AccountId: 011433970860
ContactId: 8ec135ac-dbeb-422a-86b1-3fe02fa267e2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 656960 ms
Total Talk Time (AGENT): 280572 ms
Total Talk Time (CUSTOMER): 265087 ms
Interruptions: 1
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/8ec135ac-dbeb-422a-86b1-3fe02fa267e2_20250312T22:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, um, I am wanting to file a claim and um
[CUSTOMER][NEUTRAL] I know that I'm supposed to send a copy of the original pathology report.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Just wanting to know.
[CUSTOMER][NEUTRAL] What page do I send of it? Cause it's like
[CUSTOMER][NEGATIVE] It's like over 80 pages.
[AGENT][NEUTRAL] Oh, OK. Let me take a look here.
[AGENT][NEUTRAL] Um, are you filing under, are you filing a cancer claim?
[CUSTOMER][NEUTRAL] Yes, uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So are you filing the claim for the initial diagnosis or the?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, well, they told, it says on the claims that
[CUSTOMER][NEUTRAL] We have to put
[CUSTOMER][NEUTRAL] The pathology report?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] So it would just need, if it's for the initial diagnosis, it would just need to be where it's showing the diagnosis.
[AGENT][NEUTRAL] Of cancer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't know if they sent you all those pages, that's a lot.
[AGENT][NEUTRAL] To go through, um,
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I went to the hospital, to the business office to get the original pathology report, and she gave me a big old envelope full and there's over 100 pages, so I don't know.
[CUSTOMER][NEUTRAL] What exactly um
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It needs to look like, yeah.
[AGENT][NEUTRAL] Let's see, let me see if I can find.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Because he got
[CUSTOMER][NEUTRAL] He got diagnosed, um.
[CUSTOMER][NEUTRAL] [PII], I wanna say.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] So you should have something hopefully in there that is just like.
[AGENT][NEUTRAL] A summary of what they found, like the type of cancer and like um
[AGENT][NEUTRAL] If there was any sort of like tumor and then we give the diagnosis of where the cancer was.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] You can definitely submit all of the pages, I mean, if you want to, and they'll go through it, um.
[CUSTOMER][NEUTRAL] It says here, um,
[CUSTOMER][NEUTRAL] Like it has progress notes, rectal cancer, encounter for chemotherapy, chemo, I mean.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] I guess I could have asked him there at the hospital, like, can I just have the paper?
[CUSTOMER][NEGATIVE] That shows that, I mean, he has cancer, I don't know what to send you.
[AGENT][NEGATIVE] Yeah, I mean, with that many pages, I would either send all the pages if you want just to be on the safe side, or if you want to contact them back and say, hey, you know, I came to get a pathology report cause I'm filing a claim for my insurance. Um, I was given 80 pages. What I need is just the pathology report.
[AGENT][NEUTRAL] Showing the diagnosis of cancer. Can you guys tell me where that's at or just send me a single page with that?
[AGENT][NEUTRAL] Um, so you don't have to go through all of the 80 pages, you know.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Maybe it's this one, the one that says 1923, cause that's basically when she got diagnosed.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It says uh
[CUSTOMER][NEUTRAL] Rectal cancer, liver, liver metastasis?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] And then like the rest of these are where he's gotten chemo, which I don't know why they gave me that.
[AGENT][NEUTRAL] Yeah, that would just be like treatment and stuff, you know, if you were gonna, that, yeah. So it sounds like you might be on the right, right page um if that's what you recall being the date of diagnosis.
[CUSTOMER][NEGATIVE] Yeah, that's when he, and like I requested the UB 40s, but I go in there and I've been getting them like 3 months at a time. But she gave me like all of this and I don't think we can use this for the UB 40s.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Shows his treatment, but it doesn't have any like
[CUSTOMER][NEUTRAL] Money stuff on it, you know.
[AGENT][NEUTRAL] Or dates of treatment, yeah. Like if you're gonna, OK.
[CUSTOMER][NEUTRAL] It does, it says, it says the infusion and all that, but I think with [PII] there's where it has like the actual amounts of money, right?
[AGENT][NEUTRAL] Yeah, it's gonna need to have an amount, yeah.
[CUSTOMER][NEUTRAL] Yeah, and these are just like infusions, which I don't know why she gave me all this, like, maybe this is what they consider a pathology report, just has everything she's been through.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well it sounds like that first sheet might be just what we need if that's got the initial date of diagnosis and where the.
[AGENT][NEUTRAL] The cancer findings were, um, you could submit that and just hang on to the rest, you know.
[CUSTOMER][NEUTRAL] Yeah, because it's
[CUSTOMER][NEUTRAL] It starts [PII], and I wanna say that's when his first, you know.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] When everything was happening, and this one is.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Like 5 pages long.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And it shows where he got scanned and it's signed electronically by his doctor.
[CUSTOMER][NEUTRAL] It shows all the findings.
[CUSTOMER][NEUTRAL] So maybe I'll send that.
[AGENT][POSITIVE] Yeah, I would definitely send that. Um, it's always better to send more than not enough. That's why I was saying if you wanted to send it all, you could, um, but I would definitely, whatever you have there with the initial date as far as what you recall for the diagnosis and where they found it, I would go ahead and send those for sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, because it has on here, maybe I can send everything before his actual first treatment.
[CUSTOMER][NEUTRAL] Do you know what I mean? Like.
[AGENT][NEUTRAL] Mhm. Yeah, just for the initial diagnosis, yeah.
[CUSTOMER][NEGATIVE] Yeah, and then when it starts saying infusions, I won't send that. And I had another question. So do I have to send this every single time or is it gonna be on file?
[AGENT][NEUTRAL] The claim form, but you won't need to send the pathology report or any of that. It'll just be the claim form and then um documentation for like if you're gonna send for reimbursement for chemo, then you would need the itemized bill and procedure codes for like the dates of chemo when it, when it was done for that, but not a pathology report, no.
[CUSTOMER][NEUTRAL] OK, because I was told I needed a pathology report.
[AGENT][NEGATIVE] No, I don't think you need it for.
[CUSTOMER][NEUTRAL] To start the claims.
[AGENT][NEUTRAL] Well, to start them, yeah. So, like, if you're filing for the initial diagnosis, you need that, you do need it for that. If the insured is diagnosed with a different type of cancer, then you would need that.
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] Uh, you would need it for that. The only other time you would need it is if you're filing claims for surgeries, for like biopsies and things like that.
[CUSTOMER][NEUTRAL] OK, so there's gonna be the the initial one, right?
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] And then the chemos are gonna be different.
[AGENT][NEUTRAL] Correct. So for like chemotherapy when you're filing those claims,
[AGENT][NEUTRAL] You'll just need the itemized medical bill from the provider.
[CUSTOMER][NEUTRAL] Which is the UB 40 and then the explanation of benefits, right?
[AGENT][NEUTRAL] Yeah, yep, that's it.
[CUSTOMER][NEUTRAL] OK, so for the initial, initial one, I was just trying to file for the chemos, but for the, so there has to be an initial one, right? Cause they told me I needed a pathology report. So is that the only thing I need for the initial one?
[AGENT][NEUTRAL] Mhm. Correct, yeah.
[CUSTOMER][NEUTRAL] That's it, just the pathology. OK.
[AGENT][NEUTRAL] Yep.
[CUSTOMER][NEUTRAL] Cause on the website I'm I'm only seeing for like chemotherapy, so I'm like, huh.
[AGENT][NEUTRAL] Oh, OK. Yeah, I know. So for the initial diagnosis, we need the pathology.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK, and then I have another question. So for the chemo, I have to do each one or by month? because he gets treatment every 2 weeks.
[CUSTOMER][NEUTRAL] So like in 1 month he gets 2 treatments. So what I'm asking is, do I have to file each treatment separately or by the month?
[AGENT][NEUTRAL] It's personal preference, honestly. If you wanna do it, yeah, if you wanna do it every time he receives treatment, you can, or if you wanna just do it once a month, then you could do it once a month.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, OK, well, thank you so much. I'm gonna try to do this, see what happens. It's just so hard. I'm like, I wish I could go to an office and just say, here's the papers. Here's.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, not a problem. If you have any questions.
[AGENT][POSITIVE] I know. It's so much work. I hear you. Well, if you have any other questions or concerns, feel free to call.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Uh huh bye bye.