AccountId: 011433970860
ContactId: 8c40694c-2e24-4bb6-aca9-217a77cd6aaf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1216500 ms
Total Talk Time (AGENT): 311036 ms
Total Talk Time (CUSTOMER): 440925 ms
Interruptions: 5
Overall Sentiment: AGENT=1.1, CUSTOMER=-0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/8c40694c-2e24-4bb6-aca9-217a77cd6aaf_20250603T21:16_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I filed a claim, uh, cancer claim for my husband. I talked with, I believe, [PII] in the claim department, the cancer claim area.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] I uploaded some documents um.
[CUSTOMER][NEUTRAL] But, uh, one of the things that she asked me to upload is not available, so can I talk to somebody or should I just ask you the question or how, what should I do?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, uh, let me go ahead and pull your information first, Miss. Uh, may I have the policy number and a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, I'll look up the policy number um.
[CUSTOMER][NEUTRAL] My callback number is [PII].
[CUSTOMER][NEUTRAL] And it is a cancer policy and it is policy number 2,477,090.
[AGENT][POSITIVE] All right. Thank you.
[AGENT][NEUTRAL] OK, and Miss class right, go ahead.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I had filed the claim originally and then she told me that I needed uh an itemized bill and a copy of the pathology report indicating uh malignancy.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] So I uploaded and let me ask a question I had uploaded those documents before you changed over to the new online service center so I just created a user ID and password for that and uploaded an additional document will that convert together or do I need to file the claim all over again?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Uh, no, no, no, it comes, it, it, I see it already here, so no, you don't have to upload anything else. It's up here. Yeah, you don't have to worry about it. Um, let me, let me go ahead and verify some uh.
[CUSTOMER][NEUTRAL] Oh you do? OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEUTRAL] So I uploaded
[CUSTOMER][NEGATIVE] Yeah, I uploaded the itemized billing statement which is fine, and then I also uploaded my request to Auer to provide the the pathology reports for the two dates of service for the work that was done for my husband, and they came back and said that there's no record available.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The reason for that is because he was diagnosed with leukemia, which is
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] The which is um
[CUSTOMER][NEUTRAL] The malignancy is determined with a blood test. So I had already initially with the claim, sent all of the copies of the blood work which included references from the pathologist.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] But there isn't a separate.
[CUSTOMER][NEUTRAL] Form from pathology that it, it's the, it's the results of the blood work. So, um, the lab is the, is the, is the determination to show the malignancy. There is apparently no.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Additional pathology report, which is what I just uploaded, so now I don't know what to do.
[AGENT][NEUTRAL] Oh, OK. Um, hm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you see the itemized billing that was there?
[AGENT][NEUTRAL] Uh, we don't review claims. That's for the claims department. Um, let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, bear with me just a second. I'm just going over the um the notes.
[CUSTOMER][POSITIVE] Sure, absolutely.
[AGENT][NEUTRAL] OK. So, um, looks like you spoke to Ms. [PII].
[AGENT][NEUTRAL] And she's the one that asked for that pathology report and you say you're not able to get that pathology report the way that she asked for it.
[AGENT][NEUTRAL] Um, so.
[CUSTOMER][NEUTRAL] Well, I just uploaded what I got. I, I just sent it. Do do you see that? Do you see the document I just uploaded?
[AGENT][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] I see a uh upload. um I can check and see how many pages uh but she will have to review that and let me go ahead and see if I can view the.
[CUSTOMER][NEUTRAL] It was just, yeah it was just 2 pages and I just uploaded it.
[CUSTOMER][NEUTRAL] A few minutes ago.
[AGENT][NEUTRAL] OK, yeah, I see the upload. I see something came over, so I see there's something here. I'm, I'm trying to see if I can open now I, I, I need to verify you. I wasn't able to verify you. Um, let me have your date of birth, mailing address and email address on file.
[CUSTOMER][NEGATIVE] Oh, but you can't open it.
[CUSTOMER][NEUTRAL] I, I see, OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII], and what else?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] And the email address on file.
[CUSTOMER][NEUTRAL] Date of birth.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] confirmation.
[CUSTOMER][NEUTRAL] Are you allowed to open that document that I just uploaded?
[AGENT][NEUTRAL] Yeah, I can open it and see if it says pathology anywhere, um.
[CUSTOMER][NEUTRAL] Well, what I sent was the request that we sent him for requesting pathology and, and you'll see the document that we signed making the request for the dates, the two dates of service that he saw the doctors and then I got the report back from [PII] saying no reports available.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Do you see that? So there I made the request and she asked me to, but they're saying there is no additional pathology report because the pathology report is included in.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] The blood test
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The flow cytometry test is what includes the notes from the pathologist.
[AGENT][NEUTRAL] OK. Let me see if I can get Ms. [PII] in. Maybe she can tell you what will be the next step. I, I do see what you're saying, what you send in. Um, let me go ahead and see what we can do.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect. Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[AGENT][POSITIVE] Hi [PII], how are you? This is [PII].
[CUSTOMER][NEUTRAL] Hey so how are you?
[AGENT][NEUTRAL] I'm good, I'm good. Oh, I'm not that good, but I'm OK.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I'm trying not to cough. OK, um, I have a member on the line that it looks like she spoke to you earlier about a pathology report, and she just uploaded some documents, but it, it is not a pathology report. It's just a report that they was not able to find a pathology report. So she's wanted to know what else could she send.
[AGENT][NEUTRAL] Uh, and I see she spoke to you the last time.
[CUSTOMER][NEUTRAL] OK, um, what's the policy?
[AGENT][NEUTRAL] Um, the.
[AGENT][NEUTRAL] It's 247.
[AGENT][NEUTRAL] 70.
[AGENT][NEUTRAL] 90.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Glass
[AGENT][NEUTRAL] And it's for the husband.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, I was just gonna say I don't remember speaking to this person.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No, I don't think I talked to her, but now she's asking, she uploaded, uh, a pathology, but it's not the pathology report, is that what you said?
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Uh, correct, yeah. It's like a request for pathology, but um, the request uh for the pathology was kind of denied saying that they didn't find a pathology. So that's why she sent in basically a letter.
[CUSTOMER][NEUTRAL] OK, I'm gonna pull up that mail.
[AGENT][NEUTRAL] Yeah, it's the last one she's sending just now.
[CUSTOMER][NEUTRAL] And see what the
[CUSTOMER][NEUTRAL] The the 7:50. OK. All right.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Oh boy, 68 pages [PII].
[CUSTOMER][NEUTRAL] On that one.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm pulling it up now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK looks like she last spoke to.
[CUSTOMER][NEUTRAL] [PII] and then before that it was [PII].
[AGENT][NEUTRAL] Oh [PII], OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Need the pathology report that first diagnosed the cancer, she submitted new patient office notes.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] I'm waiting for it to load. Sorry, my on base has been terrible today.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Oh, trust me, everything's better.
[CUSTOMER][NEGATIVE] I mean, really terrible. Earlier it froze up on me completely.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] I had to restart
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] I know, I know. Uh, today has been one of those OS these days and it's been terrible.
[CUSTOMER][NEUTRAL] OK, so
[AGENT][NEUTRAL] The online service and all the changes and everything and everybody going cuckoos about it.
[CUSTOMER][NEUTRAL] Yeah, right.
[CUSTOMER][NEUTRAL] OK, so they're telling them they're telling her on this request that they don't have any records?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That's exactly what they're saying.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] That supposedly the records are together with the blood work, with the lab results, which
[AGENT][NEUTRAL] Mm, usually that's not the pathology report. That should be something different.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] There has to be some sort of and what's.
[CUSTOMER][NEUTRAL] So now she's wanting to know what she can get or what I'm sorry, what was her question? What should she do now?
[AGENT][NEGATIVE] So, basically, basically, uh, she's saying that that's all she can get and then there's nothing else she can get. So what else could it be done? Do we still need that or that's gonna be sufficient, which I don't think this is gonna be sufficient at all.
[CUSTOMER][NEUTRAL] No, because it's telling us there is no records, but there it did she request it from the correct place?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEGATIVE] She, yeah, she's saying that she did. Um, that's who did the um find cancer.
[CUSTOMER][NEUTRAL] I mean,
[AGENT][NEUTRAL] [PII] is one I found that you have, sir.
[CUSTOMER][NEUTRAL] And do we know if she tried to contact them, but she's sure they had, they, she didn't have a pathology or she doesn't know?
[AGENT][NEUTRAL] Mm mm.
[AGENT][NEUTRAL] Um, she said that she don't have a pathology report. That, that's why she sent that request for that pathology report to be sent to her, and that's what she got in return. So, um, she's just confused on what else, uh, how she's gonna get that to us when she cannot, she don't have, they don't have one and she don't have one and
[CUSTOMER][NEUTRAL] She's
[AGENT][NEUTRAL] It doesn't seem to be one.
[CUSTOMER][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Well, there has to be because according to this, it says the first diagnosis cancer new patient office visit note for 35 and lab results for 35 indicates it was newly diagnosed. So where did they diagnose that from is, that's why we need the pathology.
[AGENT][NEUTRAL] Mm. Maybe if you send it to her like that, maybe she will get it and maybe I don't know.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and she's been, everything's been verified and I'm speaking with the policy holder, right? [PII]?
[AGENT][NEUTRAL] Yes. Yes.
[AGENT][POSITIVE] Yes, Ms. [PII]. Yes, yes, I do have Ms. [PII]. I fully verify her. Yes.
[CUSTOMER][NEUTRAL] Everything's verified and then her phone number um listed [PII].
[AGENT][POSITIVE] Yes, that is correct. Yes. Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, you're ready for her
[CUSTOMER][NEUTRAL] You can go ahead and transfer. Yeah, take your call.
[AGENT][POSITIVE] OK, thank you. Here she comes. You're welcome. Hi, good afternoon.
[CUSTOMER][POSITIVE] You too. I want
[AGENT][POSITIVE] Thank you. Thank you for holding and being patient for Ms. [PII]. I got Ms. [PII] on the line. She's in the claims support team and she's gonna assist you from here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] You're welcome. Have a good afternoon.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Hi Ms. [PII]. Hi, can you hear me OK?
[CUSTOMER][NEUTRAL] I can hello? OK, good. My name is [PII]. I'm on the I'm on the claim support team.
[CUSTOMER][NEUTRAL] Um, and so I'm looking at the paperwork now, so it looks like um we needed a pathology report for the new diagnosis, um, and apparently you submitted a request for those records and they're telling you there's none available?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I can tell you why.
[CUSTOMER][NEUTRAL] The reason and I and I had this conversation before.
[CUSTOMER][NEUTRAL] Because the diagnosis is leukemia.
[CUSTOMER][NEUTRAL] The pathology report is embedded in.