AccountId: 011433970860
ContactId: 8e3343d4-194d-4234-bc4c-d2b72cd086ec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 480440 ms
Total Talk Time (AGENT): 117174 ms
Total Talk Time (CUSTOMER): 142757 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/8e3343d4-194d-4234-bc4c-d2b72cd086ec_20250611T19:32_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. Uh, I'm calling about claim number 36096009.
[AGENT][NEUTRAL] OK, [PII], and is that a claim for yourself?
[CUSTOMER][NEUTRAL] Yes it is.
[CUSTOMER][NEUTRAL] I have a policy number if you need.
[AGENT][POSITIVE] OK, yes, that would be great. What is that?
[CUSTOMER][NEUTRAL] 00708029.
[AGENT][NEUTRAL] OK, thank you. And then can you verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then what is the address on your policy?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much. Do you have a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Cell number [PII].
[AGENT][NEUTRAL] OK. Let me get this claim pulled up. Give me just a moment.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, and how can I help you today?
[CUSTOMER][NEUTRAL] OK, I received the letter um saying explanation of benefits saying this information received does not indicate that a screening test to detect counsel took place and a couple other things it has on here. Uh, but when I faxed the form, I did fax the narrative, my screening mammogram bi bilateral and it's date and everything.
[AGENT][NEUTRAL] Uh, it looks like we did pay.
[CUSTOMER][NEUTRAL] And the
[AGENT][NEUTRAL] 60 for the mammogram. Let me see.
[CUSTOMER][NEUTRAL] Um, I just opened this letter and there's no check included.
[AGENT][NEUTRAL] Uh, it looks like it went to direct deposit.
[CUSTOMER][NEUTRAL] Oh, that's why. OK, so I didn't tell my husband, so they don't mail checks I didn't.
[AGENT][NEUTRAL] Uh, it looks like
[CUSTOMER][NEUTRAL] They don't mail the checks out?
[AGENT][NEUTRAL] No, it looks like you've got direct deposit set up, so that's how we're depositing the payment.
[CUSTOMER][POSITIVE] OK, alright, sounds good thank you. I thought they was telling me that.
[AGENT][NEUTRAL] OK. Anything else?
[CUSTOMER][NEUTRAL] To pay for it
[AGENT][NEUTRAL] Oh, no. Any, anything else I can help with, Ms. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, one other question, um.
[CUSTOMER][NEGATIVE] With this cancel policy.
[CUSTOMER][NEUTRAL] As far as screening done, does it, um.
[CUSTOMER][NEUTRAL] Tape any blood work at all?
[AGENT][NEUTRAL] Um, let me see.
[CUSTOMER][NEUTRAL] Uh, uh, just, uh, just prostate and, uh, um, breast exam.
[AGENT][NEUTRAL] Um, let me double check. Let me pull up your policy real quick. You give me just a moment.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, getting that pulled up, um, let me read what's covered.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, so is there like a, a blood test that you're doing to detect as a screening? What is, is there a specific
[CUSTOMER][NEUTRAL] So I
[CUSTOMER][NEUTRAL] I was just checking if it covers the blood as well.
[CUSTOMER][NEUTRAL] Cause I did a uh not a colonoscopy. My husband did colonoscopy last year. Will that cover that colonoscopy?
[AGENT][NEUTRAL] I just see where the
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh, either and a, and a cologuard, I, I did a Cologuard, I think last year, and he did the colonoscopy this year.
[AGENT][NEUTRAL] OK, let me see.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, give me just one moment. I'm gonna pull up that I pulled up the document, but it doesn't have what I'm looking for. So, can I place you on a brief hold real quick?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] E
[AGENT][NEUTRAL] Policy certificate.
[AGENT][NEUTRAL] Maybe that's just it.
[AGENT][NEUTRAL] OK, here we go.
[AGENT][POSITIVE] OK, so sorry about that. Yes, so.
[AGENT][NEUTRAL] Under your benefit, it does cover for a colonoscopy. Um, let me see what the benefit.
[AGENT][NEUTRAL] Um, anything I quote is not a guarantee of payment. It's a basic outline of your policy.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Why are you doing that cause I just the form over and I see where it did not cover my bone density, my A1C.
[CUSTOMER][NEUTRAL] And it didn't cover those items, is that correct? It won't cover that?
[AGENT][NEUTRAL] I think there's a $1 amount maximum. Let me double check.
[AGENT][NEUTRAL] OK, so looks like.
[AGENT][NEUTRAL] OK, that looks like there's a diagnostic and preventative benefit.
[AGENT][NEUTRAL] And that that benefit just pays $60 once per calendar year.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So that's that's why I didn't pay on the others.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so if I would submitted one of the others before this one, it would have paid.
[AGENT][NEUTRAL] If it would have been for [PII], correct.
[CUSTOMER][NEUTRAL] Yeah, OK, so let's go back to the colonoscopy. I don't think my husband has submitted anything. He's had fat and also prostate, so he can just just submit his form and you'll get paid for for one of the preventive cares, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][POSITIVE] OK, all right, thank you.
[AGENT][POSITIVE] OK, thank you for calling APL. Hope you have a good day.
[CUSTOMER][NEUTRAL] Alright you too bye bye.
[AGENT][POSITIVE] Thank you, bye-bye.