AccountId: 011433970860
ContactId: b79483b2-d546-43e9-8eb3-685eb2cf6dee
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 396500 ms
Total Talk Time (AGENT): 104996 ms
Total Talk Time (CUSTOMER): 146469 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/25/b79483b2-d546-43e9-8eb3-685eb2cf6dee_20250325T15:26_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning, sir. I have a question. Um, I received an email saying that um you needed more information for um my claim, but it says, um, like see the form below.
[CUSTOMER][NEUTRAL] And there's not form, so I was wondering what form is the one that you need from me.
[AGENT][NEUTRAL] OK, yeah, let me take a look. Do you have by chance your policy number, claim number?
[CUSTOMER][NEUTRAL] Yes, I have a policy number. It's 0254.
[CUSTOMER][NEUTRAL] 888 4.
[CUSTOMER][NEUTRAL] And I do have a claim number too.
[AGENT][NEUTRAL] OK, let me.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Pull this up and then.
[AGENT][NEUTRAL] May I please have your first and last name?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] First name is [PII], last name [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And then I need to verify please your date of birth and address.
[CUSTOMER][NEUTRAL] Uh, date of birth is [PII] and the address is um [PII].
[AGENT][NEUTRAL] Thank you and then what is the email we should have on file?
[CUSTOMER][NEUTRAL] Um, like, uh, on the claim, because, um, I was diagnosed with, um, uterine cancer, so I filed a claim the other day, but then I got this letter saying, I mean, no letter, um, you know, uh, uh, this email that, um.
[CUSTOMER][NEUTRAL] That it tells me like go check like your messages or whatever, and it says um
[CUSTOMER][NEUTRAL] And it is based on your effective date of coverage, is it necessary that we obtain your past medical history to determine.
[CUSTOMER][NEUTRAL] To determine if your claim due or to a pre-existing condition, please complete the enclosed form and return to our office, but there's no form.
[AGENT][NEUTRAL] What's the claim number on there?
[CUSTOMER][NEUTRAL] It's uh 357-975-4.
[AGENT][NEUTRAL] OK, let me.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] I don't know if you maybe you need my gynecologist.
[CUSTOMER][NEUTRAL] Information.
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] Mm.
[AGENT][NEGATIVE] And there was no form with the explanation of benefits that was sent out to you, huh?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Like it's those two pages. Mom says that.
[CUSTOMER][NEUTRAL] Like, um,
[CUSTOMER][NEUTRAL] They will cover for the Pap smear, $50.
[AGENT][NEUTRAL] Yeah, I see that it
[CUSTOMER][NEUTRAL] And then it says
[CUSTOMER][NEUTRAL] Now, the second page of that one, it does say like.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Usually.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] So it looks like they mailed you the form that needs to be returned to us, and that was just done yesterday.
[AGENT][NEUTRAL] Uh, the rep, she put notes in here, but it's dated [PII]. So when you send the form back, it can be done um via fax. You don't have to mail it back, but it looks like they just sent it out to you.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, what about email? Can I email it?
[AGENT][NEGATIVE] No, unfortunately email is not secure so we only can receive it back via fax or in the US postal mail.
[CUSTOMER][NEUTRAL] OK, OK, because I don't have a fax machine, so I just I'll mail it then.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And is that form for me to fill it up or for the uh doctor?
[AGENT][NEUTRAL] So it'll ask for like attending physicians and like contact information. It'll be for you and then um the examiners can reach out to those medical professionals if they need to for the documentation.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Oh, OK, OK, OK, I'll just wait for the phone then. Thank you.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome, [PII]. Anything else I can help with?
[CUSTOMER][POSITIVE] No, right now, thank you for your help.
[AGENT][POSITIVE] You're welcome. Have a good day.