AccountId: 011433970860
ContactId: d4b531aa-65ce-4ce6-8204-ac7e5b407ed2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 739859 ms
Total Talk Time (AGENT): 320074 ms
Total Talk Time (CUSTOMER): 315021 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/d4b531aa-65ce-4ce6-8204-ac7e5b407ed2_20250417T17:37_UTC.wav
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[CUSTOMER][NEUTRAL] Receive the claim form for the just.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I?
[CUSTOMER][NEUTRAL] We have a
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hello, this is [PII] with APL. How may I help you?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEGATIVE] Yes, I'm calling for [PII]. Um, he's supposed to have surgery on the [PII], and they sent me some uh cancer claim forms, and the lady told me that I'm supposed to have a form that that the doctor fill out after surgery, and I don't see that form with the forms they sent me.
[AGENT][NEUTRAL] OK, alright, I can help you with the client. Can I please get your name and your call back number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And what is your name?
[CUSTOMER][NEUTRAL] I'm [PII]. I'm his wife, and [PII] is right here. I'm out. I'm right here on the phone.
[AGENT][NEUTRAL] OK. Thank you, Ms. [PII] and Mr. [PII]. May I please get your policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 00708357
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] OK, Mr. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what is your address, phone number and email address that we have on the policy for you?
[CUSTOMER][NEUTRAL] The address is [PII]. I don't think he have an email down. He don't have an email.
[AGENT][NEUTRAL] Yes ma'am, and then the cell phone number that's on the policy?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I have a different number.
[CUSTOMER][NEUTRAL] Uh [PII], that's my number, but his number is [PII].
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] And uh I faxed some papers in to you all.
[AGENT][NEUTRAL] Let me real quick.
[CUSTOMER][NEUTRAL] This
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Did y'all receive the papers I faxine?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] I do show that on, um, first let me speak with Mr. [PII] one more time. Mr. [PII], this is [PII]. Can I please get your confirmation and your um permission to be able to speak with your wife, um, Ms. [PII], about your claim and your policy?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes you do. Yes you do.
[AGENT][POSITIVE] Thank you, Mr. [PII]. I appreciate you. Thank you so much, sir. OK, Ms. [PII]?
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I do see on [PII], which was yesterday, we did receive a claim form.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And it's in process right now. There's no information on it as it takes. It can take 7 to 15 business days to process a claim.
[CUSTOMER][NEUTRAL] No, we hadn't
[CUSTOMER][NEUTRAL] Um, OK.
[CUSTOMER][NEGATIVE] When I, when I signed in yesterday, which I received that I faxed supposed to be the uh authorization for me to speak because the paper he had filled out for me to speak on his behalf was in [PII] and it needs to be updated. And I sent in the pathology, I sent in the pathology report from when he got diagnosed with the uh cancer. That's what they told me that I need the two things I need to send in.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then she told me she was uh she mailed me some claim forms to fill out and one of them is supposed to be, the one section of it is supposed to be after he had his surgery, the doctor's supposed to fill it out and I'm supposed to mail it back in to go along with the pathology report.
[AGENT][NEUTRAL] Yes ma'am, I understand. I do see that um authorization form was sent in it just hasn't they're in the process of applying it to the policy at this time.
[AGENT][NEUTRAL] And as far as the rest of the paperwork that you sent in also with the authorization form, it is also in process um.
[AGENT][NEUTRAL] And you said that the pathology report is the one that you're having trouble getting?
[CUSTOMER][NEUTRAL] No, I sent the pathology report to you all.
[AGENT][NEUTRAL] Or is the operation.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] At the forms that they sent me to fill out for for him, the, the claim, it say the cancer claim form and the cancer claim forms, he told me to fill out and then there's a part on there that the doctor has to fill out and I mail it back in to you all. But I don't see a part on the APL cancel claim form that a part for the doctor to fill out.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, let me look at the claim form real quick.
[AGENT][NEUTRAL] It's gonna be just a second, I'm gonna pull it up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so on the claim form itself, on the top of the claim form.
[AGENT][NEUTRAL] It does tell you what you need to send in with this claim form.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I am not seeing.
[CUSTOMER][NEUTRAL] What do you say?
[AGENT][NEUTRAL] I do see about the patient on there. That is not, uh, that does not have to be filled out by the doctor.
[AGENT][NEUTRAL] Um, that can be filled out by you. And then on that first page of the claim form, it tells you everything that you need to send in with the claim. Now, if he had surgery, that operative report that comes from the doctor will need to be sent in.
[AGENT][NEUTRAL] With the claim form.
[CUSTOMER][NEUTRAL] Now, what needs to be sent in from the doctor?
[AGENT][NEUTRAL] The operative report if he had surgery.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Did you mention that he had surgery?
[CUSTOMER][NEUTRAL] He's gonna have it on the [PII], this coming Wednesday.
[AGENT][NEUTRAL] OK. So that, um, there's a, a form that's called the operative report, and that is what needs to be sent in because he's having surgery, after the surgery.
[CUSTOMER][NEUTRAL] So what do I get that from?
[CUSTOMER][NEUTRAL] So what where that farm at?
[AGENT][NEUTRAL] You get that from
[AGENT][NEUTRAL] It's actually uh comes from the physician's office. It's called an operative report.
[AGENT][NEUTRAL] And that's what the physician completes.
[CUSTOMER][NEUTRAL] You see it
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I don't see it, but I know it.
[CUSTOMER][NEUTRAL] Uh, uh, OK, well, I'm, I'm gonna write that down. I thought miss uh.
[CUSTOMER][NEUTRAL] OK, so just fill out this claim form that says section A above the issue and then section C.
[CUSTOMER][NEUTRAL] It's a non-local transportation and we need to fill out the.
[CUSTOMER][NEUTRAL] The transportation part, she says. So I guess that's just the part.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] When he go
[AGENT][NEUTRAL] Yes, and that you're.
[CUSTOMER][NEUTRAL] I just put um.
[AGENT][NEUTRAL] You also need to fill out section B because that says about the patient who is also the insured, so you're going to fill out section A, B, and C, and if you guys had to stay in a hotel room or anything like that because it's so far away, then you'll fill out that member lodging section and send in all your receipts.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so on the transportation part, and she said somebody do the gas, the gas thing, so I just put like from my house to, to where the hospital is.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Like we say, uh, transportation, so I just put.
[CUSTOMER][NEGATIVE] Like my address to the address where, where he going or I just put the, I just see uh it just say one address, don't it? So you don't put your, you say, they begin a travel, mess with a trail and treating location. So you just put where you're going freeport state zip code. That's all you do. So you don't put the name of the hospital or uh or you just put the the town he going to?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You, you're going to put um the date of travel, how you traveled, the street that you traveled to, and then you'll also bring on the second lots when you go to, and then on the 2nd line when you leave, you're gonna put the date of travel, the method of travel, and the street that you're gonna come back to.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That way they have where you're going and where you're coming back to because in order to get a travel pay it has to be 50 miles or more one way.
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] OK, so you'll make sure that you fill that out so that you can get reimbursed for your travel. And if you have any receipts that you've hung on to, you can send those too. If you don't, that's OK also.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Hold on one minute.
[CUSTOMER][NEUTRAL] OK, and if I've traveled like 2 and like one procedure, we travel Monday and Tuesday. So I would put going to Monday, coming back Monday, going going to Tuesday, coming back Tuesday, but when I run out of lines, where do I write the remaining information? On the bottom of this page.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] You can just
[AGENT][NEUTRAL] You can just, if, if there's room on the bottom, yes, ma'am. If you run out of room, just attach another piece of paper.
[CUSTOMER][NEUTRAL] And I can document all travel cause cause.
[CUSTOMER][NEUTRAL] So I only document.
[CUSTOMER][NEUTRAL] The travel after the surgery or can I document any travel because of the cancer due to because of it?
[AGENT][NEUTRAL] Yes, you can document any travel due to the cancer diagnosis.
[CUSTOMER][NEUTRAL] OK, so each time that I've had to go over to see the doctor, whether it was blood work or to have other test run to see if there was cancer in another area. Anything related to since the diagnosis of the cancer that was recommended by my cancer doctor, correct?
[AGENT][NEUTRAL] Right. After you received the date of the pathology report of the first initial diagnosis of cancer, any back and forth after that first initial diagnosis on the pathology report. You can, yes.
[CUSTOMER][NEUTRAL] Can be documented.
[CUSTOMER][POSITIVE] Oh, OK, thank you. OK, thank you for your help and I appreciate it.
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You're very welcome. Is there anything else I can help you guys with before we go?
[CUSTOMER][NEUTRAL] That'll be all.
[AGENT][POSITIVE] All right, well, you guys have a blessed Easter and thank you for calling APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, same to you. Thank you.