AccountId: 011433970860
ContactId: 997fbdf0-6040-45bd-8db8-bdfd64f3c209
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 796000 ms
Total Talk Time (AGENT): 371069 ms
Total Talk Time (CUSTOMER): 375734 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/03/997fbdf0-6040-45bd-8db8-bdfd64f3c209_20250303T15:24_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Uh, yes, good morning. My name is [PII]. I'm calling um on behalf of my father, trying to help him. My, uh, my mother's had a policy with you since, uh, [PII]. It was revised in [PII]. I've got all that information with me. Uh, but, um, so she was diagnosed with, uh, cancer.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And and then she had to have a
[CUSTOMER][NEUTRAL] colon surgery, this was in May and then she, she passed away on, on [PII] and
[AGENT][POSITIVE] Oh, I'm so sorry.
[CUSTOMER][POSITIVE] Uh, yeah, thank you very much. Um, and, you know, I'm just trying to help my father, he's [PII] and
[CUSTOMER][NEUTRAL] You know, this, um, we, we found the, the cancer policy, but uh, you know, I, I, I see how to submit a claim and everything, but I, I just wanted to call and see if I
[CUSTOMER][NEUTRAL] Um, could you submit something online or?
[AGENT][NEUTRAL] Um, what is the policy number, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] it's, it's 837-85.
[AGENT][NEUTRAL] 78 OK thank you give me one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And your mom's name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] OK. And I will say, um, since you are helping your father, um, we would need a copy of the
[AGENT][NEUTRAL] Well, we would need a copy of your mom's death certificate because I don't show it, but she.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Uh, yeah, sure, yeah, yeah, I've got, I've got that. I think I've got everything.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But I definitely, I definitely have multiple copies of the death certificate.
[AGENT][NEUTRAL] OK, OK, because we will need a copy sent, um, and if you are helping your father, we probably would need a POA, or do you have a POA or he can sign a third-party authorization form.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, he, he, he could sign the, the authorization form.
[AGENT][NEUTRAL] OK. Um.
[CUSTOMER][NEUTRAL] I don't, I don't have a power of attorney.
[AGENT][NEUTRAL] OK. If he can sign that authorization form, uh, giving us permission to speak with you in regards to any claim status or any benefits, um, then that will make it a lot smoother since you're helping them. And as far as your mom, um, we would just need a copy of that death certificate and any billing that you may have for her, uh, for any, you said she was diagnosed with cancer?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yes, yes, um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Do, now I have, I have them, I have, I think all of her medical records. Uh, so I have, you know, pathology reports, I have surgeon reports, uh, oncology reports. I have
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You know, every, all of those things also.
[AGENT][NEUTRAL] OK, well, and I think you asked if you can sit down one,
[CUSTOMER][NEUTRAL] Or
[AGENT][NEUTRAL] The best way is either mail or submit or fax. I'm not sure how big it is, but you can fax it to us. Um, I'll give you that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I can, I mean, I, I could, I could do any of those options, uh, have access to fax and email and whatever needs to be done, uh, but, um.
[CUSTOMER][NEUTRAL] Is it
[CUSTOMER][NEUTRAL] What, what are the options as far as the documentation? Uh, does it have to be a billing statement or, or does it, or could you have like the, would you accept like the actual, um, you know, pathology reports and that type of thing?
[AGENT][NEUTRAL] Um, well, when it comes to any conf if she was confined in a hospital or re receiving any kind of treatment like chemo, radiation, or immunotherapy, or had surgeries, we would need those bills because it will have those procedure codes we need to process. But any and all of the pathology reports you have to submit it to us, especially the initial pathology report.
[CUSTOMER][NEUTRAL] I see, right, right.
[CUSTOMER][NEUTRAL] Sure, I've got that. I, I don't think it's gonna be a problem, uh, to get anything for you. Uh, it's just uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I want to see exactly what all I needed to see. The first thing you'll need me to send you is that is that is that uh authorization?
[AGENT][NEUTRAL] Well, the first thing we would need is the death certificate cause we don't show any anything in our system that um Ms. [PII] is no longer with us, so we would need that.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, now I have that I have that today. I mean, I've got that with me right now and I could fax it to you or whatever uh is best.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, yes, sir. I can give you the fax number to our customer service department when you're ready.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] Uh, OK, it is 877.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 807.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 0911.
[CUSTOMER][NEUTRAL] 0911. Do I put to anybody's attention?
[AGENT][NEUTRAL] Uh, just claim, I mean, not claims, customer service department because they will need that in the system, um.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] For any claim information you can fax it to our claims department. I can give you that number when you're ready.
[CUSTOMER][NEUTRAL] For, for faxing the claims, OK, sure.
[AGENT][NEUTRAL] Yes, sir. Uh, the claims fax number is 877.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] And 423.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right, um,
[AGENT][NEUTRAL] And let me see if that form is available. Give me one quick moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see because they usually have most of our forms on our website. Oh, and they do that.
[CUSTOMER][NEUTRAL] Uh yes, ma'am.
[AGENT][NEGATIVE] If you go to um secured, no, that's wrong, sorry, [PII].
[CUSTOMER][NEUTRAL] Right. Yes, ma'am.
[AGENT][NEUTRAL] Under claims and forms, we would need that authorization to disclose form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's, that's no problem whatsoever. So I can just uh submit that electronically?
[AGENT][NEUTRAL] Uh, you can fax that to us along with the, uh, fax it to the claims department that way we will have it in our system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Fax the authorization to the claims department.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Yes, sir. And that will give us, um, we can put it in our notes that you are helping your dad. Um, and it's on the form, it is, does, uh say what information we can disclose. And he would just need to sign it, date it, and there is a timeline. Uh, usually it's from, uh, 2 years from the date it was signed. And if he want more specific time, he can put it in there as well.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Um, so fax the authorization form after he signs it and dates it and uh go ahead and and fax you the death certificate to the number you gave me for that.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And then once I've done both of those things,
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What, what should I do next?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] That's pretty much it. And then um you can just start fax or any billing that you have for her, just uh you can send to that claims fax number and that way claims can have it. You can fax all of it together. It doesn't have to be separate.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh, so it didn't have to be separate for the diagnosis of cancer or the surgery?
[AGENT][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] If you sit it all together.
[AGENT][NEUTRAL] Yeah. Yes, sir. Cause what the examiner should do, they'll go by that uh pathology report and then go by the date on which you received any kind of treatment. So you, you can always um pull them together. And if additional information is needed, they will send out a, an explanation of benefits, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Um,
[CUSTOMER][NEUTRAL] It's a, I know it's it's an older policy, uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And I was just reading where it, it said it was stating that uh
[CUSTOMER][NEUTRAL] For, for filing a claim just for the diagnosis of cancer.
[CUSTOMER][NEUTRAL] Or filing a claim for hospitalization or surgery related to cancer, those things would be separate, but you're saying it's OK for me to send all that together?
[AGENT][NEUTRAL] Uh, yes, sir.
[CUSTOMER][NEUTRAL] OK, all right, OK, well, very good. Uh, I'll, I'll go ahead and get started on that then and get my dad to sign and date that, and, and I'll go ahead and is it OK to go ahead and fax the death certificate to you now?
[AGENT][NEUTRAL] Uh, yes, sir. Uh, it's best to go ahead and send that, that way we'll have it in the system, uh, customer service can go ahead and add that. Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, all right, well, very good. I'll go ahead and and get those things started and uh.
[CUSTOMER][NEUTRAL] It, but as far as the, uh, other than the billing statement that shows the codes and everything, uh, you would recommend for me to go ahead and and send uh the pathology report and uh like the, the surgeon's, um, inpatient report when, where she had her surgery or
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes. Anytime um she has, or anytime she had surgery, also, if you have those surgical pathology reports, to submit it to us. And if you don't mind me asking, what was she diagnosed with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, she had an adenocarcinoma of the sigmoid colon.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] With, uh, with, with, uh, metastasis to both lungs.
[AGENT][POSITIVE] Oh, bless her heart. I'm so sorry.
[CUSTOMER][POSITIVE] Yes ma'am well thank you.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] But yes, any, anytime, any surgery she's had, um, usually there, it comes with a surgical pathology report as well, if you can submit that to us. Um,
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Any billings for chemo? Did you, do you know if she went through chemo and radiation?
[CUSTOMER][NEGATIVE] She, she, she never did, yeah, she never did any treatments. Uh, the oncologist didn't recommend that. It was just too advanced. Um, so she had a colonoscopy, um, oh, she had a PET scan, then a colonoscopy, and then immediately after that, she had surgery to remove um a mass that was almost completely blocking her, her lower colon.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] And, uh, and then after the surgery, she was discharged from the hospital and uh of course, I had follow-up visits with the surgeon and the oncologist and, uh, you know, did well for a couple of months, maybe, and, uh, and then, you know, the the oncologist recommended hospice immediately and, and that's, that's what we did. And, and she, you know, uh, survived a few months.
[AGENT][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Oh, cancer is so horrible. It really is.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yes, yes, ma'am, it is.
[AGENT][NEUTRAL] But um,
[CUSTOMER][POSITIVE] Absolutely.
[AGENT][NEGATIVE] Yeah, so any billing that you have for her, for even for hospice just to submit that into us, um, it's better to have too much and not enough.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And, and you prefer that I fax?
[AGENT][NEUTRAL] Uh, yes, sir. And that way if you fax, you still have a copy just in case if something happens, then you'll have that on the ready instead of sometimes it, well, I don't want to put that out, but
[AGENT][MIXED] Sometimes it can take a while for mail or could get lost, but faxing is the quickest and um
[AGENT][NEUTRAL] Wait and we can verify that it's been received.
[CUSTOMER][POSITIVE] That's that's better than uploading it in in the APL site.
[AGENT][NEUTRAL] Um, the, the site, you can if your mom had, uh, set up an account on the online service center because it's basically using her information.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, to set up.
[CUSTOMER][NEUTRAL] Yes, yes. Yeah, my father, my father has access to that. He's on the policy also.
[AGENT][POSITIVE] Oh, well, that's good.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So if you have, I mean, if y'all have access to it, you can upload it as well, but not the um death certificate. I would say the fax that, but the claims, you can definitely upload that in the system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, very good then then that that'll be good then I'll, I'll go, I'll do that and I'll go ahead and get that death certificate to you right away.
[AGENT][NEUTRAL] OK. Well, what is there anything else I can assist you with today, Mr. [PII]?
[CUSTOMER][POSITIVE] Uh, no, ma'am, uh, you're very, very helpful. I really appreciate it. I'll, I'll get started on this, and, uh, I may have more questions, but, but, uh, I'll go ahead and get him to sign and date that and, and start getting this over to you.
[AGENT][POSITIVE] OK. Uh good deal.
[AGENT][NEUTRAL] Well, I
[CUSTOMER][POSITIVE] OK, well thank you very much for your help.
[AGENT][POSITIVE] Oh, you're welcome and uh thank you for calling APL. You have a great day.
[CUSTOMER][NEUTRAL] OK, you too, bye bye.
[AGENT][NEUTRAL] Bye.