AccountId: 011433970860
ContactId: c76b7ef6-2d69-40b3-88d8-669f581b01ba
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 613960 ms
Total Talk Time (AGENT): 317447 ms
Total Talk Time (CUSTOMER): 323113 ms
Interruptions: 7
Overall Sentiment: AGENT=0.4, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/c76b7ef6-2d69-40b3-88d8-669f581b01ba_20250529T21:47_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, I have a few questions about my insurance that I have with y'all, my cancer insurance.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am. I can help you with your questions for your cancer policy. What is, what is your name? You're welcome. What is your name and your callback number? You [PII]?
[CUSTOMER][NEUTRAL] OK. Go ahead.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII], it's [PII]
[CUSTOMER][NEUTRAL] Last name is [PII]
[CUSTOMER][NEUTRAL] And my phone number is [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your policy number?
[CUSTOMER][NEUTRAL] I don't have it. I'm sorry, I didn't look it up before I um got on the phone. Is there another way we can look it up?
[AGENT][NEUTRAL] That's
[AGENT][POSITIVE] Yes, ma'am. That's not a problem at all. I can look it up with your social if you'll give that to me, please.
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] OK, let me pull up your policy for us real quick.
[CUSTOMER][POSITIVE] Oh goodness.
[AGENT][NEUTRAL] I'm sorry, excuse me.
[CUSTOMER][NEUTRAL] it's OK. Too many allergies or something going on sounds like.
[AGENT][NEUTRAL] Yes, it's, yes, ma'am.
[AGENT][NEUTRAL] OK, I think I have your policy pulled up now. Um, can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is your address, phone number and email address?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, my address is [PII].
[CUSTOMER][NEUTRAL] Um, what was the next thing? Sorry, phone number [PII].
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] And then my email address, I don't know if I have to put my work email or my home, my personal email, so it's [PII] either way [PII], or it could be [PII]. I'm not sure which one I put on there.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] It looks like it's your work email address is what I have.
[CUSTOMER][NEUTRAL] The [PII], yeah, OK.
[AGENT][NEUTRAL] Yes, ma'am. OK.
[AGENT][NEUTRAL] All right. I've got your policy pulled up and you said you had questions about it. How can I help you with your questions?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I do for what I think I've had this is this that we renew all of our entrances once a year with the school district. So does this stop?
[CUSTOMER][NEUTRAL] And start every year or how does that I mean.
[CUSTOMER][NEUTRAL] I've had it, I think since like [PII] is what you know so is it ongoing? It does it accumulate or is it is the max only gonna be $20,000 ever?
[AGENT][NEUTRAL] How does it work?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] Uh, let me look at the max.
[CUSTOMER][NEUTRAL] Does that make sense?
[AGENT][NEUTRAL] Right. Um, so, let's look at this policy.
[AGENT][NEUTRAL] So you had previous policies with us as you were stating, um, and it all depends on when you need to file your claim. Do you know?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] When you need what year you need to file your claim for? Are you doing wellness claims or?
[CUSTOMER][NEUTRAL] Um, no, actually it would be for I found out in.
[CUSTOMER][NEUTRAL] I guess it was finally definite in December that I have um uh
[CUSTOMER][NEUTRAL] Carcinoma, lung carcinoma and um it's metastasized is what is, so they gave me that. So I just need to know what I can do to uh I've paid out of pocket for some of the, the uh like the PET scans and things like that because I had to meet my deductible for my health insurance.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] So do I just submit those or is it like a and once I do submit those this year when it comes time to renew the policy, we renew every like [PII] because we're a school district. So do I have the option to renew then or is it gonna be canceled after I filed this? Does that make sense?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] No, ma'am. It's not gonna be canceled just because you, you know, have been diagnosed. So,
[CUSTOMER][NEUTRAL] Yeah, I file on it. OK.
[AGENT][NEUTRAL] Right. It's, um.
[AGENT][NEUTRAL] The effective date, of course, as you know of this policy is [PII]. So if you found out in December, um you would just file on this, on this policy. If it had been something from last year or the year before, then when the claim comes in, the claims specialist would look and see which policy was active on the date of service so it goes by the date of service on your claims.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, so I just need to submit uh my I guess billing from the doctor's office or submit what I paid.
[CUSTOMER][NEUTRAL] Into them I evidently I can do it online, is that right?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Right, you can do it online, um, are you signed up for the online service center?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, not yet, but I do have the, I've pulled the documentation off about how to do that, but I haven't done it yet, so.
[AGENT][NEUTRAL] OK, good. OK, all right, so when you get in there, you're gonna choose to go to claims and forms.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you will, and we also have a website where you can look at these now without even signing up for it if you want me to give you that so you can look at it, um.
[CUSTOMER][POSITIVE] Sure, thank you.
[AGENT][NEUTRAL] It's um, yes, ma'am, it's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And when you get in the website, just above the gentleman's shoulder is a part that says claims and forms and you will click on claims and forms.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you will scroll down and you'll see the cancer claim form is the 3rd claim form on this website.
[AGENT][POSITIVE] And you can download the form and look at it and the very first page is a good cheat sheet for you. It tells you everything that you need to send in with your claim. It's very important that you send in the pathology report for the first initial diagnosis because you have a benefit for first initial diagnosis.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that's also your proof of your diagnosis too, for your cancer policy.
[CUSTOMER][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Right, OK.
[AGENT][NEUTRAL] But it's very um it tells you to send in your itemized uh invoice or your itemized receipt where you paid, um, if you have any surgeries to send in your operative report, copy of your prescriptions. It, it's very um detailed what you need to send in.
[CUSTOMER][POSITIVE] All righty then. I will look at them.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, not a problem. I will get all that together so I this is.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Hopefully going to be sounds bad, but the treatments, it's going to be a long term thing for a long time. Um, as opposed to what my doctor wrote on there to begin with and I was like, what? My prognosis was a few years. I was like, what? No, that's not what you're telling me. What is a few years? Um, anyway, so once my health insurance changes again and I can renew this in for September.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Uh yes, ma'am. Oh.
[CUSTOMER][NEUTRAL] It'll be time again one.
[CUSTOMER][NEUTRAL] Probably by about November or December again to start doing my PET scans and things again, but I'll still have to meet my deductible again. So can I file those then on this policy still?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes ma'am, um, if you have to get a, if you have to get a new renewal policy, the only thing I do know, um, just because I used to, uh, issue policies is if you already have history of cancer, you can't increase your benefits. You'll have to remain where you are with your policy, but they do not cancel you because of it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, no, cause I.
[CUSTOMER][POSITIVE] OK, alright, OK, I just needed to know what I needed to do so to help pay for this fun thing.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, and it's not gonna be a couple of years. We're not claiming that. You're gonna get through this just fine and, and everything is gonna be fine. It's all gonna work out for you.
[CUSTOMER][NEUTRAL] Anyone,
[CUSTOMER][NEGATIVE] No, no.
[CUSTOMER][NEUTRAL] Oh yeah.
[CUSTOMER][NEUTRAL] I hope so. I hope so. Anyway, I just, I wanted to get that all straight when I needed to do before my, it lapsed and I didn't get what I could get. So anyway.
[AGENT][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Right, I understand. I, OK.
[CUSTOMER][POSITIVE] Alrighty, well, that's all I need for right now. Thank you for your help.
[AGENT][NEUTRAL] You're very welcome, Ms. [PII]. How do I say your name?
[CUSTOMER][NEUTRAL] It it's, it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's like [PII], but it's with an [PII], yes.
[AGENT][NEUTRAL] Oh, OK, that made it simple for me. I have people ask about my name all the time too, so, but I want to make sure. My name is [PII], but I get called [PII].
[CUSTOMER][NEUTRAL] And what is your name?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is it
[CUSTOMER][NEUTRAL] Yeah, so is it [PII] or how do you spell it?
[AGENT][POSITIVE] Yes, ma'am. That's correct. [PII]
[CUSTOMER][POSITIVE] OK. All right. Sounds good, sounds good. Well, I do appreciate your help and I'll get this started, um, all right, thanks a bunch. right.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] All right. Well, thank you. You're welcome. You have a blessed night. Thanks for calling APL Miss [PII].
[CUSTOMER][POSITIVE] Thank you. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.