AccountId: 011433970860
ContactId: 87bbfe73-f802-43c6-958d-2bccd08e86ce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 744270 ms
Total Talk Time (AGENT): 402950 ms
Total Talk Time (CUSTOMER): 239362 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/21/87bbfe73-f802-43c6-958d-2bccd08e86ce_20250321T19:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. I can't seem to get hold of anybody in our school board. I need to find out our does Webster Parish here in [PII] still carry our cancer policy through y'all.
[AGENT][NEUTRAL] OK, um, do you, did you previously have a policy number that I can look to see, that I can look up?
[CUSTOMER][NEUTRAL] Mm, hold on a minute. I got some many papers here. Hold on one second. Let me go through here and see if I can.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] I got so much stroll out on my desk here. Let's see.
[AGENT][POSITIVE] Bless your heart, and it's Friday, so that's good.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Yes, and it's spring break next week that's even better.
[AGENT][POSITIVE] Oh girl, enjoy yourself. You deserve it working with kids for sure.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] Oh yes, ma'am. OK, try this 1. 673-685.
[AGENT][NEUTRAL] OK, and what is your name?
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][NEUTRAL] OK, Ms. [PII], let me look up and see if that policy will pull up for me.
[AGENT][NEUTRAL] OK, Ms. [PII].
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you ma'am and then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] Uh, [PII]. Uh, I don't know if you have my home home email is [PII].
[AGENT][NEUTRAL] Looks like
[CUSTOMER][NEUTRAL] Ma'am?
[AGENT][NEUTRAL] Yeah go ahead. You, you were saying the right one. Go ahead.
[CUSTOMER][NEUTRAL] And phone number [PII].
[AGENT][NEUTRAL] OK, thank you. And Ms. [PII], if we get disconnected, is that a good callback number for you?
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, let me pull this up real quick. That number you gave me was your hospital indemnity plan, which I'm showing is still active. Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You have a new cancer policy?
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Oh, I do.
[AGENT][NEUTRAL] Yes ma'am, which might be why you can't find it because it has a different policy number.
[AGENT][NEUTRAL] Let me give you the policy number.
[CUSTOMER][NEUTRAL] Is that the 711?
[CUSTOMER][NEUTRAL] Is it 711635C?
[AGENT][NEUTRAL] Yes, ma'am. Well, not C. There's no C on it. 711635.
[CUSTOMER][NEUTRAL] Oh, that's
[CUSTOMER][NEUTRAL] OK, OK, um, on the, what, uh, I can't because I can't remember because I had an accident, um.
[CUSTOMER][NEGATIVE] Couple of years ago and I haven't turned anything in, what kind of doctor bills can be turned in to be reimbursed for this?
[AGENT][NEUTRAL] Uh, you'll need, OK, so for, you'll need your, uh, for cancer, you're going to need the, um,
[AGENT][NEUTRAL] First diagnosis of cancer. You'll need that from the provider. The pathology report that shows the first diagnosis of cancer. You'll need uh any itemized statements from any facility that you went to.
[AGENT][NEUTRAL] Um, and the itemized statements.
[CUSTOMER][NEUTRAL] And that's just, right? OK, that's just if I have cancer, correct?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I don't have cancer.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK, and, but you're wanting to file for accident. Let me see if you have accident insurance with us.
[AGENT][NEUTRAL] No, ma'am. I'm showing you have a hospital indemnity plan, a cancer plan, and an intensive care plan.
[CUSTOMER][NEUTRAL] OK, so I know that I used to could turn out my bills in to get reimbursed for some. I don't remember what I used to turn into y'all.
[AGENT][NEUTRAL] OK, let me look and see if it was on your hospital indemnity plan which is also.
[AGENT][NEUTRAL] Um, you can use for medical.
[AGENT][NEUTRAL] Oh yes, I see you had a lot of claims on this plan. This is probably the one that you're inquiring about, of course that's.
[AGENT][NEUTRAL] And since [PII], does that sound about right?
[CUSTOMER][NEUTRAL] OK, I'm sorry you you cut out just a bit. What did you say?
[AGENT][NEUTRAL] Uh, the last claim we received for you on this policy was [PII]. Does that sound correct?
[CUSTOMER][NEUTRAL] Is that when I had, I guess that's when I had, I think that's when I had my um ankle actually. I had the
[CUSTOMER][NEUTRAL] Um, have the bone come out of my ankle. I had to have 10 surgeries.
[AGENT][POSITIVE] Oh my gosh, oh my gosh, ow.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. Um, I believe that it would be this hospital indemnity plan because you don't qualify for intensive care unless you've been in the hospital under ICU for a reason. Has that happened?
[CUSTOMER][NEUTRAL] No, I wasn't in ICU, no, I was just in the hospital 10 different times.
[AGENT][NEUTRAL] OK, it would be this hospital indemnity plan though. The policy number is 673.
[AGENT][NEUTRAL] 685.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 673-685 so I can turn in any kind of medical bills with that number?
[AGENT][NEUTRAL] Yes, you'll need your itemized statements with the diagnosis and procedure codes.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let me look at that. I'm gonna look at the claim form. The claim forms for the for these policies are on our website. Let me give you the website information too if you decide.
[AGENT][NEUTRAL] To send in a claim, it has um really good instructions at the top, which I always refer back to um so you'll need the itemized bill with the diagnosis from the provider must accompany the completed statement of insured. So you'll need to fill out the claim form for the statement of insured.
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It says that you don't have to fill out section C is not uh I'm sorry, E as in Edward is not required. However, completing this section will reduce delays in processing. I would go ahead and fill out section E.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, so on the claim form, you'll need to fill out the statement of insured, which is sections A through F, and then go ahead and fill out E. You'll need to send your itemized bill with diagnosis from the provider.
[AGENT][NEUTRAL] And then you'll need your signature on the claim form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And that's for any time that I've been to the hospital or to a doctor's office for anything.
[AGENT][NEUTRAL] Yes, I would send it all in, um, and.
[AGENT][NEUTRAL] File your claim, you just need one claim form and send all your paperwork in with that one claim form.
[CUSTOMER][NEGATIVE] OK, when was the last time because I was trying to figure out when's the last time I sent things in because I don't, I don't want to, you know, duplicate what I've already sent to y'all.
[AGENT][POSITIVE] Yes, ma'am. OK, for yourself.
[AGENT][NEUTRAL] Uh, the last time we received anything was [PII], and it paid out to you on [PII] by direct deposit.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Is there a way for me to go back and see what I turned in? I don't even know what I turned into y'all.
[AGENT][NEUTRAL] I can't see that information myself, but I can put in a request for somebody to call you back and let you know everything that was sent in.
[CUSTOMER][NEUTRAL] OK, because I was trying to figure out if I.
[AGENT][NEUTRAL] If you would like.
[CUSTOMER][NEUTRAL] Anything in
[CUSTOMER][NEUTRAL] You know, on my foot. So what I'm trying to find out did I, did I do anything when it came, you know, with my foot. It's what I'm trying to figure out because I've got like almost a half a million dollars out to the hospital.
[AGENT][NEUTRAL] Yes ma'am
[CUSTOMER][NEUTRAL] With 10 surgeries.
[AGENT][NEUTRAL] I understand
[CUSTOMER][NEUTRAL] It's insane
[AGENT][NEUTRAL] Right, let me look and see if I could see in the latest EOB that was sent. If I can see the EOB then that can tell me uh.
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] Actually I can look at this claim and just tell you.
[AGENT][NEUTRAL] It was submitted for WK Women's Health Associates. That was the last claim.
[CUSTOMER][NEGATIVE] Oh, well it's not helps us that's gonna be like for uh my mammogram, I mean my um.
[CUSTOMER][NEUTRAL] Pap smear and stuff like that.
[AGENT][NEUTRAL] And then it had um Spring Hill Medical Center.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] For diagnostic testing?
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's see that would have been my mammogram.
[AGENT][NEUTRAL] That's what it sounds like.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, because I had my accident.
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] OK, so that is the only thing we received for the year of [PII].
[AGENT][NEUTRAL] Was that mammogram that I just told you about.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I can, so I don't, it don't have to just be a mammogram or um my wellness check at the uh gynecologist, right?
[AGENT][NEUTRAL] No, it can be, you can file on this um anytime you have to go in the hospital, anytime you have diagnostic testing, anytime you have to go to the doctor, you get so many visits a year to go to the doctor. Um, let's see.
[AGENT][POSITIVE] It also helps with a prescription.
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It also has an intensive care rider on it and this is just to verify your benefits. It's not a guarantee of payment you have an emergency accident rider.
[AGENT][NEUTRAL] Uh, that pays a maximum of $300.
[AGENT][NEUTRAL] You have an outpatient sickness writer?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That pays the dollars. Mhm.
[CUSTOMER][NEUTRAL] I have all of that.
[AGENT][NEUTRAL] All, all on this one policy.
[CUSTOMER][NEUTRAL] OK, cause that emergency.
[CUSTOMER][NEGATIVE] OK, cause that emergency, you know, I had to be rushed by ambulance to go into surgery with my ankle.
[AGENT][NEGATIVE] Oh my goodness, that sounds like it was terrible.
[CUSTOMER][NEGATIVE] Oh, it was horrible. Yeah, I mean, literally, my ankle, my foot went to the right and the bone went to the left. It was horrible, horrible.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Oh my gosh. Oh.
[AGENT][NEGATIVE] That hurts me just thinking about it.
[CUSTOMER][NEGATIVE] From, uh, uh, oh, I'm like I see it was terrible, terrible.
[AGENT][POSITIVE] Yes, I would definitely send a claim in for it, um.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] For all that informa all that um work that you had done if you haven't already done it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I, I'm, I'm thinking I probably have not, so, um, what is the website? um.
[AGENT][NEUTRAL] The website where you can file the claim is um.
[CUSTOMER][NEUTRAL] American just
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] You're gonna do [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Uh [PII], I don't [PII] [PII]
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, you cut out again. Try one more time.
[AGENT][NEUTRAL] Oh no. OK, it's secured. [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Got it that time.
[CUSTOMER][NEUTRAL] And that will tell me the uh the information I need to know also, correct?
[AGENT][NEUTRAL] Yes ma'am. What and that's the online service center where you can file claims directly from the online service center.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, OK, alright, thank you so much.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can help you with before we go?
[CUSTOMER][NEUTRAL] You have a
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] No, ma'am, that's it. Thank you very much.
[AGENT][POSITIVE] You're welcome, Ms. [PII]. I hope you have a wonderful spring break. Thanks for calling APL.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][POSITIVE] Thank you very much. Have a good day. Bye-bye. All right, bye-bye.
[AGENT][NEUTRAL] Bye bye.