AccountId: 011433970860
ContactId: b609f34b-ad5b-42ad-b6ac-8ef3bc0d5dd1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 679020 ms
Total Talk Time (AGENT): 312200 ms
Total Talk Time (CUSTOMER): 323749 ms
Interruptions: 4
Overall Sentiment: AGENT=1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/b609f34b-ad5b-42ad-b6ac-8ef3bc0d5dd1_20250113T15:09_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 [PII], I was just wondering if you could look up something on my account for me.
[AGENT][NEUTRAL] OK. You're the insured and you have a question about something on your policy. Is it a
[CUSTOMER][NEUTRAL] Oh yes.
[CUSTOMER][NEUTRAL] No, it's just a claim.
[AGENT][NEUTRAL] OK, so you're wanting to check claim status?
[CUSTOMER][NEUTRAL] I want to see
[CUSTOMER][NEGATIVE] Yes ma'am. I'm just this 12 particular claims that I have to see how many business days it's been now there's still nothing processed. I still got nothing in the mail saving anything, and I know y'all told me 7 to 10 business days, but it's been a while now and I'm trying to figure out if we're getting close. I need to get paid.
[AGENT][POSITIVE] Yes, ma'am. I'd be happy, I can help you with claim status. And who am I speaking with?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And Ms. [PII], what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And your policy number?
[CUSTOMER][NEUTRAL] Oh yes, I'm, I'm sorry I don't have it pulled up for you.
[AGENT][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Miss [PII].
[CUSTOMER][NEGATIVE] Should have it quicker than this sorry.
[AGENT][POSITIVE] You're fine. No worries.
[CUSTOMER][NEGATIVE] I'm just not getting to where I can file all of these because insurance took forever.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Nothing is quick anymore, Miss [PII]. Not really.
[CUSTOMER][NEUTRAL] Oh, for sure, I.
[CUSTOMER][NEUTRAL] I agree. I I don't know how y'all do what y'all do.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Full time jobs keeping up with insurance these days. Let's see here.
[AGENT][NEUTRAL] It can be. Yes, ma'am, I've been there. I understand and I work in the insurance business, but it's the same for me, so I totally understand.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. No, ma'am. OK, it's slow but sure pulling up here.
[AGENT][POSITIVE] You're fun.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] And then the phone decides it's gonna just be real slow.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] It's Monday. It's OK. I promise you, it's OK. I've had my own, I've had a few struggles myself this morning, so it's OK.
[CUSTOMER][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] I mean, but overall we're doing good. Let's see here.
[CUSTOMER][NEUTRAL] Or blast. I can get.
[AGENT][NEUTRAL] Amen.
[CUSTOMER][NEUTRAL] I can get this thing open.
[CUSTOMER][NEUTRAL] Hm, I was in it just few minutes ago. No problems, and it's not opening now. It's my service, I think.
[AGENT][NEUTRAL] Well, now, miss, uh, yeah, that's can definitely affect it. Now, are you the subscriber, Ms. [PII]? Is the policy in your name?
[CUSTOMER][NEGATIVE] We've had the weather issues.
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][NEUTRAL] OK. I can try and look it up by your full social, if that's easier.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, and I think I just got it now here it is. I'm like, OK, it's [PII].
[AGENT][NEUTRAL] Oh, OK. OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, say that all again.
[AGENT][NEUTRAL] Please. Mhm.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I, I've never been so thankful for a cancer that who.
[AGENT][NEUTRAL] Well, insurance is something that, you know, we pay for. We hope we never have to use it, but if we need it.
[CUSTOMER][NEUTRAL] Amen.
[AGENT][NEUTRAL] It's, it's.
[CUSTOMER][NEUTRAL] Amen.
[AGENT][POSITIVE] Money well spent.
[CUSTOMER][POSITIVE] Agree.
[CUSTOMER][POSITIVE] This last year and a half has been just, yeah, it's been great, and then the [PII] has blessed me in that way, so well.
[AGENT][POSITIVE] And that's what we have to be thankful for.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I don't think it was even put in until the [PII] and the [PII], and then you said maybe 7 to 10 business days. What my doctor wants to know is he's trying to get real specific for me each time to make the policy easier to when I do my claims. So I have a lot of other claims to turn in yet that I haven't turned in.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEGATIVE] For different things like transportation and hotel and stuff like that. And he's wanting to make sure he's not missing something because there's been a couple of times when we sent these over, it keeps telling me I've got missing information like not proper procedure codes or this or that. I'm like, oh, we've got to get it where we can get that right, you know.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK, so what I, let me, um, let's verify your information first for security, and then I'll send this [PII] any information that I do provide for you would be a verification of benefits and not a guarantee of payment. So first off, what is your date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK, thank you. And also your home mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you. The phone number that we have for you is the same as the one that you gave me, so again, that is your best contact number, correct?
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][NEUTRAL] OK thank you and lastly your email address?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII], for verifying all of your information. OK, so I do see that there were some documents submitted to you via the online service center on [PII] and [PII]. And as of now, those still.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's the same claim, but we send it two different ways to make sure it had enough information for y'all.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Oh, OK. So those two sets of upload those two uploads, Ms. Has, are still, um, they have not yet been reviewed, but they should be being reviewed very soon. Um, again, you know, with the holiday.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Am I guaranteed at least a 10 day with any of these? Am I ever guaranteed like a 10 day return? I mean, on my old cancer policy, you got like a 10 day return around and they would give you your money in 10 days. I look it, process it, and I'm trying to get this process.
[AGENT][NEUTRAL] Yes, ma'am. No.
[AGENT][NEUTRAL] No, I mean the typical turnaround time on a review is 7 to 10 business days and then of course if there are benefits payable to you, I can see that you do have um information entered into the system for direct deposit. So then depending on your financial institution, it's typically, you know, a 2 to 32 to 3 day.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Window for that to, you know, populate in your account.
[CUSTOMER][NEUTRAL] It's like maybe, maybe 2 weeks from the [PII] then.
[CUSTOMER][NEUTRAL] Or the [PII] when we process.
[AGENT][NEUTRAL] So those were both, so those were uploaded over a weekend.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You know, we're really
[CUSTOMER][NEUTRAL] Well, the [PII] was on Monday, right? Or no, I'm sorry, it wasn't. I've got my days the [PII].
[AGENT][NEUTRAL] No, that was Sunday. Mhm.
[AGENT][NEUTRAL] Mm, yeah. The [PII] was last Monday, so, you know, we're on technically day 6.
[CUSTOMER][NEUTRAL] Yeah. OK.
[CUSTOMER][POSITIVE] OK, OK, well thank you for checking. I don't need to be impatient. I just gotta get this done.
[AGENT][NEUTRAL] Since it's business.
[AGENT][NEUTRAL] Oh, no, no, no. Oh, no, I totally understand. Now, do, I'm assuming that you have a copy of the cancer claim form.
[AGENT][NEUTRAL] Do you have that, Ms. [PII]?
[CUSTOMER][NEGATIVE] Yeah, you talk, or whoever, I'm sorry, whomever I spoke with the other day told me I did not need to refill one of those out. They told me because my bank had already received it and I'd already done that before. They told me not, they told me to leave that off. Now, should I or shouldn't I?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The actual claim form.
[AGENT][NEUTRAL] Or the bank authorization.
[CUSTOMER][NEUTRAL] Uh, you know where it says do you well?
[CUSTOMER][NEUTRAL] No no the claim form where it says do your.
[CUSTOMER][NEUTRAL] Either your wellness benefit or your cancer claim form. One of y'all that I spoke with last week concerning this, I was going to do that claim form. And the lady said that's not necessary because you, we know this is an immunotherapy claim form that you're doing by what you've processed there. This is for my immunotherapy once a year benefit for my, uh, so do I need to put that on there?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] No, uh, if she, if she told you, it appears that you spoke to one of the examiners, so that's the instructions that she gave to you since the claim is already in process, then that's, that is fine if that's the information she gave you. But on that cancer claim form, as far as you were wanting to know about like, you know, specifically what information your doctor's trying to be real thorough, which that's excellent.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But the first page of that claim form, Ms. [PII], has all of the instructions.
[AGENT][NEUTRAL] Like for the types of documents and all that. So I always recommend that you kind of use that as a checklist if you wanna call it that when submitting.
[CUSTOMER][NEUTRAL] Yes, I.
[CUSTOMER][NEUTRAL] Right, and that's what we started doing.
[AGENT][POSITIVE] Mhm. So that's helpful.
[CUSTOMER][MIXED] And when we first put in, that's what we did. And it was helpful, but the only thing was it still came back and said it wasn't enough information. And I had to redo, I can't remember whether it was the procedure code, or it was something in particular, but that's been a while. I mean, that's back when I first got canceled.
[AGENT][NEUTRAL] Yes, ma'am. Your diagnosis codes, procedure codes, those are critical pieces of, you know, that we have to have, just like your primary insurance has to have that, um, you know, and then itemized.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, bills. So those are the really three key areas.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] at where you are in this stage.
[CUSTOMER][NEUTRAL] OK. And what, so when I get ready, when I, when I get ready to send these new ones that I have out for transportation, we're working on getting an address on those. Our problem was they didn't have an address, like for you guys to know exactly.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Because I went so many days, I'm only allowed 12 a year, uh, each new calendar year for my transportation for, you know, and chemo and radiation and all that. Uh, so what I'm trying to figure out is on those, I do probably, would you, would you suggest to go ahead and do a new form?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Since it's something different like that.
[AGENT][NEUTRAL] You can. I mean, you, you can, um.
[CUSTOMER][NEUTRAL] OK, won't hurt me.
[AGENT][NEUTRAL] Right. And with us, you know, as far as your timely filing, we don't have a timely filing, Ms. [PII].
[CUSTOMER][POSITIVE] That's what I was telling my doctor that I didn't think there was any statute of limitations on it as long as you filed it. So that's good at least, yes. OK. Well, thank you. You've been super helpful.
[AGENT][NEUTRAL] There's not.
[AGENT][NEUTRAL] Yeah, so.
[AGENT][POSITIVE] Oh, well, you're certainly very welcome and it was, it was my pleasure in helping you today. And is there anything else at the moment that I can help you with?
[CUSTOMER][POSITIVE] No, ma'am thank you you have a good day.
[AGENT][POSITIVE] Well, I hope you have a nice day as well, Ms. [PII] and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Um, bye-bye.