AccountId: 011433970860
ContactId: c30d50f8-9753-40d8-a5b9-a353c21cf7e8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 701250 ms
Total Talk Time (AGENT): 293490 ms
Total Talk Time (CUSTOMER): 350868 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/12/c30d50f8-9753-40d8-a5b9-a353c21cf7e8_20250512T16:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, [PII], my name is [PII] and uh I have an insurance policy uh through my school cancer policy and um so anyway, I'm just, uh, I got diagnosed a while back.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] Um, and everything's been kind of a blur, so I'm just trying to go back and make sure what all I need to do. I know I can file my claims online and all that stuff, but I need kind of a step by step process of what I need, I need and all that stuff if you wouldn't mind doing that, that'll help me. I appreciate it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] No, sir, I wouldn't mind at all helping you um file a claim. [PII], can I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][NEUTRAL] Thank you. And then what is your policy number, sir?
[CUSTOMER][NEUTRAL] Oh, I don't know if I have that on me um I'm in a different.
[AGENT][NEUTRAL] I can look it up with your social.
[CUSTOMER][NEUTRAL] OK, that'll be fine. Uh, my social is [PII].
[AGENT][NEUTRAL] OK, let me pull that policy in real quick.
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][POSITIVE] You're very welcome, sir.
[AGENT][NEUTRAL] OK. I think I have found you. Can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am, it's [PII].
[AGENT][POSITIVE] Thank you, sir. And then let's
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Verify your address, phone number, and email address that we have on the policy for you, sir.
[CUSTOMER][NEUTRAL] OK. Address should be [PII] and that's in [PII]. Uh did you say phone number?
[AGENT][NEUTRAL] Uh yes sir, the phone number on the policy, um.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Sir.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And then one last verification, can you give me your email address, sir?
[CUSTOMER][NEUTRAL] Yes, ma'am. It should be [PII]
[AGENT][POSITIVE] It looks like I have work.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you sir I appreciate you verifying information for me.
[CUSTOMER][NEUTRAL] Can, can I do something? Can I, can I change that?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] To my personal, I just feel more comfortable sending information and gain the information from you guys, not at my work.
[AGENT][NEUTRAL] OK, yes, sir. I understand. What would you like for it to be?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, let me update that real quick.
[AGENT][NEUTRAL] And let me read it back, make sure I've got it correct. [PII]. Is that correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That that's correct, yes ma'am.
[AGENT][NEUTRAL] OK awesome alright I'm gonna um refer you to our website now you said you know how to do it through the online service center but you just needed step by step instructions and the best place to go is, yes sir, go ahead.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Well, really, really what I'm needing from you is I, I'm a little confused on some things on the website. What I'm needing from you is just to make sure that I know exactly to what I need to ask my doctors for at the doctor's office because I know that from from what I read.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] The the bill that they send you guys is not what you need because it's not itemized.
[CUSTOMER][NEUTRAL] That was my understanding.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So, um, they will need, now, did you download the cancer claim form and did you see that first page that has the step by step instructions?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Uh well, I got it from my HR people here but I'm not sure if it's the right thing. Let me walk over to another area. Hang on, I'm sorry, this building doesn't get good service, so I moved away from an area to get better service. Well, it's a about a 65 year old gym and it's the nicest one of all the elementary schools, so I'm not complaining. I've got the best facilities of anything.
[AGENT][NEUTRAL] OK. No, that's OK.
[AGENT][NEGATIVE] Oh, no.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes, sir. If you go to our [PII], like [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, let me hang on let me get back over there.
[AGENT][NEUTRAL] And you
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Cause I have a
[CUSTOMER][NEUTRAL] I have 3 forms that they gave me at the office here. This has been a blur plus about the time this happened, my [PII] mother fail, and so I mean I take care of all her responsibilities too, so OK.
[AGENT][POSITIVE] Oh goodness.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] What what they gave me at the office at the school here is a claimant statement.
[CUSTOMER][NEGATIVE] They gave me a author authorization to use or disclose protected health information.
[AGENT][POSITIVE] That's good.
[CUSTOMER][NEUTRAL] And a employer statement.
[CUSTOMER][NEUTRAL] I'm not sure what I need an employer for but.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Right. OK, so I'm gonna, um, if you'll go to our website, the [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Is that all small letters?
[AGENT][NEUTRAL] Uh, you just search it in the search bar of your computer.
[AGENT][NEUTRAL] Yes, sir. You can do all, all lower case.
[CUSTOMER][NEUTRAL] OK, not on my computer. My, my partner's using my computer loading a bunch of information for the state. We just got our state testing, so I, I'm on my phone. That's all I've got, and I'll be honest with you, I'm not very good at using it, so I apologize, but OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, no, that'd be, that'll be fine, um, so when you go into [PII] up at the top right hand corner you're gonna click on claims and forms.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you'll download the cancer claim form.
[AGENT][NEUTRAL] It's on the first page of the claims and forms.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that very first page of the cancer claim form, it tells you everything that you need to send in. So you'll need your pathology report.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um it tells you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] With your initial diagnosis of cancer.
[CUSTOMER][NEUTRAL] On your initial.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, the itemized statement that they'll need will have to have the diagnosis codes and procedure codes on it.
[CUSTOMER][NEUTRAL] OK. Hang on just a second. So the, the pathology report with the initial diagnosis.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] And what was the second time in her life?
[AGENT][NEUTRAL] Your itemized statement with the diagnosis code and procedure codes.
[CUSTOMER][NEUTRAL] Just stay on
[CUSTOMER][NEUTRAL] What is agnosis.
[CUSTOMER][NEUTRAL] And treatment.
[AGENT][NEUTRAL] And procedure codes.
[CUSTOMER][NEUTRAL] Procedure codes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then if you have another primary insurance, you'll need your explanation of benefits from your other medical carrier showing the amounts of allowed and paid for each service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Now what is that the 3rd 1 you said the explanation of benefits? What do I need to get? Do I need to get it from Blue Cross Blue Shield?
[AGENT][NEUTRAL] The
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I can just call them and talk to them.
[AGENT][NEUTRAL] Yes, they should be able to email it to you because if you're using the online service center everything can go on the computer and then you can upload it, upload your claim if, if that doesn't work for you I can give you the fax number and the claim's mailing address if you wanted to send it in that way too.
[CUSTOMER][POSITIVE] Yeah, they should be able.
[CUSTOMER][NEUTRAL] Yeah, no, I, I, I'm pretty sure I have that on these forms here, your fax number and your email address, yes ma'am, OK.
[AGENT][POSITIVE] OK, good.
[AGENT][NEUTRAL] But that first, that first um page on that claim form on our website, it gives you step by step instructions um and for services, if you have hospitalization, surgery, chemo, immunotherapy, radiation, it'll tell you what you need to send for that. Um, if you have to have a prosthetic device that'll tell you what to send for that. If you have operation.
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] You'll need the operative report and they'll tell you what to send, but it's a good cheat sheet to look at so you know exactly what you need.
[CUSTOMER][NEUTRAL] Yeah, I'm about to, as soon as schools out in June, I'm about to have a, a procedure where they're gonna implant radioactive seeds.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, it's prostate cancer, and then, uh, they have to wait two weeks and then I'm supposed to begin, uh, radiation therapy, so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And save your, um, if you, if you have to travel more than 50 miles one way, save your um hotel receipts and gas receipts so you can turn those in for mileage.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, alright, well that, that, that'll get me started. I will get on the computer when, uh, this evening when I get home and go to your website and kind of look on there and get all that stuff. What I'm trying to do is I have my I have my PET scan on Wednesday. I'm trying to make sure when I go I know what to tell them I need when I leave, you know what I'm saying?
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Right, yes, I understand, so you could take it with you and not have to make another trip. I, I.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] So take it with me and then from that because everything else was done in [PII], and when I go over there for radiation we can we can gather all that stuff up at that time and then get it all sent to you guys. So alright, well thank you very much. I appreciate your help.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You're welcome, [PII], and if you get stuck or you need further help while doing your client filing it, please pick up the phone, we'll walk you through it, OK?
[CUSTOMER][POSITIVE] All right thank you ma'am I appreciate it very much.
[AGENT][POSITIVE] You're very welcome. You have a blessed rest of your week and thank you for calling APL, sir.
[CUSTOMER][POSITIVE] Yes ma'am, thank you.
[AGENT][NEUTRAL] Bye-bye.