AccountId: 011433970860
ContactId: 93f0ce9a-fb22-4774-93d6-b079d79ab9d8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1012760 ms
Total Talk Time (AGENT): 264506 ms
Total Talk Time (CUSTOMER): 320006 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/93f0ce9a-fb22-4774-93d6-b079d79ab9d8_20250404T14:17_UTC.wav
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[AGENT][NEUTRAL] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hello, um, my name is [PII]. What information do I need to give you to get this started?
[AGENT][NEUTRAL] So [PII], can I have a policy number?
[CUSTOMER][NEUTRAL] Um, OK, I'm looking at the card. There's a group number, um, there's an in-hospital benefit and an outpatient benefit certification number.
[AGENT][NEUTRAL] OK, either one of those numbers would work.
[CUSTOMER][NEUTRAL] There's a payer ID.
[AGENT][NEUTRAL] Either one of those cert or outpatient or inpatient cert number will work.
[CUSTOMER][NEUTRAL] A pair, which would you prefer?
[CUSTOMER][NEUTRAL] Um, you were actually broke up a little bit. There's a payer ID number also. I didn't see for a second.
[AGENT][NEUTRAL] So the er numbers, either one of the cert numbers would be.
[AGENT][POSITIVE] Great.
[CUSTOMER][NEUTRAL] OK. Got it.
[CUSTOMER][NEUTRAL] 024
[CUSTOMER][NEUTRAL] 787
[CUSTOMER][NEUTRAL] 52
[CUSTOMER][NEUTRAL] M. like
[CUSTOMER][NEUTRAL] Mary, L like Lima.
[CUSTOMER][NEUTRAL] And the number 8.
[AGENT][NEUTRAL] Thank you, [PII]. And could you verify your mailing address and your date of birth?
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[CUSTOMER][NEUTRAL] And my address is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] What is a good callback number just in case the call is disconnected?
[CUSTOMER][POSITIVE] Oh, thank you for asking [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] And how can I assist you today?
[CUSTOMER][NEUTRAL] Um, I received the bill, um.
[CUSTOMER][NEUTRAL] From a company called Verisite and it was run through uh the primary insurance, Blue Cross Blue Shield, and there's after.
[CUSTOMER][NEUTRAL] All the various uh
[CUSTOMER][NEUTRAL] Information there's a $68.10 balance on that.
[CUSTOMER][NEUTRAL] OK, my wife is going to. We're wondering if this is something he should have given his APL card for. It was a genetic blood test because he has prostate cancer and it was done by an outside company.
[CUSTOMER][NEUTRAL] And we're wondering if this could, should have been submitted to APL or if it could be submitted or does APL only cover procedures such as MRIs and X-rays and things like that?
[AGENT][NEUTRAL] So he had the cancer right on his policy which falls under his outpatient benefits of $300 per calendar day and this is not a guaranteed benefits, just a disclaimer on the policy's coverage, so he can contact them, the the billing department and provide them with his APL information.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Wait, you're saying he has a cancer benefit?
[AGENT][NEUTRAL] He is a cancer writer, yes.
[CUSTOMER][NEUTRAL] Can you go in the other room?
[CUSTOMER][NEUTRAL] A cancer writer. Can, can you bring a piece of paper? Can you explain what that cancer writer?
[AGENT][NEUTRAL] OK, ma'am, so I'm gonna need, before I can do anything because I was talking to [PII], I'm gonna need you to provide me your name, mailing address, and your date of birth.
[CUSTOMER][NEUTRAL] Yeah, here.
[CUSTOMER][NEUTRAL] Of course. My name is [PII]. My mailing address is [PII]. And my date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Thank you [PII] and what is the email address that we have on file for you? Oh, we don't have one, so that's OK. Would you like for us to add an email?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Sure. [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Repeat that again.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]. Let me go into my I gotta get my shoes.
[AGENT][NEUTRAL] So I have [PII]
[CUSTOMER][NEUTRAL] I don't know anything about
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And I should already be in your system. I'm the primary holder.
[AGENT][NEUTRAL] Yeah, that's correct, but you have to verify your identity in order for me to speak with you in regards to it.
[CUSTOMER][NEUTRAL] I have the same plan.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[AGENT][NEUTRAL] It's just protocol. So your policy has a cancer writer.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] OK, so how does that cancer writer work?
[AGENT][NEUTRAL] Meaning as if he's going, if he have any services provided, like if he have office visits or anything pertaining to cancer, it will fall under his cancer rider.
[CUSTOMER][NEUTRAL] And can, where do we uh read how that cancer right? You mean like, like he has to go to an oncologist next week. So what does that mean? I can
[AGENT][NEUTRAL] Right, so say.
[AGENT][NEUTRAL] So, say if you don't, so your policy doesn't cover office visits or lab. So if he had lab done and it's, if it was because of cancer, the diagnosis is cancer due to cancer, then it'll be covered. If you have an office visit and the diagnosis would be because of cancer, then it'll be covered under the cancer writer.
[CUSTOMER][NEUTRAL] Oh wow OK so so should he now submit his APL information to this company that did this test last July?
[AGENT][NEUTRAL] Yes, so anytime, anytime he goes to a doctor's office, goes to any, get any type of medical services, he should always provide his APL card so that way they know that he has a gap insurance.
[CUSTOMER][NEUTRAL] OK, but we need to explain that he has a cancer writer and where can I read about that in the policies? Can you send me anything on that?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Well, you don't have to explain to them that he has a cancer rider. You just tell them that you have a secondary insurance with American Public Life.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] But I, I guess it's, um, I don't understand how the cancer rider works, and he was actually thinking of leaving the insurance that we have together through my company to go to Medicare because of the cancer. He was afraid that Blue Cross Blue Shield was going to leave a lot of gaps like it did with this thing, but now knowing that there's this cancer writer, I would like to understand more how it works.
[AGENT][NEUTRAL] So, so what I'm, so I
[CUSTOMER][NEUTRAL] So, is there anything in writing?
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] So his cancer rider, any services that's not covered under his policy, like an office visit or a lab and the diagnosis is because of cancer or due to cancer, it falls under his cancer rider. However, the benefits is only $300 per day. So say if he
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Has to get an MRI or something and it maxed out the $300. If he maxed out those $300 for that day, then there's no more benefits available until the following day, but it only will cover for services for whatever day that the services performed on. But if the benefits are maxed out, then that means that it won't be any available benefits for the day of service if they're maxed out. But I can send you a copy of your schedule to your email address if you would like.
[CUSTOMER][NEUTRAL] I see
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] That would be fabulous.
[CUSTOMER][NEUTRAL] Thank you for explaining this to me, cause I know that there's a cancer insurance buy and I didn't buy the cancer insurance, but I have the APL.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Yes, ma'am, it's a cancer writer. You have a policy with the cancer writer.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] So bear with me, I'm trying to pull up the policy so that I can send it to you by email.
[CUSTOMER][POSITIVE] Perfect. You've been so helpful. Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] So may I place you guys on a brief hold while I pull up your policy and send it to you by the email?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Thank you. I'll be right back.
[CUSTOMER][NEUTRAL] I got it. 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.
[AGENT][NEUTRAL] Hello, Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hello, thank you for holding. So could you provide me with your wife's email address again?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Your email address. It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Schedule.
[CUSTOMER][NEUTRAL] I can't change.
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] Like we already did.
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Oh, it was that thing where you
[CUSTOMER][NEUTRAL] Seemingly could do it daily.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Wow.
[CUSTOMER][NEUTRAL] I have, that's the 12.
[AGENT][NEUTRAL] OK, so I
[AGENT][NEUTRAL] So I've sent it over for you. Could you verify if you received the email?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII], are you able to to
[CUSTOMER][NEUTRAL] She said can you verify receipt of the email?
[CUSTOMER][NEUTRAL] So that's another thing I have to do.
[CUSTOMER][POSITIVE] Hold on, thank you.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I got it. I, I, I didn't open the attachment, but I, yeah, I see it. It's a PDF. Thank you.
[AGENT][NEUTRAL] Are you able to open it? Could you verify if you're able to open it or not?
[CUSTOMER][NEUTRAL] Pages
[CUSTOMER][POSITIVE] Yes, I can open it. Thank you.
[AGENT][NEUTRAL] OK, so,
[AGENT][NEUTRAL] All righty. So um when you scroll down to the schedule page, it should list um information in regards to your cancer writer.
[CUSTOMER][POSITIVE] Exactly thank you so much. I'll look over it and we'll call back if we have any additional questions.
[AGENT][NEUTRAL] But yeah, for future reference just give them your card and you can even go back because we there's no timely filing your policy has been active for since.
[AGENT][NEUTRAL] Um, for [PII], that means you can go back and.
[AGENT][NEUTRAL] If you have services done prior to any date of [PII].
[AGENT][NEUTRAL] Until now of [PII], you can submit your card to them to see if they can submit claims on your behalf and see if anything you do.
[CUSTOMER][POSITIVE] Perfect. Thank you. Uh, fortunately, my husband has met his out of pocket expenses. Well, actually, at the beginning with the deductible. Well, he will do that. Thank you so much.
[AGENT][POSITIVE] Alrighty well thanks
[CUSTOMER][POSITIVE] You've been so helpful.
[AGENT][POSITIVE] Thanks for calling APL and you guys have a great day.
[CUSTOMER][POSITIVE] Yeah, thank you.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thanks. Goodbye.