, give me half a moment, let me see.
[AGENT][NEUTRAL] So it shows you set up of 4.
[CUSTOMER][NEUTRAL] Let me try it again. It would be not, yeah.
[CUSTOMER][NEUTRAL] I don't know. I think I came through, um, and I.
[CUSTOMER][NEUTRAL] Maybe one time because I was gonna do try to do a clean and I just never did so I don't know if I set up or what I don't know.
[AGENT][NEUTRAL] And I do show that it looks like you have set up on the OSC on the service center, um, and I can give you your username.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it is.
[AGENT][NEUTRAL] [PII] Oh, it's your first and last name.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, OK, I've got that in.
[AGENT][NEUTRAL] And then when you
[CUSTOMER][NEUTRAL] But I guess I just don't know.
[AGENT][NEUTRAL] Uh, and when you hit, um, reset password, that's when it gave you an error message.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] It didn't give me
[CUSTOMER][NEUTRAL] Yeah, let me try. I, I don't know what my password is, I guess.
[CUSTOMER][NEUTRAL] They are for I don't know let me try another one.
[CUSTOMER][NEUTRAL] Yeah, and so when I go forget forgot enter your user name, let me try that again.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Next.
[CUSTOMER][NEUTRAL] OK, well, never mind, it did a thing, but while I go it told me to.
[AGENT][NEUTRAL] And it
[CUSTOMER][NEUTRAL] Um, yeah, OK, primary phone it should send it.
[CUSTOMER][NEUTRAL] OK, yeah, so now it's giving me a verification code now, so, OK, so is everything on there pretty good as far as um I don't probably wouldn't need any help as far as making a claim.
[AGENT][POSITIVE] OK, good.
[AGENT][NEUTRAL] Uh, no, ma'am. Uh, you just,
[CUSTOMER][POSITIVE] Is it pretty easy, OK.
[AGENT][NEUTRAL] Yes ma'am, are you trying to submit a wellness claim or just um.
[CUSTOMER][NEUTRAL] Um, no, I had a thyroid cancer and, uh, I didn't think nothing about it, but my doctor was like, well, you probably can turn it in if you have a cancer. I said, why didn't even think about that? So is that so I don't even know. Like I said, I have no idea.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, uh, do you have one of our claim forms?
[CUSTOMER][NEUTRAL] Uh, I guess I can get that on here.
[AGENT][NEUTRAL] On the, the site, it's um
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Lord, I forgot. OK.
[AGENT][NEUTRAL] And along with that,
[CUSTOMER][NEUTRAL] Oh, that's OK. I'm.
[AGENT][NEUTRAL] Yes, ma'am. Along with the claim form, uh, we will need the pathology report, first diagnosing of cancer. And have you received any treatment for it, like chemo or radiation?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I had it taken out.
[AGENT][NEUTRAL] Or surgery?
[CUSTOMER][NEUTRAL] Yes, I had surgery and it was taken out and then I've got to go back.
[CUSTOMER][NEUTRAL] And um
[CUSTOMER][NEUTRAL] Probably have the other side taken out now.
[CUSTOMER][NEUTRAL] So, but I did have where the cancer's out, it is taken out.
[CUSTOMER][NEUTRAL] So do I have to have like chemo or radiation or anything like that to receive anything? I don't even know how much it is. I mean, is there a certain?
[AGENT][NEUTRAL] Canice? OK.
[CUSTOMER][POSITIVE] Hi. Oh yes, I'm sorry.
[CUSTOMER][NEGATIVE] Yeah, I don't, I mean, I don't even know is this even worth my time. I mean what is it when I do a claim.
[CUSTOMER][NEUTRAL] I don't even know honestly what I have. I'm not gonna lie.
[AGENT][NEUTRAL] No, you're fine. And once you set up on the OSC you should be able to pull up your policy, but give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Mm, see.
[AGENT][NEUTRAL] OK. So you have benefits for hospital confinement, drug, and medicine, like if you're, when you're receiving chemo, radiation, immunotherapy and have to receive any anti-nausea or pain medication?
[AGENT][NEUTRAL] Um, you know, benefits for surgery, outpatient hospital, anesthesia.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Because I did all that. I get, I mean, you know, when I had the surgery and had it taken out.
[AGENT][NEUTRAL] And you have blood, um, well, not blood, blood platelets and plasma, that's covered, uh, but radiation and chemo immunotherapy is covered. And if you are submitting for any charges in regards to those three, we will need a copy of your primary EB since this policy pay that benefit by actual charges. Um,
[CUSTOMER][NEUTRAL] No, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] You have benefits for transportation.
[CUSTOMER][NEUTRAL] Cause I know I still owe some, you know, I know I still owe something, um.
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] I think from the anesthesiology, I believe.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK. And you do have benefits for wellness that you have not uh submitted. And if you like, you can submit that um since your policy effective date is [PII], so anything after [PII], you can still file those wellness screening benefits. Um, they have it, uh, once you set up on the uh or uh get back up on the online service in there, it'll have
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yeah, I don't ever think about that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] To file a claim and then it has a separate button to file a wellness claim.
[AGENT][NEUTRAL] And he was
[CUSTOMER][NEUTRAL] So anytime like I say I had a mammogram or something?
[AGENT][NEUTRAL] Uh, mammogram or a Pap smear, um.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, uh, I've had a hysterectomy, so I have a, I've had a colonoscopy.
[AGENT][NEUTRAL] Uh, colonoscopy.
[AGENT][NEUTRAL] Um, which you have a benefit that pays once per calendar year, so, um,
[CUSTOMER][NEUTRAL] Oh, OK, so I can only do it.
[AGENT][NEUTRAL] Once a year.
[CUSTOMER][NEUTRAL] OK, well, I'm having a mammogram.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so it's been a while since I've done the colonoscopy, so that won't count, so it's just anything.
[AGENT][NEUTRAL] When was
[AGENT][NEUTRAL] Well, anytime, uh, from [PII] till now, you can still submit. There's not a time limit to submit claims. Yes, ma'am.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK, you're just saying it's just one a year from [PII], OK.
[AGENT][POSITIVE] Yes, ma'am. And it's just a benefit that you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is available and like I say, you can fill out either the claim form or on the online service center it should have a button that says file wellness claim and you would just um it'll ask for the type of wellness you had and the date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I believe the name of the provider and then you would just um.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Kind of electronically to sign your name and submit and so it automatically send out a claim to the examiners.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so like, um, I can probably just get it like through the um check, so I went to the hospital where I had the mammogram, they can print each time I had one out.
[CUSTOMER][NEUTRAL] Each one, each time I had that to show that.
[AGENT][NEUTRAL] Uh, you don't need to submit any documents, just fill out the.
[CUSTOMER][NEUTRAL] Is it no.
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] The type of service you had done and the date and it may ask for the provider's name. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Back in the day, some of our policies you have to submit like um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Results or billing, but you don't have to anymore. I changed all that.
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, well then I, which I wouldn't know the date. I'd have to because I got one,
[CUSTOMER][NEUTRAL] Two weeks from now, but um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I know I've had some done before so they can probably tell me when I had that.
[AGENT][POSITIVE] Yes ma'am, and I mean it's a benefit that's available um let me see.
[CUSTOMER][POSITIVE] OK, alrighty.
[CUSTOMER][NEUTRAL] OK, yeah, I'll see.
[CUSTOMER][NEUTRAL] Figure out and get that done.
[AGENT][NEUTRAL] As far
[AGENT][NEUTRAL] OK. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, and then.
[CUSTOMER][NEUTRAL] OK, so, OK, so I can do the wellness on the mammogram and colonoscopy. I know I've had that done and then the claim form on the surgery I had for thyroid cancer.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, ma'am. We will need the itemized surgeon's bill and that initial pathology report, first diagnosing of cancer.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now on that they did not know it was cancer until they took it out.
[AGENT][NEUTRAL] Well they
[CUSTOMER][NEUTRAL] Because the pathology report came back inconclusive, is that OK?
[AGENT][NEUTRAL] Uh, that's fine cause, um, if they did a biopsy, uh, that is still considered uh surgical. And if there was a positive diagnosis, then it's definitely covered.
[CUSTOMER][NEUTRAL] Mhm. Yes, the biopsy.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alrighty, so I just need to get all that information from the doctor's office, the bills and stuff y'all have to have that when I do the claim?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Uh, for the surgery, yes, ma'am. Uh, was it outpatient or inpatient?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK, all the bills. No, I stayed the night. Yeah, well, I think it was, no, I stayed the night.
[AGENT][NEUTRAL] Yes, ma'am. I would say to submit the itemized hospital bill as well if you can because you do have a hospital confinement benefit.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I can understand why people don't do all this. It's just getting all this stuff. I, I know.
[AGENT][NEUTRAL] Uh, I know, it can be.
[AGENT][MIXED] Yeah, it's could be very nerve-wracking, but I mean, it's, it's a benefit there for you, you know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I know, yeah, that's what I'm saying. Why do I pay, you know, after the wazoo and insurances, I guess I might as well use them, so.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, well I'll get on here and uh well I'll try to get on here and see once um I guess I gotta reset my password and stuff so.
[CUSTOMER][NEUTRAL] OK, well thank you so much and I will get on here and try to, you know, let me see if I can just do this password one more time let me see because it still didn't work.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it's um.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Make sure you use a special, uh, it should have a list of uh special characters to use, one lower case, one uppercase. Yeah, OK, good. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, yeah, I'm I'm in now.
[CUSTOMER][NEUTRAL] Yeah, yeah, I'm in now. OK, well I'll get on here and kind of look around and see what I got and then I'll.
[CUSTOMER][POSITIVE] Hopefully get it all done. Thank you so much for your help.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You are welcome and if you need any more assistance just give us a call back, OK?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Alrighty thank you bye bye.
[AGENT][POSITIVE] Thank you, ma'am. Have a great day, Miss. [PII]. Bye.
[CUSTOMER][NEUTRAL] Bye bye uh huh.