AccountId: 011433970860
ContactId: dfcd703c-26ac-44a6-936d-2badc8f2dbce
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 649440 ms
Total Talk Time (AGENT): 264413 ms
Total Talk Time (CUSTOMER): 325640 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/07/dfcd703c-26ac-44a6-936d-2badc8f2dbce_20250507T20:31_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yes ma'am, my name is [PII] and I have a cancer policy with y'all through Brenna MSD, um, and I, my husband, um, had, um.
[CUSTOMER][NEUTRAL] Bladder or not bladder kidney cancer and they removed his one kidney um about 3 years ago and it has um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Now they found it in his lungs.
[CUSTOMER][NEUTRAL] And I was um logged in and I was about to uh file a claim I guess it just logged me out so um does it have to be the because the doctor that we're seeing for the immunotherapy and the cancer drugs for the treatment is with one Kelsey Sebo clinic.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Through their cancer center and then he's also gonna see a doctor at [PII] [PII].
[CUSTOMER][NEUTRAL] And he's did the biopsy at Memorial Herman Hospital, so do I have to do one claim for each?
[CUSTOMER][NEUTRAL] Um, doctor, each facility.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Because it asked for it there was a drop down menu that said what it was and I know there was a biopsy.
[CUSTOMER][NEUTRAL] Um, on there, but it was and there was a the CT scan, that kind of thing.
[AGENT][NEUTRAL] No, you can, um,
[AGENT][NEUTRAL] Well, there's two things. So you can put them all together if you'd like. Um, it's just asking you to specify what's what, but when you upload your documents, you can upload them all together, like you don't have to do separate claims for each.
[AGENT][NEUTRAL] You know, thing that he
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and you just need the EOBs?
[AGENT][NEUTRAL] Unless you want to, but no, you don't have to.
[AGENT][NEUTRAL] Um, yes, ma'am, the explanation of benefits, the itemized bill, and um if you're trying to prove like a positive diagnosis or anything, the pathology report.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So, um,
[CUSTOMER][NEUTRAL] If he's already being treated for the um.
[CUSTOMER][NEUTRAL] Kidney cancer, do we the the pathology report from the biopsy needs to be included?
[CUSTOMER][NEUTRAL] Is that correct?
[AGENT][NEUTRAL] Um, yes, if you are trying to prove the positive diagnosis, um, do you have your policy number? I can take a look at the policy. I can maybe help a little more specifically.
[CUSTOMER][NEUTRAL] Um, let me, let me log back in and then uh.
[AGENT][POSITIVE] Sure, take your time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My policy number is.
[CUSTOMER][NEUTRAL] 252-418-2
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] All [PII]. And I have you here, I just need to verify your date of birth and your mailing address on file.
[CUSTOMER][NEUTRAL] My date of birth is [PII] and my mailing address is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. Um, so yes, you do have the option to file it on your own, or if you'd like to give the policy number and our number to the provider and just let them know you have an additional cancer policy, they can bill um on your behalf so you don't have to, but it's up to you.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] And so I could do that even for past.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Past visits.
[AGENT][NEUTRAL] Well, yes, because you, well, now that depends on how far back they're willing to go, but yes.
[CUSTOMER][NEUTRAL] It it's [PII] [PII] was the first visit for the um the um.
[CUSTOMER][NEUTRAL] Uh, immunotherapy with Keytruda.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Oh, yes, that was just last month. Yes, let them know that you have this cancer policy and give them um the policy number and then our phone number because we don't have cards for the cancer policy, and they'll most likely call us to verify the benefits and get all the information to have, you know, on how to file a claim and then they would just file. Um, but I mean, that's up to you. I just want you to know you have another option because sometimes it gets to be a lot with all the paperwork and stuff.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes ma'am it is and I, I honestly just thought about it today. I was like, you know, I have that cancer policy I really ought to.
[CUSTOMER][NEUTRAL] Um, you know, do something about with that and yeah, so I just wasn't sure how to go about it and I tried doing that file a wellness claim.
[AGENT][NEUTRAL] Look into it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And that's where all the drop downs and stuff were coming up and I was like well I don't know if I'm in the right place.
[AGENT][NEUTRAL] So for your wellness, wellness is like um that'd be like a mammogram or a Pap smear or I don't know what test to say for guys.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Well that that's what I thought that's what kind of threw me off so and and that's that's covered even if it's just a regular every year I get a mammogram.
[AGENT][NEUTRAL] Mhm. So because on your, so there's a, there's a claim form for the wellness, I guess options where you can like select the different tests, but on your cancer policy, you also have like a cancer screening diagnostic benefit. So,
[AGENT][POSITIVE] You, your cancer policy kind of gives, gives you that extra benefit. So if you wanted to use that one for your mammogram, you know, you could, or
[CUSTOMER][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] If you had another policy with us that has well and it's just, I don't know if you just want to throw that out there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Um, and it, it would be option number 2 for the phone number correct?
[AGENT][NEUTRAL] Option number 2 for the phone number?
[CUSTOMER][NEUTRAL] [PII] and I think it said option 2.
[AGENT][NEUTRAL] For customers for the care team?
[CUSTOMER][NEUTRAL] Yeah um, yes, for the, the doctor's office if I give him this number and the policy number.
[AGENT][NEUTRAL] Oh, it all comes to the, OK, yes, so yes, it's option 2.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then have you all ever, so on your policy, you have the first occurrence benefit. I don't know if you knew about that either, um, because I looked to see.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Um, if, if we have filed any claims under this one, but you had the previous policies, but if he hasn't used that, you do still have that as well.
[CUSTOMER][NEUTRAL] It's, it's
[CUSTOMER][NEUTRAL] Well it we couldn't file on the first diagnosis because they didn't do any chemo or anything they just took the kidney out.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And got, you know, clear margins, everything was good so we I think I've tried to do that but um but it didn't uh it wasn't an option because they didn't have to do chemo or anything like that.
[AGENT][NEGATIVE] I couldn't use it.
[AGENT][NEUTRAL] So for this one, he's doing immunotherapy?
[CUSTOMER][NEUTRAL] But now we're, you know, it's.
[CUSTOMER][NEUTRAL] Immunotherapy and a chemotherapy drug because it's um it's in, they found 4 spots in his lungs.
[AGENT][NEUTRAL] Long, OK. So then you might wanna, um, so the reason I ask is because when filing a claim, I usually tell the patients like for that first occurrence benefit, you go ahead and file that one because that 2500 is coming to you, but like for every treatment and everything else, I would let the doctors file that.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] But that's up to you.
[CUSTOMER][NEUTRAL] OK, OK, yeah, the, the first one though when they found the cancer the first time they told me that I couldn't do anything so this has just been an ongoing thing where my husband's got the CT scan, um, and we were just at the point of having the one year mark and, and then they found the spots and then um then it was um.
[CUSTOMER][NEUTRAL] More often to watch them and then they did the biopsy and they did say that it was the renal cancer in his lungs.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Well, I mean,
[CUSTOMER][NEUTRAL] So I, I should just.
[AGENT][NEUTRAL] I think you should, if, if it's up to you. I think you should, the worst that, you know, the most we can they can say is no, but I mean, if you can benefit from it, definitely try.
[CUSTOMER][NEUTRAL] Because it's all
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So I just have to get the get the information from the the because they are all in the same luckily enough they're all in the same um Kelsey C bowl.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, clinic, they're all, you know, they're all over the place but they were the same doc, same clinic, yes network that's the word I'm thinking, um, and, um, and I just.
[AGENT][NEUTRAL] Like a network.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It just dawned on me I should probably do this so I should tell them it's APO life insurance, but it's the cancer policy.
[AGENT][NEUTRAL] Mm.
[AGENT][NEGATIVE] No, no, no. So American, American Public Life or APL is the company's name, but this isn't anything with your policy isn't anything with life, it's a cancer policy.
[CUSTOMER][NEUTRAL] No, what is it?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So American public
[AGENT][NEUTRAL] Yeah, I would just say I have a, I have this cancer policy with, I have an additional cancer policy with ATL. Here's the policy number, here's a phone number in case you want to call to verify benefits and just let them take it.
[CUSTOMER][NEUTRAL] Is the name.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK all right well thank you very much for your help I really appreciate it.
[AGENT][POSITIVE] You're very welcome. Well, was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Um, not at this time.
[AGENT][POSITIVE] Alrighty. Well, thank you so much for calling APL. I hope you have a good day, [PII].
[CUSTOMER][POSITIVE] Thank you you as well. Bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.