AccountId: 011433970860
ContactId: 8b3ea399-6720-402a-be5d-36959b2369a3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 467130 ms
Total Talk Time (AGENT): 175142 ms
Total Talk Time (CUSTOMER): 122682 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/8b3ea399-6720-402a-be5d-36959b2369a3_20250211T16:51_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, this is [PII]. uh, I have a cancer policy with y'all and I had sent in.
[CUSTOMER][NEUTRAL] Some a claim and stuff and I was wondering how if how that claim was going or if I did the right thing. I don't know. I haven't heard from y'all.
[AGENT][NEUTRAL] OK, and Mr. [PII], what's that policy number, please?
[CUSTOMER][NEUTRAL] 79318.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] OK, and verify your date of birth and mailing address, please.
[CUSTOMER][NEUTRAL] 21862-7310 [PII]
[AGENT][NEUTRAL] OK, thank you, ma'am. Um, I do show we received your claim on [PII] and it's in line for processing. Uh, give me a moment and I can verify if it's in an examiner's queue.
[AGENT][NEUTRAL] Or what date they're working on, give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, don't show that isn't an examiner's queue yet, but it should hopefully be processed sometime this week.
[CUSTOMER][NEUTRAL] OK, uh, do they need any additional information? I didn't.
[AGENT][NEUTRAL] It doesn't state. It only shows us that it's been received and it's in line for processing. Uh, it doesn't state if additional information is needed. We would know until after they have processed the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because how do you check a claim on um.
[CUSTOMER][NEGATIVE] On the American public thing. I put my but it says file a claim and do this other stuff but it doesn't, it's not gonna show uh the processing of my claim.
[AGENT][NEUTRAL] Well, it should show like if it's in an examiner's queue, then it will show processing and then if it's complete, it will show you completed and they do have an option to where you can put in your cell phone number to receive a text message on when a claim has been uh processed.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now, um,
[CUSTOMER][NEUTRAL] Um, I did chemo chemotherapy.
[CUSTOMER][NEUTRAL] And I'm fixing to send all that in uh [PII] and then [PII] and [PII], so I just send them the uh.
[CUSTOMER][NEUTRAL] The itemized statement.
[AGENT][NEUTRAL] Yes, ma'am. Uh, just sending the itemized billing showing the procedure codes and uh showing that you received chemo, and that will be fine.
[CUSTOMER][NEUTRAL] OK, and how much do they pay for that?
[AGENT][NEUTRAL] Uh, let's see, let me pull up your policy. Give me one moment.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Um, part of the policy looks like the max it pays is up to 10,000 per 12-month period.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] So girl, I'm getting big, big bills in.
[CUSTOMER][NEUTRAL] So the one in like the one on [PII], y'all still gonna pay on that.
[CUSTOMER][NEUTRAL] And then it'll start another year.
[AGENT][NEUTRAL] Well, when it says uh per 12-month period, so the first time, uh it shows that you received any chemo, radiation, or immunotherapy, that's when the date starts and it's 12 months from there. So, I don't know how they are, uh,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or if additional information is needed for any chemo you receive, so, uh, if it's payable, then I would say it will start from that date and then 12 months from there.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And then they pay for mileage?
[AGENT][NEUTRAL] Uh, if you receive surgery, chemo, radiation, immunotherapy, uh,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Bone marrow, is it bone marrow, um, then it could if you're going, if you're traveling more than 50 miles one way.
[CUSTOMER][NEUTRAL] Oh Lord, yeah, I'm going to uh MD Anderson in [PII] and stuff, so just one way.
[AGENT][NEUTRAL] Yes, one way, yes, ma'am.
[CUSTOMER][POSITIVE] Oh wow.
[CUSTOMER][NEUTRAL] OK. And uh hotel lodging.
[CUSTOMER][NEGATIVE] We've been having to just stay.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Then you would need to submit the hotel bill, as well as if you were confined and then submit that billing as well.
[CUSTOMER][NEUTRAL] Now how much do they pay on the uh hotel room?
[AGENT][NEUTRAL] Uh, I'm not sure. I'm trying to pull up the policy. Give me one moment, please.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Uh, it states not actual charges not exceeding $44 per day, and limited at 60 days per confinement. Um, and let me see if there's any other stipulations on it.
[AGENT][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And it's only if you're confined in the hospital because it says we will pay the benefit if one adult member of your immediate family requires lodging while you are confined in hospital.
[CUSTOMER][NEUTRAL] Oh, only in hospital.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] If I'm in the hospital. Oh God.
[CUSTOMER][NEUTRAL] OK, so.
[CUSTOMER][NEGATIVE] We didn't stay 3 or 4 days because you know it's so far.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEGATIVE] So that's not gonna be paid by y'all, OK.
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] Uh, yes, ma'am, and thank you for calling APL Ms. [PII]. Have a great rest of your day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye.