AccountId: 011433970860
ContactId: 88810742-3d67-4a71-9d24-b8118805b8c8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 818500 ms
Total Talk Time (AGENT): 328857 ms
Total Talk Time (CUSTOMER): 403266 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/88810742-3d67-4a71-9d24-b8118805b8c8_20250117T22:10_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, yes, my name is [PII], and I am needing um some information um to help me begin filing a claim.
[AGENT][NEUTRAL] OK, I can help you, Miss [PII], to file a claim. Can you please give me your callback number just in case our call gets disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you so much. And then what is your policy number?
[CUSTOMER][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] It is 778.
[CUSTOMER][NEUTRAL] 528.
[AGENT][NEUTRAL] OK, let me look that policy up real quick.
[AGENT][NEUTRAL] OK, Ms. [PII], I do see your policy. Um, can you give me your date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Uh, email should [PII].
[AGENT][NEUTRAL] OK, and then the number you gave me to call you back on is that your cell phone number, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, thank you so much for verifying your policy for me. Let me look real quick.
[AGENT][NEUTRAL] OK, so I'm gonna give you a new policy number.
[AGENT][NEUTRAL] You have a different policy number now. It's um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 2522.
[AGENT][NEUTRAL] 544.
[CUSTOMER][NEUTRAL] OK, is that because it's a new year?
[AGENT][NEUTRAL] Right, uh, it's, and yes, ma'am. It's.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and um,
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] So you're just wanting to know how to file a claim on this policy, is that correct?
[CUSTOMER][NEUTRAL] Yes, and I, I've, I've done that but it's been a couple of years ago.
[AGENT][NEUTRAL] Yes, ma'am. OK.
[CUSTOMER][NEUTRAL] And um and and so I want to um just.
[CUSTOMER][NEUTRAL] Make sure I'm doing it right and um and I'm also um.
[CUSTOMER][NEGATIVE] A little bit nervous.
[CUSTOMER][NEUTRAL] Uh, something, so I want you to, um, to kind of answer that first and, and make sure you know we're not in jeopardy here, but um as I was, so my husband had um prostate cancer two years ago I guess it was in [PII], that was our last claim on this and then he had a reoccurrence um this year or in 24.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And um
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And so we haven't filed anything on [PII], but that's when he had the treatment um it was um, he started radiation in August and then um completed it in October.
[CUSTOMER][NEUTRAL] And um and we haven't filed on this yet, is it too late? That's what I'm worried about.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] No ma'am, we don't have a timely filing limit, um, as long as you're covered on the data service you can file at any time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, well thank you that that puts my mind at ease because as I was reading some of about the policy yesterday there was some wording that I didn't understand, you know, all that more medical stuff and it was like claim of loss and you know all this kind of stuff and it had some.
[AGENT][POSITIVE] You're welcome, yes ma'am.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Some days and I'm like oh gosh I don't think I know what this is talking about. OK, so with that behind us then um so um also our insurance kind of.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh, had a, has a different procedure now than it did when we filed a couple of years ago, but they don't send us EOBs anymore. We have to go online and get those and so I was kind of waiting for them to come and they never came and um now we have them we have them now.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][POSITIVE] OK, good, good deal.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] Maybe I we should just start the claim you should set me through that process and then I'll see if I have um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And and then I have it. I, I have a lot of the information from last time and so I have a.
[CUSTOMER][NEUTRAL] Uh, a log in, is that what I should do?
[AGENT][NEUTRAL] You have a log log in with the online service center?
[CUSTOMER][NEUTRAL] Um, it's just
[CUSTOMER][NEUTRAL] I do.
[AGENT][NEUTRAL] Oh good, yes, you can do it through the online service center um the first place I'm going to refer you to though is our website at.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Let me give you the website.
[CUSTOMER][NEUTRAL] Oh yeah that's what I mean.
[AGENT][NEUTRAL] At 8
[CUSTOMER][NEUTRAL] The APL website, that's what I mean. Mhm.
[AGENT][NEUTRAL] Yes, ma'am. If you go to [PII].
[AGENT][NEUTRAL] And you click on claims and forms.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] You're going to choose the cancer claim form.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's the 3rd 1 on the 1st page.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] You'll have to scroll down a little bit and you'll see the 3rd 1 on the.
[CUSTOMER][NEUTRAL] OK, so before I ever log in you mean?
[AGENT][NEUTRAL] Yes, um.
[CUSTOMER][NEUTRAL] I'm sorry, bye.
[AGENT][NEUTRAL] And you can download that claim form.
[AGENT][NEUTRAL] And the reason why I'm having you do this is because that first page of the cancer claim form gives you every single thing that you need to send in with your claim.
[AGENT][POSITIVE] The pathology report, um, the itemized invoice, it gives you everything that you need, it's a really good cheat sheet that first page.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, um.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] At home, um.
[CUSTOMER][NEUTRAL] To do OK, cancer right there. OK, I'm sorry, I'm trying to.
[AGENT][NEUTRAL] Yes, ma'am. Go ahead.
[CUSTOMER][NEUTRAL] I wasn't with you and I'm trying to retrack that so um.
[AGENT][NEUTRAL] Now you can do this in the online service center.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] When you go into the online service center to file your claim, what you'll need to do is download your information on your computer and then you'll upload it in the online service center from your computer.
[CUSTOMER][NEUTRAL] OK, um
[CUSTOMER][NEUTRAL] I'm afraid that I hold on.
[CUSTOMER][NEGATIVE] I'm in the wrong place. I'm not, I'm not following and I'm, it's just me not knowing the legal, I think, OK, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I don't sign into the web I don't sign into your website.
[CUSTOMER][NEUTRAL] Is that what you're saying?
[AGENT][NEUTRAL] OK, OK, so the online service center and the website are two different things. The website is where you're gonna get your cancer claim form from.
[CUSTOMER][NEUTRAL] Or
[CUSTOMER][NEUTRAL] OK, so I.
[AGENT][NEUTRAL] And the online service center is where it's a direct portal to your policy and that's where you can file the claim.
[CUSTOMER][NEUTRAL] OK, and then the
[CUSTOMER][NEUTRAL] OK, alright, so I'm in the site right now then.
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] And, and can you
[CUSTOMER][NEUTRAL] Yes, it says product [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so up at the um top.
[AGENT][NEUTRAL] You're gonna click on claims and forms up at the top right hand corner.
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][NEUTRAL] OK. The 3rd form, you're gonna scroll down a little bit and the 3rd form is your cancer claim form.
[CUSTOMER][NEUTRAL] Yes, I did.
[CUSTOMER][NEUTRAL] See, I'm scrolling that. Oh, there we go. There we go, there we go, download form that I just didn't go down far enough.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's OK. That's OK.
[AGENT][NEUTRAL] And once you downloaded that first page I was telling you that's that's your cheat sheet to be able to look at to see exactly what you need to send in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, good.
[AGENT][POSITIVE] And once you download this, you can actually fill in.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Your your claim form right there on your computer you won't have to like print it or anything. You can fill it in on your computer.
[CUSTOMER][POSITIVE] OK, it's a PDF. Good.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And then after I fill in the claim and get it sent um then.
[CUSTOMER][NEUTRAL] Um, I don't necessarily have to send all the documents then. I just get the claim started and then another time I can upload all of the documents.
[AGENT][NEUTRAL] No, you're gonna do it all at the same time you'll do it all at the same time with the claim form, because if you just send in the claim form without your documents, they're gonna deny it and ask for your documents and it just prolongs the process for you.
[CUSTOMER][NEUTRAL] Is that right?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's OK that makes sense, but I was, I was wondering if I had to open the claim and get it set up before I added stuff to it. So I, I like the idea so all together that's good, OK.
[AGENT][POSITIVE] Yes ma'am, all together.
[CUSTOMER][NEUTRAL] OK, and so after I get this filled out and my other documents uploaded um.
[CUSTOMER][NEUTRAL] And uh well, I have them.
[CUSTOMER][NEUTRAL] On my computer uploaded then both of those things, then I go into my particular portal.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, of it.
[CUSTOMER][NEUTRAL] And that's where I send it does.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, do you have to, to get payment back, um.
[CUSTOMER][NEGATIVE] Each time do I need to fill out this um like a new um.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Information for them to direct deposit.
[AGENT][NEUTRAL] No ma'am, the only time you need to, no ma'am, as soon as you um send in that direct deposit authorization form or you or if you do it through the online service center fill it out there, the only time you have to send another one is if your information changes at any time.
[CUSTOMER][NEUTRAL] Is that with every claim?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][MIXED] OK, so it's still good from 2 years ago if nothing changed.
[AGENT][NEUTRAL] If you're right, if nothing changed and let me look at your policy and make sure it's on there.
[AGENT][NEUTRAL] It's not on your new policy, so I would um go ahead and and.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Submit that because it yes because it's not on the new one.
[CUSTOMER][NEUTRAL] Do it again.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. All right. Um, seems like I had another question about, OK, now, aside from.
[CUSTOMER][NEUTRAL] This new claim I'm doing um.
[CUSTOMER][NEUTRAL] How do you send in just wellness claims? I wasn't aware that was part of my.
[CUSTOMER][NEUTRAL] Benefit, you know, and so like mammograms and PSA tests, things like that, and scans that y'all pay on, how do you, uh, is that different than a regular claim?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's, it's OK, what you'll do is you'll go back to that a.m. public website where you got the cancer claim form.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] You'll go to page 3, scroll down until you see the page numbers. You'll go to page 3 and you'll see the wellness claim form.
[AGENT][NEGATIVE] And it also has a cheat sheet for you.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] OK, I'll do that too while I'm doing all this paperwork.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK. Well, you have been most helpful. I appreciate it a lot.
[AGENT][POSITIVE] Well, it's no problem at all. I enjoy helping.
[AGENT][NEUTRAL] And we, we are, they, they.
[CUSTOMER][NEUTRAL] OK, before it's all over, I might need to call back.
[AGENT][POSITIVE] Well, please do if you need any help at all, you always can pick up the phone and we'll help you all we can.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome, Ms. [PII]. I hope you have a blessed three-day weekend.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, you too. Thank you. Bye-bye.
[AGENT][POSITIVE] Alright, you're welcome thanks for calling APL.
[CUSTOMER][NEUTRAL] Uh-huh. OK, bye bye.