AccountId: 011433970860
ContactId: 89be655e-9b7e-4f63-b5d6-80da258f479f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 460000 ms
Total Talk Time (AGENT): 188481 ms
Total Talk Time (CUSTOMER): 156182 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/02/89be655e-9b7e-4f63-b5d6-80da258f479f_20250602T19:38_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII]. My name is [PII]. Um, I'm calling, um,
[CUSTOMER][NEUTRAL] About, I had a PET scan, I had an MRI. I had prostate cancer.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um I have, we got the payment from y'all for $7500 but we're trying to get the payment for the MRI or the PET scan. I think it's a $500 benefit.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And so kind of what happened prior, and I don't know if you need to pull up my account number or whatever and look and see what all has been done, but.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The um
[CUSTOMER][NEUTRAL] Uh, we submitted my, actually my wife actually submitted the stuff. She was helping me out on that. And um basically, we got a thing back that said that they couldn't pay the
[CUSTOMER][NEUTRAL] The, the MRI.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] It did not have a pathology report, correct?
[CUSTOMER][NEUTRAL] Right, so I need the pathology report which had already been uploaded and so we uploaded the pathology report to get the initial to get that the lump sum.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, and so
[CUSTOMER][NEUTRAL] And so my wife had called and was talking to another person about um
[CUSTOMER][NEUTRAL] Being able to get that um pathology report, um, but because I wasn't there, I was gone, and they needed to talk to me to be able to
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] Access that pathology report.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, OK, so we just need to get that pulled up and um make sure that all of that's been squared away.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Got it. OK. Uh, [PII], before we go any further, can I get a good callback number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you. And then do you have your policy number?
[CUSTOMER][NEUTRAL] Mhm. I think so. Let's see, check date reference number policy number, you ready?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] 02525064
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] OK, and I'm just gonna verify some information really quick, uh, [PII], can I get your date of birth, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] Mailing address is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Perfect. The last thing I need is the email address we've got on file for you. uh, looks like it might be through your employer.
[CUSTOMER][NEUTRAL] OK. It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, OK, thank you so much for verifying all of that. OK, so I will take a look at this claim information but before I do, I'm not sure if this information has been passed along to y'all uh or not but um regarding your wife calling on your behalf.
[AGENT][NEUTRAL] Um, there is a form you can fill out that's an authorized, essentially an authorized user form, uh, with her information, and if you submit that, um, then we'll have on file we'll be able to speak with her about everything regarding the policy, uh, without you having to be present.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, all right.
[AGENT][NEUTRAL] Just so that you're aware, OK, so let's take a look here.
[AGENT][NEUTRAL] OK, bear with me just a moment.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so the most recent claim that I have is state this, and I do see the spot that you're referring, uh, needing the pathology report. However, I do see other notes stating that the claim information has been received, but we couldn't process it as we needed additional information. Um, it's stating the a claim form was incomplete. So let me take a look at that.
[CUSTOMER][POSITIVE] OK. And so I can even get log in.
[CUSTOMER][NEUTRAL] on
[AGENT][NEUTRAL] OK, so [PII], if you don't mind, I'm going to put you on a brief hold and reach out to our claims specialist um I kinda just see, um, surface level, so I might just pass this along to them so they can give me some more uh details about exactly what's going on with this and what we need to do.
[CUSTOMER][POSITIVE] OK, yeah, sounds good.
[AGENT][POSITIVE] OK. Alrighty, thank you, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Ferring
[CUSTOMER][POSITIVE] Good afternoon. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hey [PII], this is [PII] over on the care team. How are you?
[CUSTOMER][NEUTRAL] I'm fine thanks how are you?
[AGENT][NEUTRAL] Doing all right, thank you. Um, I've got a member on the line who was calling regarding um a claim for his cancer policy. Um, essentially it was for an MRI. He said that um they had already submitted the uh pathology report, um, and they saw that it was stating we couldn't pay the benefit because we needed the pathology report, but I also see a note saying that um that it's an incomplete claim.
[AGENT][NEUTRAL] So they want kind of a deeper look at that and what's going on and what they can do.
[CUSTOMER][NEUTRAL] OK, what was the policy number?
[AGENT][NEUTRAL] It is 0252.
[AGENT][NEUTRAL] 5064.
[CUSTOMER][NEUTRAL] OK, and what was the claim number?
[AGENT][NEUTRAL] Uh, let's see, 359-023-7.
[CUSTOMER][NEUTRAL] OK, and do you have the callback number?
[AGENT][NEUTRAL] Yes, uh, that is, give me just a moment. Uh, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK and you said it's Mr. [PII] on the phone?
[AGENT][NEUTRAL] Yes, we are speaking with him.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, you ready for him now?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] OK thank you bye bye.