AccountId: 011433970860
ContactId: b66af3c4-2266-4294-875b-7b1bebb051a1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 704750 ms
Total Talk Time (AGENT): 313136 ms
Total Talk Time (CUSTOMER): 320028 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/10/b66af3c4-2266-4294-875b-7b1bebb051a1_20250310T14:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes, this is [PII]. Um, I've had a, I got, uh, a short slant that's uh.
[CUSTOMER][NEUTRAL] Uh, policy there.
[CUSTOMER][NEUTRAL] And I've uh had it was is I'm paid to what I'm doing is, uh.
[CUSTOMER][NEUTRAL] I got my prostate's high and I've got a MRI coming up but I've done had several uh uh.
[CUSTOMER][NEUTRAL] Like PSA test and I just wanted uh I could file that and get reimbursed. I guess, I guess that's the question.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so, uh, for the MRI, is that right?
[CUSTOMER][NEUTRAL] Well, it's, it's, it started back uh.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Probably November last year it is, is high. I don't been twice and I gotta go this coming Thursday for a uh out.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, OK, I could take a look at those benefits, make sure that's uh covered, and then yes, um, really quick, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] 983-571-0983-5710662
[AGENT][NEUTRAL] Got it. Thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] Uh yes, uh 00715481.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] Alright, [PII], just gonna verify some information really quick. Uh, can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address we've got on file for you. Uh, looks like it's [PII].
[CUSTOMER][NEUTRAL] [PII]. Yes, ma'am. Mm.
[AGENT][POSITIVE] Yes, sir. OK. Thank you for verifying that. OK.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] Let's see. So this is your cancer policy. Um, do you have a positive diagnosis of cancer, [PII]?
[CUSTOMER][NEUTRAL] Uh, no, I guess that's the reason why they, uh, don't do the MRI because the last two times it's been high, it's like 8. something.
[AGENT][NEGATIVE] Gotcha.
[AGENT][NEUTRAL] OK, so this is part of that kind of trying to determine what's going on.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] All right. Give me just a moment. I'm gonna get your policy pulled up and I will take a look at those uh covered benefits, see if there's some sort of um preventative uh benefit.
[CUSTOMER][NEUTRAL] Well, they paid over the years, but I've had 3 right here real close together, you know, like, uh, 2 weeks ago.
[CUSTOMER][NEUTRAL] And then uh let's say what is this March it's so it's a I guess it was uh like in November last year they told me.
[CUSTOMER][NEUTRAL] What is the week of, uh, last week of uh December.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, they, they paid before. I'll just, uh, I just said what, uh, what kind of address I need or that covers, yeah, go ahead and do what you gotta do.
[AGENT][NEUTRAL] Sure, yes, um, because sometimes there are certain limitations as to um how often and uh things like that it could just be one test a year that's covered, um, so that's kind of what I wanna look at just to make sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Like I said, it's uh.
[CUSTOMER][NEUTRAL] I guess it was
[CUSTOMER][NEUTRAL] Uh, I know I got the, the results the last week of December because I was on the coast from vacation.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then I had to go again, uh.
[CUSTOMER][NEUTRAL] I guess it was 2 weeks ago.
[AGENT][NEUTRAL] OK, here we are.
[CUSTOMER][NEUTRAL] It was still high
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] I have one, only one claim on file for you, [PII], for this policy. Um, it looks like this was
[AGENT][NEUTRAL] Several claims that uh went back from [PII], so you could potentially file a claim for last year. Now I don't see.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Not necessarily for an MRI and I can definitely send this to you if you'd like so you have a, a visual reference you can see uh the covered diagnostic preventative benefits uh those are going to be.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Like mammograms, uh, colonoscopy, um, uh, chest x-rays, things like that. It does not specify, um, an MRI.
[CUSTOMER][NEUTRAL] OK, see, I'm, I got a colonoscopy, but it's not due till like November this year. Yeah, I called the other day I.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Did you get one last year?
[CUSTOMER][NEUTRAL] Uh, no, uh.
[CUSTOMER][NEUTRAL] I checked on it. I think, I think it was 5 years ago when I had that, and, uh, I checked on it the other day was I was done. I, I was gonna try to get both, both of these done this coming Thursday while I was off, wasn't doing anything.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK. Let's see. There's also um prostate-specific antigen blood tests. Do you know if you had anything like that?
[CUSTOMER][NEUTRAL] I did 2 weeks ago, the blood test, yes, again, that.
[AGENT][NEUTRAL] OK, so that, that's covered. Um, so that would be one of the diagnostic, um, benefits. So there's a colon cancer blood test and the prostate-specific uh blood test as well. So, yes. What I would recommend anyway, and again, if you would like, I can absolutely send you a copy of this policy, uh, if you don't have it.
[AGENT][NEUTRAL] That wa[PII] you've just kind of got it for your records, but you are more than welcome to file any claims that you would like if you're not sure um I mean the worst we're gonna say is sorry this isn't covered.
[CUSTOMER][NEUTRAL] Oh yeah, OK.
[CUSTOMER][NEUTRAL] Yeah, like I said, it's been uh.
[CUSTOMER][NEUTRAL] And like I said, the blood test 2 weeks ago, no it was.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And there's like I said last fall when I had that, then it came back high and they wanted to wait a month or so and, and do the blood thing and see if it, you know, cause it, it was high one time, low one time, then, then it's high 2 times this time.
[AGENT][NEUTRAL] Oh, yes.
[AGENT][NEGATIVE] Those inconsistent results, yeah.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] But like I said, I knew I, I had looked at it, I guess it was 2 weeks ago, I guess when they uh
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Or 3 weeks ago when they've done this, I can't remember exactly what day it was, uh, but
[AGENT][NEUTRAL] OK, yeah, sure.
[CUSTOMER][NEUTRAL] But, but they said that MRI, uh, this coming [PII].
[AGENT][NEUTRAL] Got you. OK. um, now would you like me to send you a copy of this policy, [PII]? I can send it to you through an email or you can get a paper copy in the mail.
[CUSTOMER][NEUTRAL] Uh, paper copy that way I, I can keep it on file and instead of.
[AGENT][POSITIVE] Perfect yes sir OK yep I can have this sent to you um and that way you know I'm, I'm a visual person. I like going back and actually looking myself but of course if you've got any other questions or anything you're more than welcome to give us a call.
[CUSTOMER][NEUTRAL] So that's not
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, yeah, I'm just, uh, like I said, that's my wife's email address, um, that way, so I've got a little folder I keep this in. I, I see why I found the number where where I make my payments every 6 months, uh.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, yeah, if you don't mind please.
[AGENT][POSITIVE] Alright, yes sir, definitely, and was there anything else I could help you with?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] All I need to do is, uh, when I get this file the, uh, the blood test from 2 weeks ago or 3 weeks ago, whatever it was that.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] What about the
[CUSTOMER][NEUTRAL] Uh, last fall.
[AGENT][NEUTRAL] What was it that you had last fall? I'm sorry.
[CUSTOMER][NEUTRAL] I, I, I had uh.
[CUSTOMER][NEUTRAL] Well I
[CUSTOMER][NEUTRAL] I had uh the blood test and the urine sample I guess last fall. I need to put that on the.
[AGENT][NEUTRAL] OK, yes. So you can file that um blood test and I apologize, I did just see you also do have the medical imaging benefit that is separate from the diagnostic benefit as well. So the diagnostic benefit would be like those blood tests, those are limited to 1 per calendar year. Um, however, the medical imaging benefit, um, is up to, I think, I believe it's 2, per calendar year, and those are separate. So you can follow those as well.
[CUSTOMER][NEUTRAL] OK, alright then.
[CUSTOMER][NEUTRAL] So it's OK, 2 per year and 1 per year.
[AGENT][POSITIVE] Correct, yes, sir.
[CUSTOMER][NEUTRAL] One is what now?
[AGENT][NEUTRAL] So the diagnostic and prevention benefit, that would be like those blood tests you got. That's the 1 per calendar year. Uh, the medical imaging, um, that's 2 per year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 2 medical.
[AGENT][NEUTRAL] Yes, I.
[CUSTOMER][NEUTRAL] OK, yeah, I'm writing this down on the, on the, on my APO uh paper right here, so, OK, one blood.
[AGENT][POSITIVE] Yes definitely.
[CUSTOMER][NEUTRAL] OK, uh oh, went on the water.
[AGENT][NEUTRAL] Sorry?
[CUSTOMER][NEUTRAL] I have a phone. I, I just went underwater it started.
[CUSTOMER][NEGATIVE] I've, I've, I've got bad surgery.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Oh, that's OK. All right, was there any, did you have any other questions for me, [PII]?
[CUSTOMER][NEUTRAL] That, that should work. That's what I mean just uh.
[AGENT][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] And uh, so, uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Can you send, what, how do I send this, uh, uh, the blood test and all that? Do I get the, uh,
[CUSTOMER][NEUTRAL] They uh
[CUSTOMER][NEUTRAL] Oh, you I just send it or I send it.
[AGENT][NEUTRAL] Whatever is easier so if.
[AGENT][NEUTRAL] The sense or file a claim we would simply send that payment to them, um, whereas if you filed the claim we would send that um benefit to you. So if you wanted to do it, you can use our have you used our online portal before?
[CUSTOMER][NEUTRAL] No, ma'am, no ma'am. I don't, I hadn't.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you have a desktop or a laptop computer?
[CUSTOMER][NEUTRAL] Uh, my wife does, but I don't, uh.
[AGENT][NEUTRAL] OK, so if you're if you're comfortable using that, I would generally say that's going to be the quickest and easiest way to get claim information to us is through our online portal there's simply a spot where you could just upload that information there, otherwise I do have a fax number and a mailing address if you prefer.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah, just send the fax number because, uh, yeah, uh, because I said, uh, this was, uh, yeah, I need to put that on there because um I'll do it myself because I've already OK fax nu[PII] please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] If you go ahead and, sure.
[AGENT][NEUTRAL] Yes sir, that is um [PII].
[CUSTOMER][NEUTRAL] 877
[AGENT][NEUTRAL] 3365.
[CUSTOMER][NEUTRAL] 365
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 942 3
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yeah, sure, uh.
[CUSTOMER][NEUTRAL] OK, yeah, I, I've, uh, which I've been paid, I had, like I said, I got some of them is already paid.
[CUSTOMER][POSITIVE] OK, yeah, that'll work.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Alright, well sounds good thanks for giving us a call. I hope you have a great rest of your day. Yes sir, you too.
[CUSTOMER][POSITIVE] Alright thank you ma'am.
[CUSTOMER][POSITIVE] You have a blessed day thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Hey