AccountId: 011433970860
ContactId: a633ffcf-de67-49a4-9c31-250fa07d338d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 973500 ms
Total Talk Time (AGENT): 281121 ms
Total Talk Time (CUSTOMER): 344129 ms
Interruptions: 1
Overall Sentiment: AGENT=0.6, CUSTOMER=-1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/05/a633ffcf-de67-49a4-9c31-250fa07d338d_20250205T16:46_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEGATIVE] Yes, uh, my, oh crap, uh, can you give me one second? My timer just went off. Hold on one second. I'm trying to cook also. Give me one sec, one minute.
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] Yes, sure. Yes, yes.
[CUSTOMER][NEUTRAL] All right. Sorry. Um, I don't know why I'm cooking fish. I can't cook it and I'm usually burn it, so I'm trying again. All right. Um, my name is [PII] I have an insurance policy with you for cancer, but I don't have my, um,
[AGENT][NEUTRAL] I think
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] ID number, group number, whatever. I have nothing that says I have, I have the insurance with you. I started this through my school.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And they don't give out cards. And so now, um,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm retired. I was wondering if there's any way I can get a card or something that says I have insurance with you. And um I have a question about my insurance coverage.
[AGENT][NEUTRAL] OK. I'm sure, I can assist you with that information. And can I get the spelling of your first name?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And I live in [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK, it's this number I'm calling you right now. [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], I did it. I got it all through that stopped me.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. Thank you. All right. And I need to verify your date of birth, mailing address, and email address for security.
[CUSTOMER][NEUTRAL] And my email address is [PII].
[CUSTOMER][NEUTRAL] My birthday is [PII].
[CUSTOMER][NEUTRAL] And my address is um [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, perfect. Thank you. All right. And let's see, so I, I did find your policy and you said you need the policy, but we don't have an ID card, but I can send you the policy certificate information, OK?
[CUSTOMER][POSITIVE] That would be great. That way I could cut it open, uh, and carry it in my wallet or something so I have that.
[AGENT][NEUTRAL] Yeah. Mhm.
[AGENT][NEUTRAL] OK. All right. So let me go ahead and send the request over.
[AGENT][NEUTRAL] For the policy certificate.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And what type of questions do you have about the policy, about the benefits?
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] What does it cover exactly? Because um I had a mammogram.
[CUSTOMER][NEUTRAL] And uh my doctor said, oh fine. Of course, he calls me obese too. Um, and um then the hospital called, sent me a letter saying I need to come back for a sonogram, so I did.
[CUSTOMER][NEUTRAL] And um,
[CUSTOMER][MIXED] My insurance covered, covered the first one, no problem, because it was preventive, whatever. And the second one, they covered a little bit, part of it, but I still had to pay some.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I just got another letter from my hospital. Apparently, I missed the first uh the first one in December, but they wanted me to come back and um have another mammogram to look and see if what they found is benign.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In my breast.
[CUSTOMER][NEUTRAL] So I called my health insurance.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] And they're not sure they're gonna cover it.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK. Uh.
[CUSTOMER][NEUTRAL] So they said just depends on what my doctor writes.
[AGENT][NEUTRAL] OK. OK, let me check and see what are the benefits for diagnostic testing, OK? One moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and this is not a guarantee of payment, just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And let's see.
[CUSTOMER][NEUTRAL] Yes, I understand.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] That's great.
[AGENT][NEUTRAL] OK, so for the first diagnostic testing, which is the first one you got, um, the, uh, we cover $50 and that's one time per year. And then if you need to have a follow-up test, and the follow-up test is covered at $100 and that's one time per year as well.
[AGENT][NEUTRAL] Um, if, um, if it comes back that is, um, cancerous, then you do have a medical imaging benefit of $500 and that's again one time per covered person per calendar year. But that $500 is if it was positive for cancer. Um, if it's not, then it's just gonna be that $50 1st diagnostic benefit, which is your preventative and then your follow-up, which is the $100.
[CUSTOMER][NEUTRAL] OK. So, can I get the $50 and the $100 from last year, or is it too late?
[AGENT][NEUTRAL] No, you can always submit a claim. Um, there's no timely filing limits, so you can still submit that claim. Um, do you have the claim form or do you need to know where to find that claim form?
[CUSTOMER][NEGATIVE] I have no claim form. I have, I have nothing from you. I had to search in Google to find your number, and I, the only way I could, I knew I had you is because um uh my auto uh payment from my bank and my bank said your name. That's the only way I could find you.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK. So let me go ahead. OK, I'm sorry for that. Let me go ahead and send, u[PII], I'm gonna go ahead and send the request for the certificate and I'm also gonna send the request for the claim form to be sent out to you, OK? Uh for the wellness claim form. So let me go ahead and do that and if you have access to a computer and you want to register online, you can also do that and you can send the claim electronic if you want to do that in the future.
[CUSTOMER][NEGATIVE] That's so I have nothing.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but that is an option as well, and that's through [PII], OK?
[CUSTOMER][NEUTRAL] Wait, wait, wait, wait, wait. [PII]?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is it all upper or lower case or half and half?
[AGENT][NEUTRAL] No, it doesn't matter. Just however you want to put it, it's just [PII].
[CUSTOMER][NEGATIVE] OK. All right. I'm gonna write cancer.
[AGENT][NEUTRAL] Yeah, it's gonna take you to our website. Yeah, it's gonna take you to our website and you're gonna click on sign in and you can create your account.
[CUSTOMER][NEUTRAL] OK, I will do that. I will get on that, but if you could still mail me the other one because I don't have a printer right now. Well, correction, I have 2 printers and a new laptop because I just retired, so I just bought myself a laptop because the school provided me a Chromebook. So my laptop doesn't talk to the printers.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, I understand.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Oh, [PII]. Mhm. OK. It's fine.
[CUSTOMER][NEUTRAL] So, I need to go get another printer.
[AGENT][NEUTRAL] Yeah, gotcha. OK. Let me go ahead and send this through and send a copy of the um form, OK? Do you mind holding for me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] No, no, no.
[AGENT][POSITIVE] Thank you. Thank you.
[CUSTOMER][NEGATIVE] 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][POSITIVE] Thank you for holding and being patient for me, Ms. No. OK, I went ahead and send that request over for the certificate and the form, OK? You should be receiving those within 5 to 7 business days.
[CUSTOMER][NEUTRAL] OK. And just out of curiosity, what do I have to have, what?
[CUSTOMER][NEUTRAL] What do I need to show proof that I had my mammogram? Do I have to get a letter from the doctor or do I have to get a note from the imaging center, from the hospital?
[AGENT][NEUTRAL] Um, no, um, the form is uh really explanatory, but we just need the date that you had that done and the doctor's name and information so we can verify. So you don't need to send any document. You just need to fill out the form.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK, right now I have another question.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] When I did my mammogram, I had Doctor [PII]. He's no longer with the
[CUSTOMER][NEUTRAL] The chain, whatever it is that I'm going to, um, and he's left.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He took everybody in the, in the office except for one PA. So I think he was there.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Or maybe he was still there. I don't remember now. It was close to if she was there when I asked for the other one or if he was still there. But it was really close between the two of them. But technically, Doctor [PII], the one who signed off for me to go, is no longer at the, I don't even remember what, what the facility is called, or that I go to.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] So is that OK?
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] Yeah, you can just put the facility information and the information of the doctor and the phone number of the facility. So if we need to call and get in contact, we can just um ask about them. Um, more than likely they're gonna have the records that you did have the test there and who took care of the test for you. Mhm. Yeah. Mhm.
[CUSTOMER][NEGATIVE] 00 yeah, they don't have the records because I said I was there. But good luck calling them cause I call them every day I call them and I, I, I get at [PII] that they are, that they're close, they close at this time and they go to lunch at this time and I get the answering service. I leave a message and no one calls me back.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Uh, well, if you have anything in your position that has the information of your testing, like a letter of findings or anything like that, you can send us a copy if you want us to use that as a reference just in case we don't get in touch with the doctor. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, well, I can, I'm um.
[CUSTOMER][NEUTRAL] I can go, I'm gonna be near the hospital tomorrow or Friday. And so I can swing by there and I can just get them to print out saying that I came there, if that will be OK. And then I, I can talk to my doctor on Friday and see if she can look up stuff for me and give me stuff.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] Yeah, that'll be great. Yes.
[CUSTOMER][POSITIVE] OK. All right. Thank you very much. I appreciate your help.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] You're welcome. Is there anything else I may help you with today, Ms. [PII]?
[CUSTOMER][POSITIVE] No, that's it for right now. I'm still trying to figure out what's going on with all this stuff. Thank you so much.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right. You're welcome and have a good afternoon.
[CUSTOMER][POSITIVE] You too. You too.
[AGENT][POSITIVE] Thank you, bye bye.
[CUSTOMER][NEUTRAL] Uh-huh. Bye-bye.