AccountId: 011433970860
ContactId: dbc52f61-beb8-433e-a727-ac9ced98f7de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1939310 ms
Total Talk Time (AGENT): 369573 ms
Total Talk Time (CUSTOMER): 728505 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/11/dbc52f61-beb8-433e-a727-ac9ced98f7de_20250411T19:14_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes, uh, my name is [PII], and I'm in the process of completing, um, forms for my husband's cancer submission. He did pass away. And so I was calling um to talk to you about uh a couple of questions I have. Can you pull up my file?
[AGENT][POSITIVE] Yes, ma'am, I can.
[AGENT][NEUTRAL] Uh, do you have the policy number?
[CUSTOMER][NEUTRAL] Yes, it's 258-206-3.
[AGENT][POSITIVE] OK, thank you. Let's see.
[AGENT][NEUTRAL] And then [PII], what's a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] OK. And then, [PII], what is your date of birth and your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And then your mailing address?
[CUSTOMER][NEUTRAL] My mailing address is um [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and then your email, please?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK. And then your husband's first and last name and then his date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK. So, you're completing the forms right now or have you sent them in already?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][MIXED] No, no, I'm completing them right now. So I did go to, um, because I wanna do it on form, so I don't wanna do it online because it's just so much. Uh, I've talked to someone before and they helped me a little bit and they're very helpful. Uh, but I'm just a little overwhelmed because it's a lot. So I did go to download the forms and the first cancer form I downloaded was the one for um
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's for mileage and transportation, I mean, transportation and lodging. So I have that one and I feel pretty good about that one. But it's the other one, the wellness and screening benefits form.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So, OK, so on this one, I, I, I downloaded it and I made a bunch of copies of it and um you know, I'm, I'm trying to work through it right now. So as I'm looking at it, um, I, I was looking for, um, you know, all the things that they have. Do we get any benefits for a doctor's visit or not?
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] OK, give me one second. I need to pull up, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The certificate for this so I can look deeper into it.
[AGENT][NEUTRAL] Sorry, I'm still here, just one second.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] OK, sorry, there's a lot on this policy certificate. Can I put you on a brief hold and reach out to a colleague really quick? OK, thank you.
[CUSTOMER][POSITIVE] Yes, ma'am. Yes, yes, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK [PII], thank you for holding so it looks like office visits are not covered.
[CUSTOMER][NEUTRAL] OK, so office visits are not covered. OK. So, um, my other question is, let's say on a particular day, he had a, uh, he had a blood test and he had um a PSA done plus the regular blood test done. Can I do it on the same form if he did it on the same day, or do I have to do a separate form?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] For blood tests, a separate form for PSA.
[AGENT][NEUTRAL] So you should be able to do it on the same form if it's in the same day.
[CUSTOMER][NEUTRAL] OK. All right. Cause that's what I was wondering because, I mean, he's had, like, he had the metabolic lipid panel and a PSA done every time, um, you know, every time we had blood tests done. So it's like, OK, do I have to do like different ones? Or can I do it the same, the same one? So you're good with that if I do that.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Yes, that is fine. Yes, that's, that would be a lot. Yeah.
[CUSTOMER][NEUTRAL] OK. All right, that's that.
[CUSTOMER][NEUTRAL] Because it, it is a lot, but uh,
[CUSTOMER][NEUTRAL] All right. Uh, it's just, it is a lot. It, it's, it's a lot. That's all I could tell you, but I'm just gonna try it. So now, the, the form with the transportation.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Our doctor's office was 48 miles away.
[CUSTOMER][NEUTRAL] And I saw that it has to be 50 miles away. So do they round up any or do they not?
[AGENT][NEUTRAL] No, they don't round up. So they just go based on uh what Google Maps says. So if your map says that, that's what they will go by.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, so I can't do, uh, but then the hospital was the um
[CUSTOMER][NEUTRAL] The 49. 0, OK. This is the other question I had. All right. Do y'all cover hospital stays?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] Because I don't see a form for a hospital stay.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Let me look on their certificate really quick, um.
[CUSTOMER][NEUTRAL] Because the chemo put him in the hospital twice.
[AGENT][NEUTRAL] OK, and he stayed the night?
[CUSTOMER][NEUTRAL] Yeah, mhm.
[AGENT][NEUTRAL] OK. So, it looks like for this policy, there is hospital confinement. So per day of hospital confinement days.
[AGENT][NEUTRAL] Uh, 1 to 30 is 2, we cover $200.
[CUSTOMER][NEUTRAL] A day
[AGENT][NEUTRAL] And yes, a day.
[CUSTOMER][NEUTRAL] So what form would I use to put that on? Because the only two forms I see on the cancer are the cancer claim form for the lodging and transportation and the wellness and screening benefits form, but I don't see a form like for a hospital stay.
[AGENT][NEUTRAL] Mm, let me look at.
[CUSTOMER][NEUTRAL] And then if I go into other claims and forms, OK, let me see, like for other ones, there's an accident, there's a cancer claim form which I have, and there's a um
[CUSTOMER][NEUTRAL] I think, OK, let me see.
[CUSTOMER][NEUTRAL] I don't know what indemnity hospital indemnity claim form. I don't know what that means. Um,
[AGENT][NEUTRAL] So, it should just be the cancer claim form.
[CUSTOMER][NEUTRAL] But how do I put a hospital stay on it?
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Can you look at the hospital claim form in a minute and tell me where would I put a hospital?
[AGENT][NEUTRAL] Yes, I'm gonna pull up that form right now so I can tell you, let's see.
[CUSTOMER][NEUTRAL] I'm not, I'm not trying to be a problem. I just, I'm just needing some help with this. It's just
[AGENT][POSITIVE] Oh, no. You're not a problem at all.
[CUSTOMER][NEUTRAL] It's, it's a lot.
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] You know, uh, I'm trying to do all this by myself.
[CUSTOMER][POSITIVE] And it's just a lot and then it's just, it's like you're reliving the whole thing, you know, because.
[AGENT][NEGATIVE] Oh no.
[AGENT][POSITIVE] Uh, I'm so sorry. I can only imagine. You have to fill all this out on top of it.
[CUSTOMER][NEUTRAL] It's just
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] No, we're here to help, so just call us anytime.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] OK, I'm trying to find where I went for cancer, just plain old cancer and, OK, right here.
[CUSTOMER][NEUTRAL] Uh, it's download. So the only two options I get for cancer for forms is just the cancer claim form and the wellness and screening benefits claim form.
[CUSTOMER][NEUTRAL] But I don't see where I put hospital stays on that.
[CUSTOMER][NEUTRAL] Unless I do um where it says other wellness tests, but it's not really a test.
[AGENT][NEUTRAL] So,
[AGENT][NEUTRAL] So it says.
[AGENT][NEUTRAL] So it should say like at the top it has instructions so on like the 3rd bulletin.
[AGENT][NEUTRAL] It says the indicated documentation must accompany the completed statement of insured when filing a claim.
[AGENT][NEUTRAL] So you will fill out this claim form.
[AGENT][NEUTRAL] Uh, to like the best of your knowledge, you know, your first, your last name, just all the basic.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] That you will need the pathology report.
[AGENT][NEUTRAL] Along with this claim form. So that's where um the initial diagnosis of cancer, um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The surgery that you'll include in this as well.
[AGENT][NEUTRAL] And an itemized bill so that way we'll be able to see everything.
[CUSTOMER][NEUTRAL] So, are you telling me that I don't have to do a wellness claim form for every blood test, every PSA test?
[AGENT][NEUTRAL] No, so you can just attach all of those from uh the pathology report.
[AGENT][NEUTRAL] And you can
[AGENT][NEUTRAL] Just put them with this cancer claim form.
[CUSTOMER][NEUTRAL] OK, so what can cause, all right. OK, can you look, can you look back, uh, I already, I had submitted a claim form like in the beginning and they told me that they needed all kinds of stuff, you know, so can you go back to like the beginning where I put a claim form, I'm gonna go back to the beginning. I'm reopening this because.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I, I don't know where I couldn't go back on the form, but if you could reopen, you will see that on.
[CUSTOMER][NEUTRAL] On, uh, [PII], I tried to send something in.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And he has a claim number.
[CUSTOMER][NEUTRAL] He has a claim number I sent it [PII], um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Uh,
[CUSTOMER][NEUTRAL] Wait, no, when did I send that in? Let me see. No, I sent it in [PII]. I sent that in.
[CUSTOMER][NEUTRAL] Alright, do you see that where it has process 0SC 6165758 and 59?
[AGENT][NEUTRAL] Do you have the claim number?
[CUSTOMER][NEUTRAL] Um, yeah, it's 3342529.
[AGENT][NEUTRAL] OK, I'm looking, let's see.
[AGENT][NEUTRAL] Sorry, my computer's thinking.
[CUSTOMER][NEUTRAL] Oh, that's OK, that's OK.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] So, I'm seeing.
[AGENT][NEUTRAL] Under this claim form.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Um, it says, I think this is the one you're talking about, it says in order to give consideration to the state of service, we will need a fully itemized hospital facility billing with all charges.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so then you send that in.
[CUSTOMER][NEGATIVE] No, I never, I never sent anything back in. um, no, I just sent in that just, you know, I don't know what I sent in because I can't see what I sent in, but I know I just like try to start the claim off. Then I got this.
[AGENT][NEUTRAL] You didn't?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] And then he was really sick. And then I was working and it was just a mess. So I didn't have time to do this again, to tell you the truth. So I'm wondering right now, can I, can I just send in all my itemized bills from my oncologist, from the hospitals, and
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] On this open claim and not have to fill out all those individual claim forms, or do I have to fill out all those individual new claim forms like for blood tests, for PET scan, for this, for that? I don't know what to do.
[AGENT][NEUTRAL] Um, so you will just fill out that cancer claim form and then also the, um,
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Believe it's the.
[CUSTOMER][NEUTRAL] OK, so can you tell me which cancer claim form you're talking about? The wellness ones?
[AGENT][NEUTRAL] So it will be.
[CUSTOMER][NEUTRAL] Because uh, you know, it seems like I have an open case right now.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, so you will need.
[AGENT][NEUTRAL] The cancer claim form.
[AGENT][NEUTRAL] What you said that you have, right?
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] OK, so when you say the cancer claim form, I make sure that I got this right. We're talking about the one that is called the Wellness and screening benefits formed on the top it has wellness claim form.
[AGENT][NEUTRAL] Uh, so it looks like, yes, you will need to fill out the wellness claim form. I'm sorry. So fill out the wellness claim form.
[CUSTOMER][NEUTRAL] All right, but
[CUSTOMER][NEUTRAL] OK. So when I fill that out, look below that, like, look at section C. Do I have to do C and
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Or do I just attach because you realize that we have almost 18 months of stuff. So you realize how many blood tests, how many PET scans, how many MRIs he had. So that's what I'm confused about. Do I just do one
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] These forms and then just don't check off see don't check off uh anything else just sign it and do I just send it in with all of my itemized bills or do I have to do separate everything separate?
[AGENT][NEUTRAL] No, so you will just attach your itemized bills.
[AGENT][NEUTRAL] To the wellness claim form.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] So I'm not
[CUSTOMER][NEUTRAL] I'm not doing section C, right?
[AGENT][NEUTRAL] Let me see. I'm on the form now.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] No, not unless he
[AGENT][NEUTRAL] This, so this is for diagnostic imaging studies?
[CUSTOMER][NEUTRAL] I mean, that's for everything. I mean, it has, that's where you see your PSA. If you go to the next page, you see your blood test, you see all of this stuff that he had. So that's what I'm just wondering and I printed out 150 of these forms, because I mean, he has so many treatments.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so just fill this wellness form out one time and what you're going to do is.
[CUSTOMER][NEUTRAL] and you're talking about, you're talking about the top, like the top part, the statement of insured, like A and B. Is that the part you're talking about?
[AGENT][NEUTRAL] Um, section C. So you will fill out the section A, section B, and then section C.
[AGENT][NEUTRAL] You are going to go through and you are going to check in those boxes what he had done and the date of service.
[CUSTOMER][NEUTRAL] OK, but that's where I have a problem because he had probably 10 PC PSAs. He probably had 5 MRIs. So you see how there's just one box for data of service. So that's what I'm asking you, do I have to do like a separate one for every MRI for every, cause I don't have room in that little box to put all those dates.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yes, I see.
[AGENT][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] You think you could go ask somebody for me, like somebody else and find out?
[AGENT][NEUTRAL] Yes, yes, because you'd only be able to put one date of service.
[AGENT][NEUTRAL] And the one, OK, let me go ask, let me put you on a brief hold, OK?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so just tell them that I have 18 months of paperwork, 18 months of treatments, and that I have a lot of tests. I have a lot of stuff, and I was just wondering, you know, do I have to fill in a separate thing for every procedure?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, I'm sorry, but I really need this answered.
[AGENT][POSITIVE] No, no, you're OK. I wanna provide you with the correct answer, OK? So I'll be right back, OK?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Hey [PII], thank you for holding.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I'm going to have to physically talk to one of my colleagues about this, so um I can better explain what's going on. Um, can I please give you a call back? I'll call you back within 30 minutes, OK?
[CUSTOMER][NEUTRAL] Oh, that was
[CUSTOMER][NEUTRAL] That's, that's perfectly fine because so let's check my number [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]. Do you have that?
[AGENT][NEUTRAL] OK. The first one you gave me was
[CUSTOMER][NEUTRAL] Oh [PII], no, no, no, no, no, no, no, no, no, [PII], is that what you have?
[AGENT][NEUTRAL] Um, I have [PII]. It's [PII].
[CUSTOMER][NEUTRAL] No, it's [PII].
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][POSITIVE] That's it. That's right. All right, great, great, great. Yeah, I would appreciate that.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] OK, yes. I
[CUSTOMER][NEUTRAL] OK, so you understand what you, you understand where I am, right? Like I have this open case and I just never submitted anything and now I'm like trying to go through this, but I'm just trying to figure out, do I have to do a separate form for every procedure.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, and there's a lot of procedures.
[CUSTOMER][NEUTRAL] And if, and if they and if they tell you that we have to do a separate form for every procedure, could you ask them if I could do like 2 or 3 procedures on one form if it happened in the same day?
[AGENT][POSITIVE] OK. Yes, I will.
[CUSTOMER][POSITIVE] OK. All right, great. Thank you so much. I appreciate it. All right. Bye-bye.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Of course, yes. OK, bye.
[CUSTOMER][NEUTRAL] Yeah.