AccountId: 011433970860
ContactId: d68581f6-ab4c-4890-9e71-4e1723e72ccd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 476940 ms
Total Talk Time (AGENT): 148243 ms
Total Talk Time (CUSTOMER): 303230 ms
Interruptions: 4
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/d68581f6-ab4c-4890-9e71-4e1723e72ccd_20250218T17:57_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, my name is uh [PII].
[AGENT][POSITIVE] Good morning. How are you doing today?
[CUSTOMER][NEUTRAL] It's fine. Oh, I got the paperwork y'all sent out. I just printed it out.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I'd like to know which piece do I need to send back to y'all. I see one got my name on it with my uh policy number, and then there's another one that has uh this.
[CUSTOMER][NEUTRAL] It's about the same thing it has nothing on it.
[AGENT][NEUTRAL] Alright, and what is your policy number? Do you have that available?
[CUSTOMER][NEUTRAL] Yes, 256.
[CUSTOMER][NEUTRAL] 60, 30.
[AGENT][NEUTRAL] All right, thank you, Mr. [PII] and can you verify your date of birth and current mailing address?
[CUSTOMER][NEUTRAL] Uh [PII].
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Is it in [PII]?
[CUSTOMER][POSITIVE] Yes ma'am, still got [PII].
[AGENT][NEUTRAL] I was just gonna say, is that how you say it, [PII]?
[CUSTOMER][NEUTRAL] Yeah, it's like you you know how you how you wanna say it.
[AGENT][POSITIVE] Thank you
[AGENT][NEUTRAL] And what is a good callback number just in case we get disconnected, please, sir.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] Let's see and you said someone just sent you something?
[CUSTOMER][NEUTRAL] Yeah this morning I just got home and I just printed it out. I see two papers. One has my name insured by [PII] has the date the 1st, [PII] [PII].
[CUSTOMER][NEUTRAL] And then there's another one I guess something I guess they said something about my medical records. I got, I went to the hospital, I got my medical records.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And so you do have your medical records available?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes, I didn't know which one y'all need sent to y'all. I guess in [PII].
[CUSTOMER][NEGATIVE] And it stops right there the whole month, the whole year [PII] when I went to see the doctors.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Do you mind holding just one moment, Mr. [PII]? Let me get you to that cancer cue so they can check and see exactly which one, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, one moment please sir.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling ATL. This is [PII]. With whom am I speaking and how may I help you?
[AGENT][NEUTRAL] Hi [PII], it's [PII].
[CUSTOMER][NEUTRAL] Hi.
[AGENT][NEUTRAL] Hi, I've got policy number 256-6030, Mr. [PII].
[AGENT][NEUTRAL] I'm wondering if you can, he said that he received.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Letter, what was his name and policy number?
[AGENT][NEUTRAL] And the other one with not and he wants to know which one he needs to send back.
[AGENT][NEUTRAL] Do you have any clue what we might have sent him? And he said he's got his medical records.
[CUSTOMER][NEUTRAL] Hold on one second.
[CUSTOMER][NEUTRAL] I mean, I remember talking to him.
[CUSTOMER][NEUTRAL] It's um
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Let me look at the notes because I spoke to him. I could have swore I did.
[AGENT][NEUTRAL] Well, I was looking.
[CUSTOMER][NEUTRAL] On [PII], checking the status of the mail in line for processing, advised he is subject to preexisting because of his face, his uh effect date. No takeover information is listed on P now. I explained to him cause I stayed on the phone with him for a long time. Uh, let's see, I explained to him, you know, the pre-existing. I got my notes out here, but, um, uh, what is he, uh, I'm, I'm not really sure. Today he's calling because
[AGENT][NEUTRAL] Through the post, yeah.
[AGENT][NEUTRAL] Yeah, so.
[AGENT][NEUTRAL] He's calling because he received.
[AGENT][NEUTRAL] Um, 2 things from us, yeah, and I don't see where anything has been sent.
[CUSTOMER][NEUTRAL] Letter
[AGENT][NEUTRAL] And I'm just trying to figure out how to best help him.
[CUSTOMER][NEUTRAL] No, we, we sent mental.
[CUSTOMER][NEUTRAL] Let's see, uh, also verify, also verify that APL did not receive the info he sent in on a blah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, yeah, I don't know what he's talking about. I, I mean, you, you can send him over to me because I spoke to him and yeah, uh, like I said, on the [PII], well, it's, yeah, I think it's a couple days or two ago.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, I don't know. There's no notation that somebody sent him anything, so I don't know why he's saying that.
[AGENT][NEUTRAL] That's why I was just like, I wonder if, cause he said he went to the hospital and got medical records so I didn't know. I don't see where anybody's really requesting medical records.
[CUSTOMER][NEUTRAL] Nope.
[CUSTOMER][NEGATIVE] And the only thing he's getting that from, he's getting that from because you know I believe in telling everybody everything up front. He's subject to preexistence. So I don't believe in that having them file a claim and then they're under the impression that that's it. No, cause he was thinking that, and I stayed on the phone with him for a long.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh, yeah.
[AGENT][NEUTRAL] It
[AGENT][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] Time [PII] so long that I told him he's like, well, I might as well not have this policy. I said, Well, sir, I can't tell you that. I said, but I can't, we don't process claims over the phone. I said, but you should reach out to the pharmaceutical company the issue of the drug. Sometimes they have programs that will assist you.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um, you wanna get with the social worker at the treatment facility because they're there to assist you with programs that may be in place. Me and him got so in debt. We got so in debt that I told you and told him, well, you're right, it is expensive, but it's gonna make you hit a 10.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] You're 100% out of pocket. I said, and once you get 100% out of pocket with your main insurance, they're gonna be paying everything at 100%. He goes, yeah, they told me that. So go ahead and send him over to me and um I'm gonna try to decipher what he's saying because, you know, I think he's trying to make something happen and it's just.
[AGENT][NEUTRAL] I wonder
[AGENT][NEUTRAL] Yeah, it's just a process and.
[CUSTOMER][NEUTRAL] You know, he, he said he was gonna get the medical records and I told him, you, you have, you, you can do that. But understand that your, your claim is gonna be investigated. It's got to be investigated.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, um, and unless it's that email, uh, [PII] said that she would email him the treating physician form.
[CUSTOMER][NEUTRAL] But go ahead and send him over, uh huh.
[CUSTOMER][NEUTRAL] The list of treating, yeah, that's, that's probably all we sent him.
[AGENT][NEUTRAL] That's the only thing that I could even, but he said he got home and opened it up.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I, I bet you that's what it is.
[CUSTOMER][NEUTRAL] It may be, it's the list of treating physician and then she probably sent him the HIPAA form because, you know, we need that to request the medical records. So that's normally two things that we send, but I'll tell them it's not a problem. Yeah.
[AGENT][POSITIVE] All right. I don't, I really do appreciate that, [PII].
[CUSTOMER][NEUTRAL] Uh, you, you verified everything, right?
[AGENT][POSITIVE] I did, and I'll get him on the line for you. So if you'll hold on just a second. Thank you, [PII]. I appreciate it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you, [PII].
[CUSTOMER][NEUTRAL] All right, uh huh. You're welcome. Mhm. You'll see.
[AGENT][NEUTRAL] Hi, Mr. [PII], I have [PII] on the line. She's going to assist you further with the documents, OK?
[CUSTOMER][POSITIVE] OK, yeah, thank you, ma'am.
[AGENT][POSITIVE] All right. Thank you. You have a wonderful day and thank you, [PII].
[CUSTOMER][POSITIVE] Thank you. Hey, Mr. [PII], I spoke to you, uh, I did get to though on the [PII]. I spoke to you yesterday.
[CUSTOMER][NEUTRAL] OK and then uh so I understand that you're calling because you had some forms were they emailed to you?
[CUSTOMER][NEUTRAL] Yeah, I got them already. I got two of them. One has my name and my policy number, and they look the same one just my name. Yeah, it's just a list of treating physician form and so it's 2 pages is what it probably is. So you just need to fill out because remember we talked about pre-existing we only need to know the physicians that you saw 12 months prior to your effective date for the condition that you're filing for so that would be for the cancer, nothing else, OK?
[CUSTOMER][NEUTRAL] OK, but uh like I said, I didn't see this person for my cancer treatment until this year.
[CUSTOMER][NEUTRAL] It doesn't matter we still have to have that form filled out. We have to have their name and we'll be reaching out to them as well, mhm.