AccountId: 011433970860
ContactId: dd5acddd-0ca0-421e-a1bf-38e88e68eff0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 468940 ms
Total Talk Time (AGENT): 286131 ms
Total Talk Time (CUSTOMER): 167472 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/dd5acddd-0ca0-421e-a1bf-38e88e68eff0_20250218T17:02_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. You're speaking with [PII]. How may I help you today?
[CUSTOMER][NEUTRAL] Hi um I am trying to figure out how I can um put some claims in. I thought my insurance was noted um to my provider and I just recently found out that it wasn't so I was wondering if there's a way that I could go back and claim.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Make some claims.
[AGENT][NEUTRAL] OK, let me see, can I help you? What's your, what's your name?
[CUSTOMER][NEUTRAL] Now that
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, [PII], what's your phone number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] And [PII], do you have your policy number?
[CUSTOMER][NEUTRAL] I do.
[AGENT][POSITIVE] OK, I'm ready.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] Hold on, let me get to it. Um, is that the same as the policy certificate number?
[AGENT][NEUTRAL] Yes, ma'am. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, 02.
[CUSTOMER][NEUTRAL] 52
[CUSTOMER][NEUTRAL] 3686.
[AGENT][POSITIVE] All right, thank you for that.
[AGENT][NEUTRAL] And [PII], uh, what is your mailing address and date of birth?
[CUSTOMER][NEUTRAL] Um, mailing address is [PII].
[CUSTOMER][NEUTRAL] 4, sorry, I went blank for a second. Um date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what about your email address on file, [PII]?
[CUSTOMER][NEUTRAL] Uh, I believe it is the [PII].
[AGENT][NEUTRAL] Yes, ma'am. Thank you for that information. And you're saying that you're trying to call because you want to file some kind of claims. Have you been diagnosed with cancer or what kind of claims you're trying to file?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Um, it's cancer, and I was diagnosed last year and everything went pretty smoothly and I thought my insurance was still being noted, um, and so I'm, I've had a reoccurrence and um starting in [PII], um, and I noticed that none of my um.
[CUSTOMER][NEUTRAL] Claims are going through even to be reviewed and so then that's kind of when I caught the mistake that.
[CUSTOMER][NEGATIVE] My provider was not.
[CUSTOMER][NEUTRAL] Letting y'all know about it, does that make sense?
[AGENT][NEUTRAL] OK, uh-huh, [PII]. When was she diagnosed with cancer?
[CUSTOMER][NEUTRAL] The first time or reoccurrence?
[AGENT][NEUTRAL] The first time because we don't need that first termA report because I do see on your previous policy that that you had starting [PII] all the way up [PII] you uh had been uh uh your provider was filing uh let me see that we don't look like we never, well we did pay something, yep, because we paid the first occurrence you was diagnosed back on [PII], is that correct?
[CUSTOMER][NEUTRAL] The first time
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, that's my first, yeah, and then I have been.
[AGENT][NEUTRAL] Uh, that's
[CUSTOMER][NEUTRAL] I've been diagnosed with the reoccurrence of um in that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm not sure exactly what the date is. I believe it's [PII] is my reoccurrence.
[AGENT][NEUTRAL] OK. OK, [PII]. OK, so what's the 1st, 1st thing you're gonna have to do is, so the, the one in [PII] is related to the one in [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I mean, yeah, OK, so you're gonna send a new path that path where they, where it reoccurred, you need to send in that pathology report.
[AGENT][NEUTRAL] Once in that.
[CUSTOMER][NEUTRAL] OK, and how do I do that?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Would you, you're gonna have to get your pathology report from your provider.
[CUSTOMER][NEUTRAL] How do I do that?
[CUSTOMER][NEUTRAL] OK, and then I just like email it to y'all or what?
[AGENT][NEUTRAL] No, ma'am. You either mail, fax, or upload your claims to our office. We do have a website where you can get set up on and you can upload your claims to our website.
[CUSTOMER][NEUTRAL] OK, that's, I think I have um my password and everything to that. I do that in there?
[AGENT][NEUTRAL] when you go on the site, you just follow the direction. It'll tell you how to upload claims. You need to first get a claim form, a cancel claim form, complete the cancel claim form, attach your path report, your updated pathology report, and attach any itemized bills, surgery bills, chemo, radiation, any kind of itemized bills that you, that you want us to review, we need to itemize bills in order to process the benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and I can just upload all that today.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yes ma'am, once you get all the information you can upload it. You can send it in for review if we need any additional information, we will let you know what was missing or what was needed in order to process any benefits on your policy.
[CUSTOMER][POSITIVE] OK, that sounds good.
[AGENT][NEUTRAL] OK. And let me look at something I wanna, yeah, let me see. You did have.
[AGENT][NEUTRAL] Uh, I was trying to see that you have awareness, uh, on, on your policy and see, have you ever filed like a mammogram, [PII] colonoscopy on your policy before. But let me look at your policy and make sure she do would have that, OK?
[AGENT][NEUTRAL] Cause you can, you can file a wellness if you got it. And I'll go over that with you as soon as we see, do you have that on your card.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh yeah, I had a well mammogram last year.
[AGENT][NEUTRAL] Uh-huh. Yeah, and so you can see that in, and it's a wellness claim form out there that is, it's different from the cancer claim form. It's gonna be a wellness claim form. It's simple to do, you just complete the claim form, sign and date and put your doctor name on there or the facility you had your wellness done at, and that's all you have to do. And so it's easy to do, but let me look on your policy to make sure you do have awareness on here and I'm trying to bring it up.
[AGENT][NEUTRAL] OK, let's see in your policy.
[AGENT][POSITIVE] And while you're out there, you can do that, you know, you can get that taken care of too.
[AGENT][NEUTRAL] OK, go down to your billing.
[CUSTOMER][NEUTRAL] Uh, I, I see um, OK, never mind, sorry.
[AGENT][NEUTRAL] Go ahead, you can go ahead, go ahead and tell me what you think. Go ahead.
[CUSTOMER][NEUTRAL] No, I, I just see, um, I'm in my account online and see where you can, it says file a wellness claim so I see that in there.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, yeah, you got that in there, uh, yeah, and you do have awareness, so you just do the wellness claim. And let me see on your previous policy that you have awareness on that because I didn't see where you had filed a awareness on that and you can go back and file for a wellness like you had over the years it's one wellness per calendar year, so it's one wellness per calendar year. So let me bring, let me bring up that policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] And I'm sure it is on there because usually stick to the thing and I don't see, I don't see nowhere that you found a awareness on this old policy that we have.
[CUSTOMER][NEUTRAL] No, I never have.
[AGENT][NEUTRAL] OK, well, you can go back and, uh, file your wellness. Like I say, all you do is fill out those, those wellness claim forms and uh go from there. Uh-huh. OK. All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, I really appreciate your help thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling American Public Life. There's nothing else I can help you with today?
[CUSTOMER][NEUTRAL] No, I don't think so. You've been very helpful thank you.
[AGENT][POSITIVE] Oh, you have a great day and thank you for calling American Public Life. Bye-bye.
[CUSTOMER][POSITIVE] You too. Thanks.