AccountId: 011433970860
ContactId: ad42fe4a-e382-49db-acf2-8f981db32670
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 947219 ms
Total Talk Time (AGENT): 335803 ms
Total Talk Time (CUSTOMER): 516114 ms
Interruptions: 7
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/ad42fe4a-e382-49db-acf2-8f981db32670_20250409T20:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII], and I'm a little confused. I have received uh for mine and my husband's wellness checks.
[CUSTOMER][NEUTRAL] Two checks, which is correct, of $50 each, but they're all, they have all of his stuff on them, not anything from me.
[AGENT][NEUTRAL] Oh, my. OK, Ms. [PII]. OK, I can check them for you. Um, can you please give me your
[CUSTOMER][NEUTRAL] I'm just a little confused here.
[AGENT][NEUTRAL] Your callback number and that way if our call is disconnected I can call you right back.
[CUSTOMER][NEUTRAL] Sure it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then Miss [PII], what is your?
[CUSTOMER][NEGATIVE] 00 you're cutting out.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Um, I'm sorry, I didn't catch that. What is your policy number, please?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] It is 02414789.
[AGENT][NEUTRAL] Oh, let me look that up.
[CUSTOMER][NEUTRAL] And I have a claim 2 different claim numbers.
[AGENT][NEUTRAL] OK. First, um, let's go ahead and verify your policy. Can you please give me your date of birth?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Thank you. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] So my address is [PII]. The phone number is [PII], and the email address is [PII].
[AGENT][POSITIVE] Thank you. I appreciate it, Ms. [PII]. OK, what is the first claim number?
[CUSTOMER][POSITIVE] Absolutely.
[CUSTOMER][NEUTRAL] OK, the first claim number uh is.
[CUSTOMER][NEUTRAL] 358-3384
[AGENT][NEUTRAL] OK, let me look that one up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I think what confuses them is I attach all the documents together.
[CUSTOMER][NEUTRAL] When we
[CUSTOMER][NEUTRAL] File a claim
[AGENT][NEUTRAL] It may have. OK, on your claim number 3583384.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, that check number is 2,036,520.
[AGENT][NEUTRAL] In the amount of $50 and.
[CUSTOMER][POSITIVE] That is correct.
[AGENT][NEUTRAL] OK. And then yes, ma'am. Now let's, can you give me the next claim number and I'll tell you what that check number should have been.
[CUSTOMER][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] OK, cause that's got Doctor [PII]. He's not my doctor. He's my husband's doctor.
[AGENT][NEUTRAL] 00 my. They must have just mixed up the doctor names on it.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, well, and I, I wondered about that and I thought I don't know what they're doing here. OK, the other claim number is 3583389.
[AGENT][NEUTRAL] OK, let's look that one up.
[AGENT][NEUTRAL] Give me just a second while it pulls in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And he didn't have a bone density test. I did.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I'm sure it's all OK. It's just one of those things, you know, you go, wait a minute.
[AGENT][NEUTRAL] Yes, ma'am. Yes, ma'am. It is gonna work out, um, and then that check number for your husband's $50 is 203-7296.
[CUSTOMER][NEUTRAL] OK, perfect. OK, so they just messed up the doctors on mine and
[AGENT][NEUTRAL] I, they may have, yeah, that's what it appears to be.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Because it was supposed to be [PII]. OK, I do, while I have you on the, on the phone because um we are going through cancer treatment right now. My husband, uh,
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] He has follicular lymphoma and he has, he had a biopsy in
[CUSTOMER][NEUTRAL] January?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] January or February.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And uh we are doing the bite treatment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] But my question is because we're getting ready to send them out my bills and um because we've got 3 of them right now and uh we don't have anything regarding the EOB yet so do we have to send the EOB in? I, I'm confused because it lists several things to send in and I'm just a little confused.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK. Uh, on the
[CUSTOMER][NEUTRAL] So we have the actual biopsy.
[AGENT][NEUTRAL] OK. All right, let me look real quick at the cancer claim form.
[CUSTOMER][NEUTRAL] When they did the biopsy.
[AGENT][NEUTRAL] Um, and you do have the cancer claim form, is that correct? And you saw at the top of it all the
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] I do, yes, I have it so.
[AGENT][NEUTRAL] Yeah, OK.
[AGENT][NEUTRAL] It states to send the explanation.
[CUSTOMER][NEUTRAL] Yeah, now, and on the
[AGENT][NEUTRAL] Of benefits when you have, when you're filing a claim for services such as hospitalization, surgery, chemotherapy, immunotherapy, radiation therapy, hormone therapy, or anesthesia. Um, it does say.
[AGENT][NEUTRAL] To send the explanation of benefits from your other medical carrier showing the amounts allowed and paid for each service. So, yes, ma'am, you will need to send that in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So we need these when Medicare gets.
[CUSTOMER][NEUTRAL] To it.
[CUSTOMER][NEUTRAL] OK, um, is that also including where they did the biopsy?
[AGENT][NEUTRAL] OK, so,
[CUSTOMER][NEUTRAL] That we need that EOB as well.
[AGENT][NEUTRAL] Right. Um, and the operative report may be required to file a claim for surgeries, multiple surgeries performed on the same date. Now, if they did more than one on the same date, then you'll need to send in the operative report. But yes, you will need to send in the EOB for that also.
[CUSTOMER][NEUTRAL] OK, you'll be and, OK, so they only did the the one surgery and that was through his lungs, uh, to do that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh so we're doing, so I'll only send, I guess the report from the doctors.
[CUSTOMER][NEUTRAL] From the hospital area with everything on it, the I just wanna make sure I have everything together before I send all this stuff.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes ma'am, I understand, I understand and if there's anything that you feel like will be beneficial to the claim, go ahead and send it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm it's
[CUSTOMER][NEUTRAL] OK. All right. So so far we've gotten, he's had 4 treatments and we've got 3 of the um.
[CUSTOMER][NEUTRAL] Out of my statements here.
[CUSTOMER][NEUTRAL] From Doctor [PII]'s office at the cancer center.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] I can't believe how expensive this is. Oh my gosh.
[AGENT][POSITIVE] Oh, I know, my goodness. I, I will definitely will keep you in my thoughts and prayers because I know that's gonna be a whole lot for you guys um to go through. But you'll make it. You guys are gonna do OK a lot at one time.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Oh yes.
[CUSTOMER][NEUTRAL] Yes, no kidding. So, um, OK, so on the pathology report must be submitted when filing a claim for initial diagnosis of cancer.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So he's had um
[CUSTOMER][NEUTRAL] CT scans and PET scans.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And is that what they're talking about? And then it also says um.
[CUSTOMER][NEUTRAL] Surgery including biopsies, so would that be the one that.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, so that's what the EOB, not the uh.
[AGENT][NEUTRAL] That's a very important, right. That pathology report is separate. That's the most important. It's very important that you send that because that is what actually says that he has cancer so that you can claim the benefit for your cancer policy.
[CUSTOMER][NEUTRAL] OK, OK, so.
[CUSTOMER][NEUTRAL] I'm just like oh man this is a lot OK and so the initial the initial diagnosis of cancer.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What are we talking and just the doctor's visit? Or are we talking a PET scan or a CT scan?
[AGENT][NEUTRAL] Right. The, um, when you go to the doctor or even if you can call the doctor and ask them to email it to you, um, the pathology report is what you're gonna tell them. I need the pathology report with the initial diagnosis of cancer.
[CUSTOMER][NEUTRAL] Report.
[CUSTOMER][NEUTRAL] With initial.
[CUSTOMER][NEUTRAL] Diagnosis.
[CUSTOMER][NEUTRAL] Cancer.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then when we did the surgery for the biopsy, we need the surgery stuff from the doctor there and the EOB is that correct?
[AGENT][NEUTRAL] Yes, you'll need that pathology report for that biopsy also. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK, so we need the pathology report. OK, and then we've got the autoized bills so far.
[CUSTOMER][NEUTRAL] And I got
[CUSTOMER][NEUTRAL] had a heart attack when I seen the third one that's the 60 mg he received last week and today was $96,000.
[AGENT][NEUTRAL] Oh my.
[AGENT][POSITIVE] Oh good.
[CUSTOMER][NEUTRAL] Well, OK, then. Well.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, he's in there laying down now, so.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Um, let's see, and then we've gotta have the Medicare EOB.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And Medicare is so different. It depends on when it comes through, that's the bad part.
[AGENT][NEUTRAL] Yeah, they're they um.
[CUSTOMER][NEUTRAL] We don't know how long it'll be.
[AGENT][NEUTRAL] They march to the beat of their own drum because they're government, so it's, it's a whole different.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Different bird with that one.
[CUSTOMER][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] Exactly, now I do have a question for you on we live locally but we travel about 30 to 40 minutes to the cancer center every time. Do is there anything that.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It has to be.
[AGENT][NEUTRAL] Right. Um, it has to be more than 50 miles.
[AGENT][NEUTRAL] And you'll have to keep all of your receipts to show.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You know where you're traveling to?
[CUSTOMER][NEUTRAL] OK, is that 50 miles one way?
[AGENT][NEUTRAL] Oh, yes.
[CUSTOMER][NEUTRAL] A round trip.
[AGENT][NEUTRAL] One way.
[CUSTOMER][POSITIVE] One way OK so we're not gonna do that so I don't have to do that, yay.
[CUSTOMER][NEUTRAL] For me,
[CUSTOMER][NEUTRAL] OK, yeah, for me it's bad for my car to have miles but I, OK, and then, um, they gave him a prescription.
[CUSTOMER][NEGATIVE] For nausea.
[CUSTOMER][NEUTRAL] Uh, do we anti-nausea supplied through their pharmacy and so do we need a, I think I have the copy of where we paid for it.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] It wasn't it wasn't much. Do we just send that little piece of paper in?
[AGENT][NEUTRAL] Yeah, the copy of the prescription.
[AGENT][NEUTRAL] And you'll also need it if they do, if they do any other like chemotherapy, hormone therapy, or pain.
[AGENT][NEUTRAL] I do see that you saw the anti-nausea supplied, but yes, go ahead and keep that receipt and send it in also.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright and um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I can't think of anything else. I just needed some explanation because I've seen all these dots and I was like, wait a minute, what do I do here?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh my.
[CUSTOMER][NEUTRAL] So because it's a lot, it's a lot. OK, so I've got the paperwork filled out. I just gotta get these other little payment I mean these pieces to go with it and then I can file it with you guys.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's still I mean if you ever get the process.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Always feel free to pick up the phone and call us, OK?
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, alright, well I just uh I just know you guys have been very helpful and everything and I'm like I'm not sure I need to figure this out, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Anyway, but I will uh I will definitely.
[CUSTOMER][NEUTRAL] Uh, keep all this together and we'll get the all the other stuff to go with it and then go from there.
[AGENT][POSITIVE] OK. OK. That sounds like a deal.
[AGENT][NEUTRAL] All right. Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] All right, well, I'm gonna go ahead and.
[CUSTOMER][NEUTRAL] No, I think that's it. I'm gonna go ahead and deposit these checks. I just wanted to make sure there wasn't any kind of craziness going on on my end.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][POSITIVE] No, ma'am. They're good to, they're good to go ahead and cash.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, I'm gonna just put them in the savings so.
[AGENT][NEUTRAL] OK. All right, Ms. [PII].
[CUSTOMER][POSITIVE] All right. Thank you so much for your help.
[AGENT][POSITIVE] You're very welcome and like I said, if you feel you need extra help later on, always feel free to pick up the phone, OK?
[CUSTOMER][POSITIVE] OK, I will. I appreciate it.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] You're very welcome. You have a, you have a good day and thank you for calling APL Miss [PII].
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] You too take care.
[AGENT][NEUTRAL] You too. Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.