AccountId: 011433970860
ContactId: c3d412fb-e206-464f-b136-17ec44d8ff19
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 464489 ms
Total Talk Time (AGENT): 329175 ms
Total Talk Time (CUSTOMER): 110255 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/c3d412fb-e206-464f-b136-17ec44d8ff19_20250219T16:52_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APA. You're speaking with [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Yes. Excuse me. This is [PII] and I have an old policy, and I need to know what it covers. And also, I was just diagnosed with a basal cell carcinoma that has to be removed.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And I need to know what
[CUSTOMER][NEUTRAL] What to do from here.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, I can help you with that, Miss [PII]. Miss [PII], give me your phone number just in case we get disconnected.
[CUSTOMER][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] All right, and give me that policy number, Miss [PII].
[CUSTOMER][NEUTRAL] A as in Apple 0094248
[AGENT][NEUTRAL] Alright, let me see what I can find.
[AGENT][NEUTRAL] OK, that didn't bring you up because it's an old policy. Let's do it this way.
[AGENT][NEUTRAL] Let me have your social, Miss [PII].
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] before you start Miss [PII], the policy is in your name or someone else's name.
[CUSTOMER][NEUTRAL] So let's, it's probably under my husband's. Let's give you his social security number [PII].
[AGENT][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And his name is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me. I do see, give me your mailing address.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] All right, let me pull up what I have.
[AGENT][NEUTRAL] All right, just verify your date of birth for me.
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] Alright, thank you for that information. And I do have your policy up and you are a dependent on the policy, so I do have you, and you want to know what this policy covers, is that correct?
[CUSTOMER][NEUTRAL] Yes, and I also, it says it's a family policy. How, how old, how long does it cover the children up until what age?
[AGENT][NEUTRAL] It, oh, they stop at age [PII], so I'm sure they've been off of this policy. Yeah, cause right now, it's just you and your husband covered on it.
[CUSTOMER][NEUTRAL] T
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] Uh-huh, uh-huh. And, uh, Ms. [PII], uh, the policy pays for medical treatment related to cancer. If you're diagnosed with cancer, you would have to send in the pathology report showing what the date that you were diagnosed with cancer. It does pay benefits related to cancer. So you're calling cause you said you've been diagnosed with some kind of skin cancer, correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK. The first thing you're gonna need is your pathology report from the doctor showing that you've been diagnosed with that particular skin cancer. Then you're gonna send in the autoized surgery bills when they do the procedure where they remove the, the, the, the cancer is.
[AGENT][NEUTRAL] A skin cancer, you're gonna need to ask your doctor for the itemized surgery bill. Submit that with the pathology report and the itemized surgery bills for review, along with a claim form. And that claim form I can have it mailed to you if you need a claim form.
[CUSTOMER][NEUTRAL] Yes, I will need a claim form.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And also on this policy you do have a benefit that pays for a wellness one per calendar year on each person. Looks like the last time you filed one was back in [PII]. So you can go back and file if you had like a mammogram, Pap Smith, colonoscopy, he had a PSA, chest X-ray, stool specimen, colonoscopy. You can go back and file for each one of those years on.
[AGENT][NEUTRAL] Both of y'all, which you know, whatever type of weapons you have, it's a wellness claim form. You're just going to check the type of wellness you had, put the date of service you had, write down the name of the facility or the doctor's office and their phone number signed and dated. You can do it for each one of y'all, and I can send you the the wellness claim form also when I send you the regular claim form for you to file for your skin cancer.
[CUSTOMER][NEUTRAL] OK, and that goes back to how long to file for those just one a year or?
[AGENT][NEUTRAL] Well, the last time the one year is 11 calendar year per year. Looks like the last time you filed on you was [PII].
[CUSTOMER][NEUTRAL] [PII], so can I file for [PII]?
[AGENT][NEUTRAL] You want.
[AGENT][NEUTRAL] Uh huh. You go back, yeah, you have the information showing where you had, uh, in 22, [PII], 24, yes ma'am, and looked like when you filed for him, let me see, I don't know if you ever filed for one for him. Yeah, yeah, it was in 21, yes, he is [PII], he had a PSA done. He had some kind of, he had a, uh, we, we paid a $75 benefit for awareness. We paid the wellness, so yeah.
[CUSTOMER][NEUTRAL] No, I haven't.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So yeah you can go back on both of y'all just do two separate claims for each one of y'all though you know because he's gotta be for him and yours gotta be for you but once I send the claim form, uh, you can get copies made of it or if you need me to send you more than one I put on the thing, please send at least uh.
[CUSTOMER][NEUTRAL] Uh.
[AGENT][NEUTRAL] 5 or 6 awareness claim form to you if you don't have no way of making copies. Now if you got an email address, if you got an email address I can email you the claim forms.
[CUSTOMER][NEUTRAL] No, I can
[CUSTOMER][NEUTRAL] OK, I can give you that. The
[AGENT][NEUTRAL] OK, give it to me.
[CUSTOMER][NEUTRAL] The email address is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, yes ma'am, and that's what we got on file. Yeah, I'll email you those claim forms. All right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, they're, they're not doing the surgery till [PII], so I, it'll be, you know, like.
[AGENT][NEUTRAL] there, there's no, there, yeah, there's no time limit in filing a claim. Once you get your surgery done, just make sure you, make sure you send in that pathology report cause that's the first thing we have to have. And you do get that from the doctor telling you you need a copy of your pathology report and you need to itemize surgery bill to send in for the claims to be reviewed to see what can be paid on your cancer policy. But then on the wellness, you can go ahead and get
[AGENT][NEUTRAL] That filled out and submit that back to our office. Now you can't email anything back to the adjuster, but it can be mailed, faxed or uploaded on our website, and it's all on the, uh, it's all on the claim form giving you direction on how to file for the wellness and for the cancer. So it's going to be two separate types of claim forms. one gonna be for the regular cancer when you file it for cancer and the other one is just gonna be a wellness claim form, OK?
[CUSTOMER][NEGATIVE] OK. And now on this, on this, uh, cancer that I'm going to have, what does it pay for, uh, just all.
[AGENT][NEUTRAL] I wouldn't be able to tell you that until you, I wouldn't be able to tell you that until we you send it in because with the surgery, it depends on the type of surgery you was performed and it's based on the percentage. So I would have to have like the itemized surgery code to be able to give you an estimate what it would pay.
[CUSTOMER][NEUTRAL] Get the
[CUSTOMER][POSITIVE] OK, thank you very much and I will get this done then.
[AGENT][POSITIVE] OK, thanks very much.
[AGENT][POSITIVE] All right. So thank you for calling American Public Life, Miss [PII], and you have a great day.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.