AccountId: 011433970860
ContactId: ada0aab9-c420-4b93-b41e-75ed0fc22edf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 434799 ms
Total Talk Time (AGENT): 165431 ms
Total Talk Time (CUSTOMER): 220096 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/ada0aab9-c420-4b93-b41e-75ed0fc22edf_20250408T17:14_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Oh thank you for calling AP.
[CUSTOMER][NEUTRAL] And your name is what?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] My name is [PII]. OK, Ms. [PII], my name is [PII], and I have uh received your cancer claim form.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um I uh was just want to ask some questions about it. Uh, I got all of my um.
[CUSTOMER][NEUTRAL] Uh, bills from, uh, the hospital and from the doctors and from, uh, everybody. So can I just
[CUSTOMER][NEUTRAL] I mean, do I just fill out this.
[CUSTOMER][NEUTRAL] Statement of insured or uh
[AGENT][NEUTRAL] Yes, ma'am, um, you'll just fill out that, um, well, first, let me do this. May I have your name?
[CUSTOMER][NEUTRAL] Do that
[CUSTOMER][NEUTRAL] OK. I'm sorry, [PII]. You can look me up.
[AGENT][NEUTRAL] Well, I'm sorry, you already said [PII]. And Ms. [PII], may I have a
[CUSTOMER][NEUTRAL] And
[AGENT][POSITIVE] Good contact number in case we're just go ahead.
[CUSTOMER][NEUTRAL] Date of
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And your policy number?
[CUSTOMER][POSITIVE] Oh goodness. Oh goodness gracious.
[CUSTOMER][NEUTRAL] Hold on just a second.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] OK, I can look it up with your social also, whichever you prefer.
[CUSTOMER][NEUTRAL] I know you're there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. You need my whole social?
[AGENT][NEUTRAL] Yes, ma'am, to search for the policy.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] I had all that right there.
[AGENT][NEUTRAL] So I'm just waiting for the policy to come up here. Hold on one moment.
[CUSTOMER][NEUTRAL] That's OK. That's OK. I talked with the [PII].
[CUSTOMER][NEUTRAL] At one time.
[AGENT][NEUTRAL] OK. You said for cancer. Yes, I do.
[CUSTOMER][NEUTRAL] Do you know her?
[CUSTOMER][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] OK, here we go, and I just need you to.
[CUSTOMER][NEUTRAL] My policy number.
[CUSTOMER][NEUTRAL] OK, go ahead. Date of my birth.
[AGENT][NEUTRAL] I just need
[AGENT][NEUTRAL] Mhm. Your date of birth, your mailing and email address on file?
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Uh, my email is [PII].
[CUSTOMER][NEUTRAL] And my address is [PII]. That [PII], I always spell it out because it kind of blends all in together when you say it, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am, and thank you so much for verifying your policy, um, and all the information provided is a verification of benefits, not a guarantee of payment. So, yes, ma'am, you're gonna fill out the um statement of insured. So page one, page.
[AGENT][NEGATIVE] I'm sorry, page 2 is the statement of insured, page 3 is just like verbiage and then page 4 there you'll have to sign at the bottom, but that, so page 2 and 4.
[AGENT][NEUTRAL] And then whatever documents you're sending in.
[CUSTOMER][NEUTRAL] OK, 2 and 4. I'll need to send that.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. And then I just signed number 4 and then I, uh, fill out this, uh, well there was some stuff I didn't understand on here. Uh, part B, OK, first name, middle name again, and then section C.
[CUSTOMER][NEUTRAL] Uh, I didn't, I mean, I traveled to [PII], but that's not, I mean,
[CUSTOMER][NEUTRAL] Uh, so, uh,
[AGENT][NEUTRAL] Yeah, it's
[AGENT][NEUTRAL] If the transportation and
[CUSTOMER][NEUTRAL] Lodging, I didn't have no lodging.
[CUSTOMER][NEUTRAL] I didn't have no transportation and lodging.
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Right. If the
[CUSTOMER][NEUTRAL] I mean, are you talking about going to the hospital or going to the doctor or what?
[AGENT][NEUTRAL] If the transportation and lodging doesn't um apply to what you're submitting for, you can just leave those sections blank as long as the A, B, and all the signatures are there, um we're gonna still process.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] OK, and then I'm gonna send all of my claims, right? My what my doctors have sent me the bills, the itemized listings.
[AGENT][NEUTRAL] Yes, ma'am, the itemized bills, um, if you're trying to prove anything, the pathology report, um, on that first page there is the list of instructions. So depending on what you're filing for, it'll tell you what's needed.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. Well, I, um, have my um doctor, my hospital, my, uh, the, uh, I had breast cancer and I had to get them removed. And so the reconstruction and everything, I have all of that.
[AGENT][NEUTRAL] So you're gonna look at bullet
[CUSTOMER][NEUTRAL] That's what they tell me to get.
[AGENT][NEUTRAL] So you're going to look at, OK.
[CUSTOMER][NEUTRAL] That's what um
[CUSTOMER][NEUTRAL] It's what Kira Kira coming to uh get with uh
[CUSTOMER][NEUTRAL] Get uh a statement from all the doc from the doctors and from the hospital and all that.
[CUSTOMER][NEUTRAL] And send it to y'all. So that's what I've got. Is that correct?
[AGENT][NEUTRAL] So, on page one.
[AGENT][NEUTRAL] Where the instructions are. The bullet points, um, you'll see where it says when filing a claim, you're looking, it was a surgery, so you're going to need the itemized bill from each medical provider and the explanation of benefits from the other insurance that you have showing.
[CUSTOMER][NEUTRAL] And.
[AGENT][NEUTRAL] What was allowed and paid for each service. So that first page is gonna be what you want to reference depending on what you're filing for.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so I need to get an itemized listing from uh.
[CUSTOMER][NEUTRAL] Uh, insurance showing what they paid.
[AGENT][NEUTRAL] So the itemized bill is from the provider, the doctor or hospital, and then the explanation of benefits is going to be from your insurance.
[CUSTOMER][NEUTRAL] OK, so I need to get something from them and I just call them and ask them for a what?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, an explanation of benefits.
[CUSTOMER][NEUTRAL] Explanation.
[CUSTOMER][NEUTRAL] X
[CUSTOMER][NEUTRAL] The nation.
[CUSTOMER][NEUTRAL] Uh benefits.
[CUSTOMER][NEUTRAL] OK, explanation.
[CUSTOMER][NEUTRAL] You know, it's not that long, but anyway, maybe I'll figure it out. OK, so I need to call my insurance and ask them for an explanation of benefits.
[AGENT][NEUTRAL] Mhm. For whichever dates of service you're filing for. So whatever the surgery dates are, it will be the explanation of benefits for those dates.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] OK, OK. All right, I appreciate your help so much, and then I'll be mailing this in, right. OK, thank you.
[AGENT][POSITIVE] You're very welcome, [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with?
[CUSTOMER][NEUTRAL] Mhm bye bye.
[CUSTOMER][POSITIVE] No, ma'am. I just wanted to understand this, and I appreciate your help.
[AGENT][POSITIVE] Alright. You're welcome. Well, thanks for calling APL. Have a great day.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Yes, ma'am. You too. Thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.