AccountId: 011433970860
ContactId: 8dd00318-23c4-4a56-9dcf-538796b2a636
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 900580 ms
Total Talk Time (AGENT): 548161 ms
Total Talk Time (CUSTOMER): 321948 ms
Interruptions: 6
Overall Sentiment: AGENT=0.9, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/8dd00318-23c4-4a56-9dcf-538796b2a636_20250121T19:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yes, I'm calling on behalf of my mother. She has a policy and I just had questions about benefits and how to potentially file a claim.
[AGENT][NEUTRAL] Sure, we can take a look at that policy. What was your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, and [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] All right, thank you. And then do you have the policy number?
[CUSTOMER][NEUTRAL] I do. It is um.
[CUSTOMER][NEUTRAL] 9 A as in apple 94686
[AGENT][NEUTRAL] OK, one moment, please. Um, what was the name, uh, what was your mother's name? I'm sorry.
[CUSTOMER][NEUTRAL] Let me see how it's listed because it's listed as [PII].
[AGENT][NEUTRAL] All right, one moment, please.
[AGENT][NEUTRAL] Alright.
[AGENT][NEUTRAL] Is that what she goes by as [PII]?
[CUSTOMER][NEUTRAL] She, her full name is [PII].
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] I'm just looking at a past statement and it was listed as [PII].
[AGENT][NEUTRAL] OK, so she goes by [PII] as well?
[CUSTOMER][NEUTRAL] She only I mean [PII] is her first name but she goes by [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] A little confusing.
[AGENT][NEUTRAL] What was your name? I'm sorry.
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK, that's where I was confused. Alright, so, OK, got it.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] All right, um,
[CUSTOMER][NEGATIVE] Yeah, it's very confusing.
[AGENT][NEUTRAL] That's OK we're on the same page now right, um, is she available that I could speak with her to verify her information?
[CUSTOMER][NEUTRAL] We can try um.
[CUSTOMER][NEGATIVE] Let, let, I, I can, all I can do is try, um, let me see, her, her memory, she, she has brain cancer. Hold on one minute.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Oh goodness, OK.
[CUSTOMER][NEUTRAL] Can we, can you turn it down for just a minute? Someone wants to talk to you, OK?
[CUSTOMER][NEUTRAL] Here, let me find, sorry, let me find the remote. OK, this is someone from your cancer insurance. They're wanting to talk with you, OK? I have it on speaker. Hello.
[AGENT][NEUTRAL] Hi [PII] how are you?
[CUSTOMER][NEUTRAL] No, it's it's [PII].
[AGENT][NEUTRAL] Oh [PII] sorry oh my goodness sorry we just went back and forth, didn't we? Alright, um, just gonna verify some information really quick uh can I get your date of birth please?
[CUSTOMER][NEUTRAL] That's OK. That's OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII]. That's right.
[AGENT][POSITIVE] Perfect thank you and then do we have.
[CUSTOMER][NEUTRAL] 30 what?
[AGENT][NEUTRAL] Appreciate you verifying that. Do we have permission to speak with [PII] on your behalf?
[CUSTOMER][NEUTRAL] I can't hear. Can, can, she said, can she talk to me on your behalf? Yeah.
[AGENT][POSITIVE] OK, thank you so much. I appreciate that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, is that, is that all?
[AGENT][POSITIVE] Yeah yeah we're good. OK, thank you for that.
[CUSTOMER][NEUTRAL] Oh, OK. I'm gonna, I'm gonna step back here so I can hear. She turned.
[AGENT][NEUTRAL] Sure, OK, so I will let you know um going forward as she is the only one listed active um under this policy, so going forward if we continue like this we would have to continue getting uh verbal consent from her to speak with you uh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or anyone else regarding the policy um if you would like or if she's able to, we can add you as um you know of course either uh she can add you as a beneficiary power of attorney or simply a third party um authorized just to be able to see it that way.
[CUSTOMER][NEUTRAL] I, I do have power of attorney I can send to you.
[AGENT][POSITIVE] Oh you do perfect. OK, yes, that would be great that way we don't have to worry about that again we could just simply take your information um going forward OK um so we were looking at benefits and um how to file claims correct?
[CUSTOMER][NEUTRAL] I can, yeah, yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, so let me get the policy pulled up here.
[AGENT][NEUTRAL] Um, if I can, uh, this is a bit of an older one. Let's see.
[AGENT][POSITIVE] Oh, awesome. OK, we do have it in here.
[AGENT][NEUTRAL] Just a second.
[AGENT][NEUTRAL] Alrighty, so while I'm getting this pulled up I will say um the quickest and easiest way to get claim information to us is going to be through our online portal um do y'all have access to a desktop or a laptop computer?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Perfect. OK, so the reason I ask is um it really doesn't have support for mobile devices like phones or tablets um so the information that we just verified, so you know her address all of that um you would use that to create the account I would need to add an email um because it does have to match what our system so what is a good email to add for the account?
[CUSTOMER][NEUTRAL] OK, yeah, sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh sure, um, it's [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That was [PII], uh huh.
[CUSTOMER][NEUTRAL] And I tried to do that.
[CUSTOMER][NEUTRAL] Yeah, I tried to to do like an the online thing and it said enter some like number and said not policy number it was like enter your.
[AGENT][NEUTRAL] OK, um, I'll make sure that you have the yes so I'll make sure that you have the correct URL first um because it is a bit confusing it's different than our public website um and then it wouldn't have worked anyway because we did.
[CUSTOMER][POSITIVE] OK, OK, perfect, perfect.
[CUSTOMER][POSITIVE] Got you. OK, thank you.
[AGENT][NEUTRAL] Have an email address on file so when you would put that in it would say that it wasn't matching um so let me get this added first before I do anything else and then um just to verify the zip code was [PII] correct?
[CUSTOMER][NEUTRAL] Right, right.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] OK, OK, and then there will be a part that asks for a member ID or a social security number you're going to put in the social.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, Social Security, OK.
[AGENT][POSITIVE] Alright, let me get this added really quick.
[AGENT][NEUTRAL] And then I can verify the social that I've got as well just to make sure that that is correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let me know when you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, I've got [PII].
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, OK, we are human and sometimes there could be one number off and I just wanna make sure while we're on the phone so there's don't have to give us a call back. OK, so anyway, once um I'll go ahead and give you that uh URL too before I forget. Let me know when you're ready for that.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Oh, perfect.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, so it's word [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] So [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then from there
[CUSTOMER][POSITIVE] [PII]. OK perfect.
[AGENT][NEUTRAL] That's it, yes, uh, from there you would just select, you know, new user and then it would be the top option which is an individual policy and then you've enter all this information, create user name and password on the main page.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, there'll be a spot that says upload claim documents or upload documents that's where you would send everything. um, we have all of the claim forms on the website as well so of course if it is in regards to cancer, it would just be the cancer claim form you could fill it out on the website, uh, and then just upload it that way and then any other documents that you've got.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I will say typically first thing we would need, let's see, I do see she's filed claims in the past. When was she diagnosed with cancer?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This last one was um November, I don't know the exact date. It was mid November.
[AGENT][NEUTRAL] OK, OK, so yeah, the last thing we received was in [PII] looks like um.
[CUSTOMER][NEGATIVE] Yeah, that was from the lung cancer, but this is brain cancer, yeah.
[AGENT][NEUTRAL] Gotcha. OK. So the first thing we would need would be that pathology report, um, showing the diagnosis. We would need that before anything else. And then once we have, yes.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK. I have a question and I'm not sure if you can answer this or not.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] Due to everything, they, they don't have an official pathology report because they were unable to do a craniotomy, and they just have, I mean, they just diagnosed her from the MRI.
[CUSTOMER][NEUTRAL] Is that gonna be a problem?
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mm, so they didn't do any kind of biopsy or anything?
[CUSTOMER][NEGATIVE] It, it was too risky. They wouldn't do it and they just sent her home on hospice.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] I see. OK, so they simply did an MRI and turned that way that was how they got the diagnosis.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Huh, OK, that is a good question. Um, if you don't mind actually I'm going to get clarification on that. um, I'm gonna put you on a brief hold if you don't mind. I'll get right back with you, OK?
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][POSITIVE] All right thank you one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Transferring.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Calling APL, this is [PII]. How may I assist you today?
[AGENT][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you today?
[CUSTOMER][POSITIVE] Great. How are you doing?
[AGENT][NEUTRAL] Doing all right, thank you. I've got um a bit of an odd question um regarding a uh cancer policy. Um, this individual said that she was diagnosed with brain cancer. They, and of course, I told her, you know, we would need the pathology report before anything else. She said that there's actually not a pathology report as they determined it through an MRI. They said anything else would be too risky, but that was how they got the diagnosis. Would that be sufficient?
[CUSTOMER][NEUTRAL] Um, she will have to send in the MRI report and any medical records.
[AGENT][NEUTRAL] OK. So it doesn't necessarily have to be the full like biopsy or anything like that if, as long as it's a positive diagnosis.
[CUSTOMER][NEUTRAL] And then we would just
[CUSTOMER][NEUTRAL] Because sometimes we don't, but see, we have to send that stuff out to for medical review, um, so we can only just ask for what they have and then if we need additional documents, then we can, but um I have seen cases where um the patho they haven't done it by actual biopsy.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] What they have.
[AGENT][NEUTRAL] OK, OK, interesting. I've just never come across that, so I wasn't sure. I appreciate you clarifying that for me. I'll let her know.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Mm, OK, thank you. Mm bye-bye.
[AGENT][POSITIVE] Alright thank you bye bye.
[AGENT][NEUTRAL] OK, [PII], sorry about that wait are you still with me?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so I did get clarification, um, and she did say that you know they have run into cases before where they've not been able to do a biopsy like this, um, so she said simply send us what you do have, um, so if it's that report from the MRI, uh, go ahead and send that to us. If any additional information is needed after they review that, then we'll be able to let you know.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][POSITIVE] All right, sorry about that confusion.
[CUSTOMER][POSITIVE] No, no worries.
[AGENT][NEUTRAL] All right. And then let me see, I do have the policy pulled up here. Did you have specific questions as to uh benefits?
[CUSTOMER][NEUTRAL] Uh, not really. I
[AGENT][NEUTRAL] So would you like me to send this to you?
[CUSTOMER][POSITIVE] Uh, definitely be actually great, yes.
[AGENT][POSITIVE] Yeah, for sure, it's very easy to read. It's not just a bunch of jargon, I promise.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So let's see, did you want me to just email it to you?
[CUSTOMER][NEUTRAL] Emailing is fine, yeah, it's that [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes, OK, I will get that sent to you. Let's take a look here actually.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Did you have any other questions for me at the moment?
[AGENT][NEUTRAL] I was trying to think. I know we talked about a lot, but I don't know if we skipped over anything or not.
[CUSTOMER][NEUTRAL] Um, I don't think
[CUSTOMER][NEUTRAL] I don't think so. I just, um, yeah, we, we knew she had been paying this monthly, but we couldn't find any information on it. So I like was cleaning out some drawers and happened to find this from her lung cancer diagnosis. So I thought, I'm gonna call and see what's going on here.
[AGENT][NEUTRAL] Oh, sure.
[AGENT][NEUTRAL] Right, yes.
[AGENT][POSITIVE] Absolutely yeah it's been active for a while, so, um, and there's no timely filing limit so whenever you're able to you can get all that to us um if you have any questions again I know it's really confusing, feel free to give us a call back we'll do what we can to help um also uh before I forget, uh don't forget to send us that uh power of attorney information as well um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, will I send that in the, the online portal as well?
[AGENT][NEUTRAL] You can um or you could just go ahead and email that to us. I can give you the email address for that as well.
[CUSTOMER][POSITIVE] OK, yes, that'd be great. I can do that.
[AGENT][NEUTRAL] OK, you, yes, so that would be to uh care team, so [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then in the body, just make sure to um
[AGENT][NEUTRAL] Reference the policy number, um, so the one that you gave me just in to clear up any potential confusion, the policy number you gave me that began with the 9A, that is the old policy number, it's the same policy but there is a newer policy number so if you see two different ones, it's the same policy just so that you're aware I can give you that new one too if you'd like.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] OK, yeah, that'd be great.
[AGENT][NEUTRAL] OK, it's 11.
[AGENT][NEUTRAL] 24
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 79.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] So again same policy just two different numbers just in case you see that you're like what in the world.
[CUSTOMER][NEUTRAL] Just, just two different numbers. OK.
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] OK, do you have any other questions for me at the moment?
[CUSTOMER][NEUTRAL] Um, I just wanna make sure you had not already sent me an email because I have not received one.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Not yet, no, ma'am.
[CUSTOMER][NEUTRAL] OK, I was just making sure.
[AGENT][NEUTRAL] Right, no, no, I'm about to get it sent to you right now.
[CUSTOMER][POSITIVE] OK, all right, that sounds good.
[CUSTOMER][POSITIVE] That's fine. OK. Um, thank you so much for your help.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Of course, yeah, thanks for calling APL. I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you, bye bye.