AccountId: 011433970860
ContactId: c23143da-7b60-48de-a11a-d0d1b4d741ab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 468690 ms
Total Talk Time (AGENT): 109334 ms
Total Talk Time (CUSTOMER): 285869 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/10/c23143da-7b60-48de-a11a-d0d1b4d741ab_20250610T15:35_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yeah, [PII], uh, my name is [PII]. Uh, I think I've talked to you before, but, uh, I'm calling because uh I started my radiation treatment on the cancer. Uh.
[CUSTOMER][NEUTRAL] Do you need the claim number?
[AGENT][NEUTRAL] Um, do you have your policy number?
[CUSTOMER][NEUTRAL] I have a policy number of 00454141.
[AGENT][NEUTRAL] OK, and then Mr. [PII], can you verify your date of birth for me, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then your address and email address.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I believe you have my [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK perfect and just lastly a callback number in case we're disconnected.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then you're wanting to check on a claim, is that right, Mr. [PII]?
[CUSTOMER][NEUTRAL] Well, uh, no, what it is is that I started radiation treatment and uh I have uh.
[CUSTOMER][NEUTRAL] What they call a uh patient liability estimate and.
[CUSTOMER][NEUTRAL] The question is, two questions, um, you already have my information that I submitted on the biopsy and all of that, so that's not required on this other form for me to submit this paperwork.
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, so, uh, the one thing they told me is that this is, uh, it's a good faith estimate, but.
[CUSTOMER][NEUTRAL] Other, uh, stuff might be uh uh also added to it, so would y'all prefer for me to wait or just go ahead and submit this uh this estimate?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, so yeah, you would have to wait until the services are actually rendered, um, and then start submitting once those are rendered. So once you actually start getting treatment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, I am getting treatment. I already started a week and a half ago.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] I, uh, the first day of treatment, so it, it's 28 days and uh I started already in, in, uh, what was it [PII], I believe it was and so.
[CUSTOMER][NEUTRAL] It won't end until uh.
[CUSTOMER][NEUTRAL] Well, it should be the [PII], but it'll probably be the week after.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So treatment has started.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So that was the question since treatment started and they gave me this estimate.
[CUSTOMER][NEUTRAL] But, but they said that there's possibly more to it.
[CUSTOMER][NEUTRAL] after we finish, so the question is, should I submit it now or wait till they finish?
[AGENT][NEUTRAL] I would wait till they finish.
[CUSTOMER][NEUTRAL] OK. All right. OK dokey. So then uh we'll submit it then and based on all the other information as far as diagnosis and all that, you all have that already, right?
[AGENT][NEUTRAL] Uh it looks like we've got a claim for
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Like we've got
[CUSTOMER][NEUTRAL] It's prostate cancer.
[AGENT][NEUTRAL] Yeah, it looks like we've gotten a claim for surgery um from [PII]. Let me see what they received.
[CUSTOMER][NEUTRAL] Yeah, yeah, it was then and uh it went back further than that, but apparently the surgical benefit was the only thing that uh.
[CUSTOMER][NEUTRAL] Uh, and well that's expenses apparently that's what y'all had gone ahead and and paid out.
[CUSTOMER][NEUTRAL] Uh, and then when I talked to uh.
[CUSTOMER][NEUTRAL] I, I believe it was.
[CUSTOMER][NEUTRAL] [PII] or [PII], and I told her about, told him about the radiation treatment, which I was still discussing with the doctor on what approach we were gonna take because he gave me some options. So we started the radiation treatment already.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, yes, we've got your pathology report, so we shouldn't need that again. And then, yes, you should just, once your treatment is over, um, you can start submitting those claims, and then we should be able to process as long as we have everything we need. Shows like the date of service, procedures rendered, and your diagnosis.
[CUSTOMER][NEUTRAL] OK, and you do have those.
[AGENT][NEUTRAL] Uh, well, we
[CUSTOMER][NEUTRAL] The diagnosis.
[AGENT][NEUTRAL] Yes, but it has to be on the, when you start submitting claims, you'll need to make sure that the diagnosis is on those claims.
[CUSTOMER][NEUTRAL] OK, so that's what I was getting at. I submitted those already.
[AGENT][NEUTRAL] Right, but we still have to.
[CUSTOMER][NEUTRAL] So, so you need, you need, you need the same paperwork?
[AGENT][NEUTRAL] No, we don't need any
[CUSTOMER][NEUTRAL] On the diagnosis?
[AGENT][NEUTRAL] No, we don't need that. It's just when you start submitting those claims for your, you said radiation, is that right?
[CUSTOMER][NEUTRAL] Right, and it's going, yes, radiation treatment is going on now.
[AGENT][NEUTRAL] OK. So when you submit the claims for your radiation, it'll need to show the date you had radiation, how much it cost, what the diagnosis was, and then that that it shows that you had radiation. Just it has to be on those documents. Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, apparently the way it reads there the service items were therapeutic radiation treatment, and it goes all the way down radiation therapy dose plan.
[CUSTOMER][NEUTRAL] The devices goes to radiation continue dose plan.
[CUSTOMER][NEUTRAL] And uh I guess it was a CT scan for guide. Yes, it, it, it has all of that. OK, alright, uh, when, when I, when I'm done, I guess I'll give you all a call and I got the form because I did ask the for the forms, the new one, and on this one here, uh, since it's the 4 pages, all I would have to do is submit page 2 of 4 and 4 of 4.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, is that for the cancer form?
[CUSTOMER][NEUTRAL] Yeah, it's a cancer claim form.
[AGENT][NEUTRAL] Uh yeah, let me make sure.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, because, uh, I know I submitted this back in January.
[AGENT][POSITIVE] That's correct.
[AGENT][POSITIVE] Yes, that's correct. Yeah.
[CUSTOMER][NEUTRAL] Yeah, because I
[CUSTOMER][NEUTRAL] OK, alrighty, OK, I was just trying because I was trying to remember when I submitted in January I submitted some forms to the, uh, I don't know if I put in there page number one anyway, OK, I'll give you all a call then when I'm all done then so I'll submit it then.
[AGENT][NEUTRAL] OK. Anything else I can help with, Mr. [PII]?
[CUSTOMER][NEUTRAL] No, I think that that was basically it. I, I just wanted to know, uh, as far as the time frame, do I submit it now or wait that you answered that question and based on the information, all I'll have to do is submit what paperwork they gave me for the radiation treatment.
[AGENT][POSITIVE] Yes, with the itemized out. Yes, that's correct.
[CUSTOMER][POSITIVE] OK. All [PII]. OK, thank you very much. Hopefully this is all I'll have to do.
[AGENT][POSITIVE] OK, thank you for calling.
[AGENT][POSITIVE] OK, thank you for calling APL. I hope you have a good day.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Thank you. Bye bye.