AccountId: 011433970860
ContactId: d3eb9261-fd02-4b75-a085-cf3710c0f68b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 369929 ms
Total Talk Time (AGENT): 142952 ms
Total Talk Time (CUSTOMER): 173785 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/10/d3eb9261-fd02-4b75-a085-cf3710c0f68b_20250210T18:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] [PII], this is [PII], and I'm calling on behalf of my daddy, [PII], and I sent in the um form giving me the
[CUSTOMER][NEUTRAL] Permission to talk on his behalf of his account.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So, uh, I had printed, they had sent me all the forms for the cancer to for uh to file, but I have a few questions.
[AGENT][NEUTRAL] OK, alright, so let's start with the policy number.
[CUSTOMER][NEUTRAL] OK, the policy number is 00436150.
[AGENT][NEUTRAL] OK, thank you. And verify the date of birth.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um [PII].
[AGENT][POSITIVE] Thank you and [PII], what's a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you and you're calling in regards to submitting a claim?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Alright, what question did you have?
[CUSTOMER][NEUTRAL] OK, so I have um.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] OK, so the wellness claim form is that where I checked that they originally found the cancer?
[CUSTOMER][NEUTRAL] Or is that on the cancer claim form?
[AGENT][NEUTRAL] That will be on the cancer claim form.
[CUSTOMER][NEUTRAL] OK. So,
[CUSTOMER][NEUTRAL] He didn't have, when we, when we went down, we just, so we just put the day of travel and
[CUSTOMER][NEUTRAL] And what they
[CUSTOMER][NEUTRAL] And that's it, right?
[AGENT][NEUTRAL] Yes, you would put the date as well as the address to which you traveled to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so let me ask you this. So he had a, he had a biopsy and he had a colonoscopy, so can he claim both of those?
[AGENT][NEUTRAL] Yes, the colonoscopy would be on the wellness claim.
[AGENT][NEUTRAL] The biopsy, if it's a positive diagnosis, then yeah, that would be the cancer claim.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Alright now, so he has to take um.
[CUSTOMER][NEUTRAL] 45 days of radiation. So do I have to do.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] For the, for the travel, do I have to do each day of someone or can I do it by the week?
[AGENT][NEUTRAL] You can, as long as the date and the address is on the claim form and it shows the location in which the therapy was received, then we will uh review the transportation benefit for each day uh covered service was received.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, so it only has a place to it says begin date for travel, so but it doesn't have an end date. So do I need to just put to and from? I mean.
[CUSTOMER][NEUTRAL] The fir the first start date and the end date?
[AGENT][NEUTRAL] I would suggest to list each date or make a note that you traveled from the home address to the treating facility for each date, because if you put that one, it'll look to us as if uh you traveled to the location and maybe stayed at a hotel or something during that process and then return back. So yeah, you wanna make it clear that there was a visit uh travel each date of service.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK, so um.
[CUSTOMER][NEUTRAL] What, what do I need to attach to that each time he has radiation of of a bill or how do I do that?
[AGENT][NEUTRAL] You want to uh submit the itemized bill as well as the explanation of benefits.
[CUSTOMER][NEUTRAL] And that's from the insurance company?
[AGENT][NEUTRAL] Yes, that's from Primary Insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, so that would be on the, on the, the form itself, but on this I can do the biopsy and the colonoscopy because he should already have that.
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, alright, OK.
[AGENT][NEUTRAL] Yeah, and it looks like for that um radiation, you won't have to submit the item, I'm sorry, the EOB so we would only need the itemized bills for that treatment.
[CUSTOMER][NEUTRAL] OK, OK, so on that I just got a house out of my bill.
[CUSTOMER][NEUTRAL] Um, for treatment. I'm writing this down.
[AGENT][POSITIVE] Mm, no problem.
[CUSTOMER][NEUTRAL] OK, so, um.
[CUSTOMER][NEUTRAL] So what'd you say daddy? OK, so in addition to the treatment, he sees the doctor once a week too. So is that different?
[AGENT][NEUTRAL] Yes, the doctor's visits are not covered. Um, it's only the covered treatment that's received. So if it's something uh like a diagnostic testing or the radiation therapy, those are the benefits that'll be payable. If it's a hospital stay and things of that nature, but for an office visit itself, that's not covered.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, alright, OK.
[CUSTOMER][NEUTRAL] OK, that's what I need to know then.
[CUSTOMER][NEUTRAL] OK, I think that's all I have right now.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK well feel free to give us a call back if you have any additional questions.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] No problem, thank you for calling APL have a great day.
[CUSTOMER][NEUTRAL] OK, you too, bye-bye.
[AGENT][POSITIVE] Thanks bye bye.