AccountId: 011433970860
ContactId: d96a2c20-4248-4304-b364-44eff02dba3a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 815750 ms
Total Talk Time (AGENT): 341316 ms
Total Talk Time (CUSTOMER): 378095 ms
Interruptions: 6
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/d96a2c20-4248-4304-b364-44eff02dba3a_20250502T13:58_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Good morning. This is [PII]. I'm, um, I work for Moulton ISD and I believe that I bought a cancer policy um through the district, and it should, the benefits should be good through [PII]. And I don't have um information.
[CUSTOMER][NEUTRAL] For my representative.
[CUSTOMER][NEUTRAL] And I wanted just to know how I go about getting benefits. I had a little basal cell.
[CUSTOMER][NEUTRAL] Um, on my face, and they're going to treat that. And I just wanted to know if this cancer policy would pay anything on that. Can you help me with that?
[AGENT][NEUTRAL] OK, yeah. Uh, yes, ma'am. Uh, Miss [PII], do you have a policy number or no? Well, you say you don't have any information. And what's your last name again? I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I do not. I don't. Mm. All I have
[CUSTOMER][NEUTRAL] [PII] I have a booklet telling me my benefits, uh, my benefits, but, you know, it just gives me general information, like your phone number and the policy, and it doesn't give me anything specific about my
[CUSTOMER][NEUTRAL] Uh, policy.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] My first name is [PII].
[AGENT][POSITIVE] Oh, and I call you [PII]. I'm sorry.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK. And Ms. [PII], verify your date of birth, mailing address and the email address for me, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]. The email here is a [PII], and my address is [PII].
[AGENT][POSITIVE] OK, thank you so much. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Sure, [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you, ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] See, yes, ma'am. I do show you have a cancer policy with us, um, effective [PII] or [PII]. And you say you hadn't received any kind of benefit information from us?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No. All I have is a booklet. Can you give me the policy number?
[AGENT][POSITIVE] Yes ma'am uh let me know when you're ready.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, uh, the policy number is 252-35887.
[CUSTOMER][NEUTRAL] And are there any other numbers there that I might need like a group or anything like that?
[AGENT][NEUTRAL] Let's see, your group number is 14611.
[CUSTOMER][NEUTRAL] OK, and this is American Public Life. Is that correct?
[AGENT][NEUTRAL] Uh, yes, ma'am. And if you like, I can uh send a request to your policy mailed out to you. And we do have an online service center uh to where you can set up an account to view your policy as well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That would be lovely.
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][POSITIVE] I'd rather you mail it to me. That would be great. Thank you so much.
[AGENT][NEUTRAL] OK, yes, ma'am. I'll send a request.
[CUSTOMER][NEUTRAL] I'm sorry, I work at a school and it's, yeah.
[AGENT][NEUTRAL] Oh no, you're fine.
[CUSTOMER][NEUTRAL] So they'll send me the, they'll send me the paper copy.
[AGENT][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] OK. And do you have a, uh, do they also send you a little card that you can give to the uh dermatologist for them to follow up?
[AGENT][NEUTRAL] Uh, no, ma'am. Uh, there's no cars issued under ours, uh, cancer policies. Um, and typically, insurers submit the claim instead of the provider, but they can and, um, for you. Uh, we do have a claim form that you need to complete and um we will need that pathology.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, can you send that to me as well?
[AGENT][NEUTRAL] Uh yes, ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what would you need?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Oh, the pathology report. And did they, um, do the mole surgery as well?
[CUSTOMER][NEUTRAL] A pathology report.
[CUSTOMER][NEUTRAL] I already have it.
[CUSTOMER][NEGATIVE] No, they're not going to do that. They're going to do something called gentle care, where they uh laser it 20 times in [PII].
[AGENT][NEUTRAL] [PII] wow. OK.
[CUSTOMER][NEUTRAL] Yeah. And it's supposed to be, um, it's scar, it's on my face. So it scars less, and it just requires more, um, you know, time.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Well, that's good if it doesn't scar.
[CUSTOMER][NEUTRAL] And do you know if this, this is covered or?
[AGENT][NEUTRAL] Uh, let me pull up your policy.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][POSITIVE] And yes, you can give me information for uh logging into that too. That would be so helpful. Thank you so much. I'm about to retire and I'm retiring um but this policy is good through [PII], so I want to make sure and use the benefit if I can.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, absolutely, yes, ma'am. Um, if you go to our site at [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Uh, secured. Ampublic.com.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEGATIVE] Uh, I don't think I got it right. Um, [PII].
[AGENT][NEUTRAL] Mhm. Am public.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes ma'am, and when you go on to the site uh you would select new user and then individual.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it'll ask for your name, date of birth, social, zip code and email address and once you've entered that, it'll let you set up a username and password.
[CUSTOMER][NEUTRAL] Does the secure, does it have a D on it or just secure?
[AGENT][NEUTRAL] Oh, no, it has to be [PII].
[CUSTOMER][NEUTRAL] Let me spell it to you, [PII], is that correct?
[AGENT][NEUTRAL] Uh, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me type it in to make sure while we're talking.
[CUSTOMER][NEUTRAL] Hm, it says this, this uh site cannot be reached, [PII].
[AGENT][NEUTRAL] [PII] Yes, ma'am.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Well, it's says the site cannot be reached. Let me put the D in there and make sure to see if that's it.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yes, OK.
[AGENT][NEUTRAL] Uh, skin cancer is covered under the policy, under the surgical benefit, um,
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] So I'm gonna click on new user and I'm gonna click on individual.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] And when it's asked for the member number, is it asking for my policy or the group?
[AGENT][NEUTRAL] Oh, no, ma'am. You have to use your social, uh, member numbers for different policies that are offered.
[CUSTOMER][NEUTRAL] OK, it's asking me for my social security or member number, so I'll put my social on there.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you so much for your help.
[AGENT][NEUTRAL] Absolutely. Yeah, let's see. But like I say, um, look at the
[CUSTOMER][NEGATIVE] Oops, there seems to be a problem. No user was found that.
[AGENT][POSITIVE] Oh bless it.
[AGENT][NEUTRAL] All right. uh
[CUSTOMER][POSITIVE] See, that's why I wanted to do it with you.
[AGENT][NEUTRAL] And zip code [PII] I'm sorry, [PII]?
[CUSTOMER][NEUTRAL] Is there uh
[CUSTOMER][POSITIVE] Yes, let me, oh, let me try that. OK, yeah, that's, that worked.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Create an account.
[AGENT][NEUTRAL] And you can also submit claims through the site as well, um.
[AGENT][NEUTRAL] For like wellness screenings, um, they have it to where you don't have to fill out a claim form and you can just fill out your email or your information electronically and they'll.
[AGENT][NEUTRAL] Send it straight to your policy to where it can be placed on for processing.
[CUSTOMER][NEUTRAL] So I can send it, can I send, really what I want to know is, is this something that I'm gonna have to do? I'm gonna have to collect all the payment information and send it in and as a claim? Or do I give the policy information to the dermatologist and they do it for me?
[AGENT][NEUTRAL] You're gonna ask them to do it for you, but for the most part, since this policy doesn't really, um,
[AGENT][NEUTRAL] Assigned benefits to providers. It's more of a supplemental for insured, um.
[AGENT][NEUTRAL] Most payments will be going to you instead of to the provider.
[AGENT][NEUTRAL] But um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On the claim form, um, it does have instructions on what we would need, especially um.
[AGENT][NEUTRAL] Well, for any treatment that you receive. Um, but we will need the initial pathology report and the billing for
[AGENT][NEUTRAL] Any of the laser, I guess, I guess that would still be considered surgeries, um, you can submit to us for any treatment you've received.
[CUSTOMER][NEUTRAL] OK, the billing and the past report.
[AGENT][NEUTRAL] Yes, ma'am, and the claim form.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, and you're gonna send me the claim form, right?
[AGENT][NEUTRAL] Uh yes, ma'am.
[AGENT][NEUTRAL] And if you like
[CUSTOMER][POSITIVE] Just send me a physical copy but you know that'd be great.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can send you a physical copy or you want me to email or both?
[CUSTOMER][NEUTRAL] Uh, both would be great just to make sure I get it. Let me get, uh, do you have my email address?
[AGENT][NEUTRAL] OK, yes.
[AGENT][NEUTRAL] Um, that's the one with the work email, the.
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] Well yes, but I'm only gonna be here through the end of May so it would be great if we could.
[AGENT][NEUTRAL] Oh, that is true.
[AGENT][NEUTRAL] OK, uh, what email address you want us to put in the system?
[CUSTOMER][NEUTRAL] Let's do [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] W A L T 32
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'll change it in the system and I'll email that form out to you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I locked.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I will email that claim form to you as well as send a request to have it mailed and your policy. And is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][NEUTRAL] Um, let me make sure that I can get all the way to it says my account has been created.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So let me go ahead and um log in and then you can help me get to where I need to be to see everything.
[AGENT][NEUTRAL] OK, yes ma'am.
[CUSTOMER][NEUTRAL] OK, it said.
[CUSTOMER][NEUTRAL] Enter your 10 digit phone number to receive updates.
[AGENT][NEUTRAL] Oh yeah, you can put in your cell phone number to where when a claim is received, uh, it will send you a text and when it's been processed, it'll send you a text.
[CUSTOMER][NEUTRAL] OK, let me do that one.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, it did. Just hang with me a minute, OK?
[AGENT][NEGATIVE] Oh, absolutely. I am not going anywhere, Ms. [PII].
[CUSTOMER][NEUTRAL] OK, thank you. OK, I'm in phone number has been verified, you're now subscribed to text messages. OK, so I see the group. I see 30 OK I see the active one down at the bottom. OK, so my claims I upload the documents here.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And um file a wellness claim. OK, so these were were process. OK, so these are things this is where I need to update everything. I need to upload everything and um I wanna make sure I upload everything the first time. So the billing does it have to be after it's paid or prior to or how does that work?
[AGENT][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] Uh, just the billing like, um, it doesn't necessarily like if you have a balance we won't accept the claim, but if you can get the billing from the provider, it just has to be after a service has been performed, um.
[CUSTOMER][NEUTRAL] Yes, so the receipt. I need the receipt.
[AGENT][NEUTRAL] Receipt, yes, ma'am.
[CUSTOMER][NEUTRAL] Right. OK. All right.
[AGENT][NEUTRAL] Showing the diagnosis and well, it will have the pro it should have the procedure codes cause the pathology report will show the diagnosis.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, you've been super helpful thank you so much. I appreciate your help.
[AGENT][POSITIVE] You are so welcome. And is there anything else I can assist you with today, Ms. [PII]?
[CUSTOMER][POSITIVE] That's it for now thank you so much.
[AGENT][POSITIVE] You are welcome and I thank you for calling APL. You have a great day and weekend.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Mm bye.