AccountId: 011433970860
ContactId: 9a7f2408-acff-4aee-a680-c490fc2588d0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1052040 ms
Total Talk Time (AGENT): 540387 ms
Total Talk Time (CUSTOMER): 450255 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/04/9a7f2408-acff-4aee-a680-c490fc2588d0_20250404T18:53_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII], and I had submitted a claim, uh, via text or excuse me, text. I mailed a copy and I faxed a copy in. And then I was going through all my stuff and I found some more bills and I don't know if it's something that I need to submit along with it.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] I don't, I'm really not sure what I need to do.
[AGENT][NEUTRAL] OK, so you filed some document you have filed or sent in things for claim and you have additional information that you also need to file?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Per
[CUSTOMER][NEGATIVE] Well, I think so. Well I mean it's, it's the bills I've gotten. I submitted it on I faxed it on the [PII] and the [PII] and mailed it in the same day also. I just did both, um, but I, you know, with so many bills coming in, I think I don't know what I, you know, I don't know what I did, but I just, when I was going through bills a while ago I thought, oh gosh, there's that bill there's this bill I didn't include this pathology bill and this.
[CUSTOMER][NEGATIVE] You know, doctor's office or or this all that and I don't even know if it would even count towards it because this is a cancer claim like.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][MIXED] I, I mean, I've never done this before. I hope to never do it again, to be perfectly honest, but like, I mean, it's uh it's a beautiful.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] But, but here we are at the moment, so, yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, well, and this is like a bill from the hospital, uh, I think.
[CUSTOMER][NEUTRAL] From when like the.
[CUSTOMER][NEUTRAL] Yes, like from the doctor in the emergency room from when we first went and then they sent us on to the main hospital, you know, I don't know if that, if I needed to send that, um, I've got a couple of those and um actually 3 of those. I don't even know why I've got off so many, but anyway, and then I have a, a, a pass, um, a pro pass bill.
[CUSTOMER][NEUTRAL] Um, that they sent me for $17,000.
[CUSTOMER][NEUTRAL] And I'm like, [PII]. um, and it was from when he was
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] When they did all the uh I sent the pathology report in but this is the pathology bill like the flow symmetry I mean they there's like.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1234, like where they I guess tested the tissue and the more from metric and the pathology consultation and the flow cement cement cytometry. I don't know, there's several of them. But anyway, I did not submit this bill and I don't know if that's something.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] I don't even know how much this little cancer policy pays.
[CUSTOMER][NEUTRAL] You know, I, I submitted a $1,809,000.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Bill for the hospital, which it had it all and then the doctor's office filled it out and all the things, but I just didn't know if that was something else that I should send in.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Or if you've received enough to be able to review it, to be able to pay the maximum amount.
[AGENT][NEUTRAL] OK, so we're needing, yes, so you're wanting to first verify if we've received the claims information yet that you sent to us and then to find out about submitting for additional bills that you have come across that you didn't send in with your other stuff. OK, so yes, ma'am, I can help you.
[CUSTOMER][NEUTRAL] Does that make sense?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I mean if
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Right, I don't know what it would.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so what I'll need to do first off, Miss [PII] is to pull up your policy information, verify several things for security, and then we can go from there. So what is a good call back number for you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] course.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. And then what is your policy number?
[CUSTOMER][NEUTRAL] Uh hm.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] Let me get that out. Surely that would be on one of these pieces of papers that I sent on the APL, um.
[AGENT][NEUTRAL] Yeah, if it's easier, are you the subscriber? Is this your policy and your husband is covered on it?
[CUSTOMER][NEUTRAL] I, yeah.
[CUSTOMER][NEUTRAL] Yes, it's my policy that my husband is covered on.
[AGENT][NEUTRAL] OK, so what is your full social security number and I can look it up that way.
[CUSTOMER][NEUTRAL] Sure, [PII], well, here's the policy number. I've got it. I, no, I wrote it right there. OK, the policy number is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII]. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, thank you. So one moment please.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] Alright, so Ms. [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. And as I stated, I would have to verify several things with you first for security. So if you could first please verify your date of birth and your husband's name and date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, my date of birth is [PII]. My husband's name is [PII]. His date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you also your home mailing address please.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, thank you and the phone number that we have on file for you is the same as the one that you gave me, so that is your best contact number that we should have, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes ma'am mhm.
[AGENT][NEUTRAL] Alright, thank you and then the last piece of information is to verify your email and this does appear to be your work email.
[CUSTOMER][NEUTRAL] Yes it does. It's [PII].
[AGENT][NEUTRAL] OK, thank you. Now I can also see Miss [PII] that you did set up your profile in our portal, the online service center.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So I don't know if you're aware of this, but you can if you have a computer you can upload your information.
[AGENT][NEUTRAL] Directly into that portal for review instead of having to fax it or mail it.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[AGENT][NEUTRAL] Now if no one has sent that because I can see where you did call back on last week to find out about filing a claim I have it if they didn't email you the user guide, I can do that. I have a user guide for the portal that I can send you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And it does give you the instructions obviously for how to set it up first off but you've already done that but it gives you information on uploading documents how to add in like your direct deposit information, but I see that we already have that um.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, maybe I did that.
[AGENT][NEUTRAL] You can opt in what you did for text you did do that, but the portal will explain to you how to upload your documents because like the what we have received for your claim, you know, I can tell that it did not come via the online service center so I will send you that email.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] No, it is I.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, I think I had, I set this maybe I probably did that after I'd already faxed and mailed in a copy.
[AGENT][NEUTRAL] And send in OK alright so.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Just so that you'll know um what to be looking for as far as the email it will come from [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I will put APL online service center portal user guide in the subject line so that that's easy to recognize again it's gonna come from care team.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] At a.m.
[CUSTOMER][NEUTRAL] Care team, OK.
[AGENT][NEUTRAL] Like a baseball team, but it's the care team.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And again, uh, let's see, so just give me a second, I'll just go ahead and send that to you right quick.
[AGENT][NEUTRAL] OK, so that has been sent to you. It shouldn't go to your junk or spam folder, but if you haven't seen it.
[AGENT][NEUTRAL] In your inbox, you know, within the next few months then I would say to check one of those, especially since it's, you know, your work emails on file and depending on the firewalls and such it might would send it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It might kick it out, yeah.
[AGENT][NEUTRAL] To the, to the junk or trash. It might. Yes, ma'am.
[CUSTOMER][NEUTRAL] I mean, yeah, yeah, I get it. I get it, OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So let's see here.
[CUSTOMER][NEUTRAL] So that will get me on how I can upload it digit, yeah.
[AGENT][POSITIVE] Mhm and uh that way you'll be able to instantly see, you know, what we, you'll get a confirmation and then you'll be able to see your confirmation number and that just gives you a little more peace and knowing it's been successfully received by us.
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, OK, and I did get that email, so I will, it just came through, so I will, I clicked on it but I read it.
[AGENT][POSITIVE] OK. OK, good.
[CUSTOMER][NEUTRAL] Let me do that in a little bit, OK.
[AGENT][NEUTRAL] Yeah, OK, just to make sure you received it. All right. Wonderful. All right, so I can, I do see that we have a couple of things on his profile, both of which looks like they were received, um.
[CUSTOMER][POSITIVE] Yes ma'am, that's wonderful.
[AGENT][NEUTRAL] The [PII] they're in line for review.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] So they haven't been reviewed at this point, so I can't answer the question as far as, you know, what all that consists of and what benefits, you know, we can pay based on what has been submitted at this time. I can tell you that they will review the documentation, you know, and for any benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That are possibly payable to you that will be reviewed.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK that.
[AGENT][NEUTRAL] But it
[AGENT][NEUTRAL] Now, the cancer claims.
[CUSTOMER][POSITIVE] Well, it makes me feel good knowing that.
[AGENT][NEUTRAL] Oops, I'm sorry, go ahead. Yes, we did, and it looks like did you submit maybe a wellness for him as well?
[CUSTOMER][POSITIVE] Did receive it, yes.
[AGENT][NEUTRAL] Like a screening
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Maybe I don't really remember what I.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Honestly, I, I'm sorry. It's been so much and.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Much. Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] It's been odd.
[AGENT][POSITIVE] Yes, ma'am. Uh, I totally understand, um.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] This situation, yes, it is. Yes, it certainly is.
[CUSTOMER][NEGATIVE] Overwhelming.
[CUSTOMER][NEUTRAL] To
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So again, you know, uh, without knowing exactly what has been submitted until it's reviewed at this point.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] I really don't know how to answer that question. Um, the claim form, do you have the cancer claim form?
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Did they tell you about that and the reason I'm asking that is the cancer claim form, um, Ms. [PII] has all of the instructions for like what you would need to include when submitting a claim on this type of policy.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I have the I have a wellness claim form which is what the doctor filled out.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And I did print out from work.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The um cancer insurance policy, the thing, the from APL.
[AGENT][NEUTRAL] OK, does it say cancer claim form at the top of the page?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] for cancer insurance.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Payment statement.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, the first page where, yeah, where it has all the instructions on the very first page at the top it should say cancer claim form.
[CUSTOMER][NEUTRAL] APL
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I don't see that, but
[AGENT][NEUTRAL] OK, so what I'm gonna do is I'm gonna send you, you can print it just for future reference you can print it directly from our main website.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] At [PII], but I'm gonna go ahead and if you'll give me just a second, I'm gonna just go ahead and email that to you as well.
[CUSTOMER][NEUTRAL] Oh, OK, uh-huh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, yes, ma'am.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Yeah, this is the first time I've ever taken any of all this in we, you know, we're like, oh we're getting older, maybe we should check, you know, take some of this stuff out and uh.
[CUSTOMER][NEUTRAL] And then it's like bam, you know.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] It's hit us and
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Just so
[CUSTOMER][NEUTRAL] So so much.
[AGENT][NEUTRAL] Give me just one second, Miss [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so I have just sent you that as well. Again, it's gonna come from care team and I did put APL cancer claim form in your subject line.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But the first page of that document, I always recommend that you use that as a checklist because it has all of the information on there as to what we need.
[AGENT][NEUTRAL] If applicable to your
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You know, to the circumstance. And that way, that just takes away a little bit of that guesswork since it's, it is such an overwhelming process.
[CUSTOMER][NEUTRAL] Mhm, mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][POSITIVE] It is so overwhelming. OK. Oh thank you. I got that. OK. Oh, OK, perfect, perfect, perfect. Well, goodness, I am so glad I called today and I appreciate all your help.
[AGENT][NEUTRAL] Oh, you are certainly so very welcome and once these claims have been reviewed that we do have currently on file since you did opt in for text notification alerts, you should receive a text from us. Now you may not be able to at that point instantly sign in and see the status of it in your portal, but you can call us, you can call us and we could give that to you and then once it's.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And the the
[AGENT][NEUTRAL] Fully been processed, you know, the claim number will show up in your portal and your explanation of benefits with any remarks on there. So for example, if there was something that we did need some additional information for, you know, the remark codes will always be on page 2 of our explanation of benefits.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And that way, you know, we give you the opportunity to
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Give get that additional information and then you would just upload whatever we were missing into the portal for further review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK
[CUSTOMER][POSITIVE] Well alrighty well thank you so much for this helpful information. I certainly appreciate it.
[AGENT][POSITIVE] Well, you are very welcome, Ms. [PII]. It was my pleasure in helping you today. And is there anything else that I can help you with at the moment?
[CUSTOMER][MIXED] No, ma'am, if you could wiggle your nose and make it go away, I would appreciate it, but I can't do that either and that's OK.
[AGENT][POSITIVE] Oh, if I could do that, I certainly would.
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Ju[PII], just hang in there. I know it's a very tough situation, but um,
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] We've
[CUSTOMER][NEUTRAL] Yeah, it's.
[AGENT][NEUTRAL] Just hang in there.
[CUSTOMER][POSITIVE] We are. We're gonna hang in and, and we're, we're just believing that we're gonna beat it and get over it, so.
[CUSTOMER][NEUTRAL] That's, that's all we can do.
[AGENT][POSITIVE] That's right. Positive, a positive mindset like that is, is definitely beneficial from firsthand experience.
[CUSTOMER][NEUTRAL] It's the key.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Oh well thank you so much I appreciate that and I hope you have a wonderful day.
[AGENT][NEUTRAL] Oh.
[AGENT][POSITIVE] Well, thank you so much. I hope you do too and if there's anything else we can help you with, please give us a call and I hope you have a wonderful weekend.
[CUSTOMER][POSITIVE] Alright thank you you too mhm bye bye.
[AGENT][NEUTRAL] All right, Ms. [PII], um, thank you again for calling APL. Yes, ma'am.