AccountId: 011433970860
ContactId: a9a06537-025a-464f-ba2c-88270fc3b79b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 557039 ms
Total Talk Time (AGENT): 250137 ms
Total Talk Time (CUSTOMER): 217874 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/a9a06537-025a-464f-ba2c-88270fc3b79b_20250213T15:40_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi there, my name is [PII] and I work with uh a school district. Well I'm, [PII]'m a let me try that again, it's early for me.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I work in a broker's office that handles insurance for a school district, and I don't know if I'm in the right spot. Do I need to be transferred anywhere for like group group claim questions?
[AGENT][NEUTRAL] How can I help you with the claim of questions regarding claims. Is that correct, [PII]?
[CUSTOMER][NEUTRAL] Yes, yes, I, I just had a really quick question just needed some direction, um, we have a gentleman, um, oh go ahead, I'm sorry.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] Well, first off, I'm gonna need to pull up, get some information from you, pull up the group's information, and if it's a specific member, verify some additional things with you for security purposes. So [PII], what is your last name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And the group number?
[CUSTOMER][NEUTRAL] Group number or policy number is 26586.
[AGENT][NEUTRAL] OK, so first off, let me.
[CUSTOMER][NEUTRAL] And it should be for [PII].
[AGENT][POSITIVE] Oh, I'm sorry.
[CUSTOMER][NEUTRAL] [PII] I see no, no, you're fine. I, I was just gonna say it just in case it doesn't pop up like with their name it's [PII] just to verify that that's who it's for.
[AGENT][NEUTRAL] OK, thank you. And then who is the agent of record for this group?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And her, and your email address.
[CUSTOMER][NEUTRAL] Uh, my email address and hers as well.
[AGENT][NEUTRAL] Uh, just, you can start with yours.
[CUSTOMER][NEUTRAL] OK, it's gonna be [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Do you have the specific number that you're calling in regards to or is this a general question?
[CUSTOMER][NEUTRAL] Um, I'm gonna give you his information, uh, just so it's more helpful, it's [PII].
[AGENT][NEUTRAL] And his policy number?
[CUSTOMER][NEUTRAL] Um, I don't know if.
[CUSTOMER][NEUTRAL] I, I guess he doesn't have a specific policy number that I know about. He's just under that group policy.
[AGENT][NEUTRAL] Let me see if I can.
[CUSTOMER][NEUTRAL] Um, unless you
[CUSTOMER][NEUTRAL] Need like a social or something I can give you that.
[AGENT][NEUTRAL] OK, so just a moment.
[AGENT][NEUTRAL] OK, so what is his social please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, and any information that I provide for you today, [PII] would be a verification of benefits and not a guarantee of payment. What is his date of birth?
[CUSTOMER][NEUTRAL] His date of birth is [PII].
[AGENT][POSITIVE] OK, thank you. So, how can I help you today with this policy?
[CUSTOMER][NEUTRAL] OK, so Mr. [PII] has had cancer since last year when we were using Guardian as our cancer coverage provider.
[CUSTOMER][NEUTRAL] And so he has um went through them uh for his first treatment and diagnosis. um I'm a little unclear if he's been re-diagnosed or if it's still the same diagnosis, but what I was curious about was.
[CUSTOMER][NEUTRAL] He's going to go through a 2nd round of treatment or some sort of services for this cancer, and I'm curious if I can open a claim with y'all instead of going back to Guardian, or do you suggest I go back to Guardian since they are the ones that initially took the claim?
[AGENT][NEUTRAL] OK, so give me a moment to see.
[CUSTOMER][NEUTRAL] Unfortunately I don't have a pathology report so I can't confirm um.
[AGENT][NEUTRAL] And that is something that we would have to have, you know, obviously.
[CUSTOMER][NEUTRAL] When
[CUSTOMER][NEUTRAL] Oh, absolutely, I'm gonna get it from him. I just, I, I don't have it handy to like give you like an actual date of when he was diagnosed unfortunately.
[AGENT][NEUTRAL] OK, so I'm not able to view this policy information at the moment, but what I can do is I can connect you.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Um, because I don't know how, I don't know if this is going to be able to pick up or if there's.
[AGENT][NEUTRAL] An elimination.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] You know, uh, period.
[AGENT][NEUTRAL] It appears that this was a takeover, but I'm not 100% since I can't access this policy information, [PII].
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] So let me try to connect you with one of the examiners.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, in our
[AGENT][NEUTRAL] In our claims division that could possibly help you with this.
[CUSTOMER][POSITIVE] OK, that that sounds perfect.
[AGENT][NEUTRAL] So you're just really wanting to know if you all can open a claim now with us or if it needs to continue on with Guardian, is that correct?
[CUSTOMER][NEUTRAL] That's correct, um, since he's receiving new services.
[AGENT][NEUTRAL] Because you're not sure if he's
[AGENT][NEUTRAL] OK. So, but you're not sure if this, these new services or a new diagnosis?
[CUSTOMER][NEUTRAL] Correct. I, I believe it's just services for the same cancer he's already had, um, so I'm gonna go that route first, um, and then I'll call him and get more information. I just wanted to touch base with y'all first.
[AGENT][NEUTRAL] Or
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I understand. OK, so give me just one moment, [PII], and I'll be happy to get you connected with an examiner. Is there anything else that I could help you with first?
[CUSTOMER][POSITIVE] Just to have a wonderful day.
[AGENT][POSITIVE] Oh, I hope you have a wonderful day too, and thank you so much for calling APL.
[CUSTOMER][POSITIVE] My pleasure.
[AGENT][NEUTRAL] Uh, one moment, please.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi, [PII], it's [PII]. How are you today?
[CUSTOMER][NEUTRAL] Fine, how are you?
[AGENT][NEUTRAL] I'm, I'm here.
[AGENT][NEUTRAL] I'm here. I have a really nice lady on the line with one of our broker's offices, and she's calling on policy 254.
[AGENT][NEUTRAL] 2822 for a Mr. [PII].
[AGENT][NEUTRAL] And there's no policy certificate for me to look at.
[AGENT][NEUTRAL] But her question is.
[AGENT][NEUTRAL] This group was had guardian last year, and he's been undergoing treatment for cancer.
[AGENT][NEUTRAL] And she's wanting to know, he's now receiving new services, but she doesn't have full information. She thinks it's related to the same cancer that he's been being treated for, but she is not sure about that.
[AGENT][NEUTRAL] She's going to have to speak with him. She's wanting to know if.
[AGENT][NEUTRAL] They can file a claim for him with APL or if it's gonna need to go back to Guardian.
[CUSTOMER][NEUTRAL] OK, so she is, she's not sure if it's for the same cancer.
[AGENT][NEUTRAL] Correct. She thinks that it is, but she's not 100%.
[CUSTOMER][NEUTRAL] OK, oh, and the certificate is not out here.
[AGENT][NEUTRAL] Oh, and the policy was issued back in September.
[CUSTOMER][NEGATIVE] Yeah. I'll have to get her name and number and have someone on the, on someone give her a call cause I wouldn't even, I don't.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I can, so, yeah.
[CUSTOMER][NEUTRAL] Yeah, I'll have to get her information so somebody can check on it and give her a call back.
[AGENT][NEUTRAL] OK. Well, her name is [PII].
[AGENT][NEUTRAL] And her callback number is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and I did verify that, you know, the group and her email is being connected with the, with the broker and the insured's name and date of birth. So everything was verified.
[CUSTOMER][NEUTRAL] OK, and you said her name is [PII] and she's with the broker's office?
[AGENT][NEUTRAL] [PII]. Correct. Uh-huh. She's with the uh Alderman Financial.
[CUSTOMER][NEUTRAL] OK, you can send it to me.
[AGENT][NEUTRAL] OK, thanks, [PII].
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][POSITIVE] All right, have a good day.
[CUSTOMER][NEUTRAL] You do.
[AGENT][NEUTRAL] Bye bye.