AccountId: 011433970860
ContactId: b91011cb-07d7-4aef-8587-3845915cea83
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 626739 ms
Total Talk Time (AGENT): 328667 ms
Total Talk Time (CUSTOMER): 159304 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/06/b91011cb-07d7-4aef-8587-3845915cea83_20250606T19:30_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. My name is [PII]. I'm calling for my wife, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh well I have a couple of questions.
[CUSTOMER][NEGATIVE] Oh, what do y'all pay only if a person has throat cancer and lung cancer?
[AGENT][NEUTRAL] Uh, do you have the policy number, [PII]?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 456-444
[AGENT][POSITIVE] OK, thank you, give me one moment please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] See. And Mr. [PII], verify your date of birth and the mailing address for me, please.
[CUSTOMER][NEUTRAL] My birthday is [PII] [PII].
[CUSTOMER][NEUTRAL] And I'm on the policy.
[AGENT][NEUTRAL] Yes, sir. That's why I asked for your date of birth cause I show you're on a plan. Um, give me one moment. And you say do you want to know the benefits for diagnosis of throat cancer?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, ma'am. My wife had throat cancer and lung cancer, and I want to know, uh,
[AGENT][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] Uh, do y'all pay on it or, or, and on chemo and radiation?
[AGENT][NEUTRAL] Uh, yes, sir. There's been, there are benefits for chemo, radiation, and immunotherapy. Um, what we will need is that pathology report, first diagnosing her of cancer.
[AGENT][NEUTRAL] As well as the claim form. Has she started treatment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] So, uh, is she doing chemo radiation?
[CUSTOMER][NEUTRAL] Radiation right now.
[AGENT][NEUTRAL] OK, give me one moment, I'm trying to pull up the policy.
[CUSTOMER][NEUTRAL] I thought y'all send all this to.
[AGENT][NEUTRAL] Uh, one moment.
[AGENT][NEUTRAL] Was she recently diagnosed or is this just an ongoing uh uh ongoing cancer treatment?
[CUSTOMER][NEUTRAL] Oh yes, ma'am. It was back in April.
[CUSTOMER][NEUTRAL] April.
[AGENT][NEUTRAL] Oh this year?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Bless your heart. OK, hold on one moment.
[CUSTOMER][NEUTRAL] It.
[CUSTOMER][NEUTRAL] 00, she, she said it started last October.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, let's see. October.
[AGENT][NEGATIVE] Oh, this computer doesn't like me. Give me one moment, Mr. [PII]. I'm trying to.
[AGENT][MIXED] It's just acting funny. It just won't do what I'm asking it to do.
[AGENT][NEUTRAL] Let me see. Uh, yes, there are benefits for chemo, radiation, immunotherapy, um, along with the itemized bill, uh, we will need the primary insurance EOB. Is she on Medicare?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Uh, we will need a copy of her Medicare EOB for the treatment she received for the chemo or radiation that she's taking.
[CUSTOMER][NEGATIVE] OK, damn.
[AGENT][NEUTRAL] Has she been inpatient in the hospital or had surgery due to cancer because you do have uh surgical benefits and confinement benefits under the plan.
[CUSTOMER][NEUTRAL] Uh, yes, she had, uh, she was in the hospital and plus she had to have a feeding tube put in.
[AGENT][NEUTRAL] OK. Yes, sir. And so any billing in regards to um surgeries she may have had, um, and inpatient confinement, we would need those bills as well, and the primary EOB since the policy is showing actual charges, those um EOBs are needed.
[CUSTOMER][NEUTRAL] What is the EOB mean please ma'am?
[AGENT][NEUTRAL] Oh, I'm sorry, explanation of benefits.
[AGENT][NEUTRAL] It's something she would get from.
[CUSTOMER][NEGATIVE] 00, like the code don't like.
[CUSTOMER][NEUTRAL] Like the code numbers and all that stuff.
[AGENT][NEUTRAL] Yes, sir. It will also show um what the primary insurance allowed for those services.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And I don't know if she is set up on our online service center. We do have um an online service center to where she can submit claims via the website as well as view her policy review.
[AGENT][NEUTRAL] To the policy.
[CUSTOMER][NEUTRAL] No, ma'am, we're not set up on all of this stuff.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Just let you know if you want to, there's a site that y'all can view your plan as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] Uh, let's see, so yes, sir, there are some benefits for.
[AGENT][NEUTRAL] Treatment as well as any surgeries or confinements due to cancer in the policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, years ago.
[CUSTOMER][NEUTRAL] Oh, the first, the first time she had cancer was about 10 years ago and they sent her.
[CUSTOMER][NEUTRAL] Uh, a $10,000 check on it. I just wondered how, you know, that would play out this time.
[AGENT][NEUTRAL] Uh, well, that first occurrence benefit is once per lifetime.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And trying to see.
[AGENT][NEUTRAL] Well, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No, ma'am, just when we get all these bills.
[CUSTOMER][NEUTRAL] Oh, how, how can you file the mileage?
[AGENT][NEUTRAL] Uh, usually, uh, typically when an examiner receives a claim for uh chemo, radiation, immunotherapy or surgery, they always check the transportation because it has to be more than 50 miles one way from the direct location of your home.
[CUSTOMER][NEUTRAL] OK, well, one of them is, but the other one is not.
[AGENT][NEUTRAL] OK. Well, yeah, they always double, they always check it for anytime they receive any claims for chemo, radiation, surgery, they always check for mileage.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Alright, well I guess we'll have to get all this stuff together and see if we can get it sent it to you.
[AGENT][NEUTRAL] Yes sir and um our claim forms are on our website at um [PII] and on the cover sheet of the claim form it does list uh exactly what information we would need in order to for y'all to file a claim along with the form.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Well, could I, could you send me the forms?
[AGENT][NEUTRAL] Yes, sir. Do you want it mailed to you?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. Yes, sir. I'll send a request to have the forms mailed.
[CUSTOMER][POSITIVE] All right. I sure appreciate that.
[AGENT][NEUTRAL] Uh, yes, sir. And is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] But.
[CUSTOMER][NEUTRAL] Got my what?
[CUSTOMER][NEUTRAL] Oh, did y'all get uh my wellness thing for last year while you looking?
[AGENT][NEUTRAL] Uh, for you, let's see.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Uh, no, sir.
[AGENT][NEUTRAL] And to file a wellness claim, you would just need to fill out the claim form. I can send a request for the wellness as well.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][POSITIVE] Thank.
[CUSTOMER][NEUTRAL] OK, that'd be fine.
[AGENT][NEUTRAL] Um, I'll send a request for the wellness form to be sent out to you as well. You just need to fill out that claim form and just submit it into us.
[CUSTOMER][NEUTRAL] OK, you don't, you don't need nothing from the doctor or just that phone?
[AGENT][NEUTRAL] Uh, just a form. Uh, they don't require anything else.
[AGENT][NEUTRAL] And another thing on that online service center if y'all ever get set up on there you can file a wellness claim from there that instead of having to fill out an actual form.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, well, we, we're not smart enough to go through all that.
[AGENT][POSITIVE] You are smart, sir. I understand. Some people don't want to mess with the internet. I get it. Yes, sir.
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] We, we
[AGENT][NEUTRAL] But um,
[CUSTOMER][NEUTRAL] No ma'am, we don't, we don't even have a computer or nothing.
[AGENT][NEGATIVE] Oh, OK. Um, well, y'all are just really off the grid.
[CUSTOMER][NEUTRAL] Yes ma'am, we just, we're just old country folk.
[AGENT][NEUTRAL] Sometimes it's best. I wish I didn't know about the internet too. It's too much stuff, too much.
[CUSTOMER][NEUTRAL] And a lot of it you don't know what to believe or not nowadays.
[AGENT][NEUTRAL] That is so true. Any and everyone can get on the internet and change stuff the way they want to, or you might think it's something. That's why a lot of doctors tell people don't go on the WebMD because
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] They think that, oh, these are all my symptoms, I have it, but it's not.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] OK, but I'll send these out to you. Hopefully you should receive it in 3 to 5 business days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that'll be fine.
[AGENT][POSITIVE] All right. Well, I thank you all so much for calling APL. You have a great weekend.
[CUSTOMER][POSITIVE] Well, you do the same and I thank you, ma'am, very much.
[AGENT][POSITIVE] You are so welcome. Thank you.
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye.