AccountId: 011433970860
ContactId: b1625d29-1474-4c2b-8089-3455054c0016
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 456890 ms
Total Talk Time (AGENT): 203215 ms
Total Talk Time (CUSTOMER): 144202 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/b1625d29-1474-4c2b-8089-3455054c0016_20250130T20:15_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling American Public Life. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, I was calling to check on the status of the cancer claim form to see if y'all needed anything else so that we could make it move forward.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, sure. I can help you with the status of that claim. Uh, what is your policy number?
[CUSTOMER][NEUTRAL] 238-213-6
[AGENT][NEUTRAL] And what is your name?
[CUSTOMER][NEUTRAL] Um, this is in regards to [PII]. I'm her twin sister, [PII]. I have POA on her account.
[AGENT][NEUTRAL] OK. OK, and what is [PII]'s, uh, date of birth?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Well, thank you, Ms. [PII]. Uh, what is, uh, [PII]'s mailing address, please?
[CUSTOMER][NEUTRAL] Um, well, it's currently [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and
[AGENT][NEUTRAL] And what is um what is a good callback number for you?
[CUSTOMER][NEUTRAL] For me it's [PII].
[AGENT][NEUTRAL] Give me just a few minutes, please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK and have you just recently uh submitted some information or is this uh a a previous submitted claim?
[CUSTOMER][NEUTRAL] No, um, so the, I think the last piece is, there were two things that we're wait we waiting on was the pathology report.
[CUSTOMER][NEUTRAL] From the initial diagnosis of cancer?
[CUSTOMER][NEUTRAL] And then y'all wanted what was it the.
[CUSTOMER][NEUTRAL] Some records sent to y'all and I faxed those. I don't, I don't know when, but I haven't heard anything else back. So I thought I would call and see where we were.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And if y'all didn't get those faxes, I'll fax them again.
[AGENT][NEUTRAL] I'm not showing that we did receive those faxes. Uh, let me give you my our fax number and um so that we can make sure that you have it. Uh, do you have your pen and piece of paper handy?
[CUSTOMER][POSITIVE] I'm getting it right now.
[CUSTOMER][NEUTRAL] OK, what is that?
[AGENT][NEUTRAL] Uh, the fax number is [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And y'all are still waiting on those two things, the pathology.
[AGENT][NEUTRAL] Yeah, so.
[AGENT][NEUTRAL] Yes, pathology report and those medical records. Um, give me one minute. I'm gonna review some additional information. Give me just a few minutes.
[AGENT][NEUTRAL] Yes, that is what we're waiting on. Uh, we do need that pathology report that we have not received, um.
[AGENT][NEUTRAL] Also, we're gonna need the detailed itemized bill for the surgery that was done on [PII].
[AGENT][NEUTRAL] We do not have that uh it needs to have the procedure code and we don't have any documentation that would have those procedure codes for [PII]. We need that detailed itemized bill and that would come from the surgeon.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or the doctor who performed the services.
[CUSTOMER][NEUTRAL] Oh, I, I have, I have all of those, I think.
[AGENT][NEUTRAL] Well, make, make sure that there's a five-digit number that is a procedure code.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Um, is she on Medicare? Does she have Medicare?
[CUSTOMER][NEUTRAL] No, she um
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] She's um a teacher and so she took teacher disability retirement.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. OK, well then what we do need is a detailed itemized bill for the, that surgery and also the pathology report and the medical records.
[CUSTOMER][NEUTRAL] OK. So,
[AGENT][NEUTRAL] And make sure you put, um, claim, I'm gonna give you the claim number on this and make sure you put on your cover sheet the policy number that you gave me and claim number 348.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 4617.
[CUSTOMER][NEUTRAL] 348.
[AGENT][NEUTRAL] On your
[CUSTOMER][NEUTRAL] 461 7.
[AGENT][NEUTRAL] 46, yes, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have
[CUSTOMER][NEUTRAL] I have a bill and it has an internal control number and it has a 3 digit billing code. Is that what you need?
[AGENT][NEUTRAL] Um, what is the three digits? because I don't think that's the correct code. What, what, what, what?
[CUSTOMER][NEUTRAL] Oh,
[AGENT][NEUTRAL] Is there like a procedure code it would say procedure code?
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] And it's usually 5 digits.
[CUSTOMER][NEUTRAL] OK, this is, this is, this is wait, I have to get.
[CUSTOMER][NEUTRAL] 23.
[AGENT][NEUTRAL] And it would come directly it would come from the surgeon at the facility.
[CUSTOMER][NEUTRAL] Yeah, I have uh what basically what I had the UNC do is I printed out and I had them send me a print out of the whole bill.
[AGENT][NEUTRAL] Well, it would, but that, that would not be the um bill that was from the surgeon who performed those services.
[CUSTOMER][NEUTRAL] For like the full time.
[CUSTOMER][NEUTRAL] No, I have her medical records and I have the billing codes.
[AGENT][NEUTRAL] OK, well you can submit it and we'll be more than happy to look at it, but I can't guarantee any benefits until we get it reviewed.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, no, I, I.
[AGENT][NEUTRAL] And we also need that pathology report as well.
[CUSTOMER][POSITIVE] Yeah, I have that I believe so I'll get that faxed over to y'all.
[AGENT][NEUTRAL] OK. Is there anything else I can help you out with, Ms. [PII]?
[CUSTOMER][NEUTRAL] No, that was it.
[AGENT][POSITIVE] OK, well, you have a wonderful day and thank you for calling American Public Life.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Goodbye.
[CUSTOMER][NEUTRAL] Mhm bye-bye.