AccountId: 011433970860
ContactId: dfeae534-473d-4bb3-b1f2-8f3fbc580bc9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 964960 ms
Total Talk Time (AGENT): 473590 ms
Total Talk Time (CUSTOMER): 272500 ms
Interruptions: 3
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/dfeae534-473d-4bb3-b1f2-8f3fbc580bc9_20250313T17:37_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] calling with a question. How are you doing today?
[AGENT][POSITIVE] I'm good, Ms. [PII]. How are you doing today?
[CUSTOMER][POSITIVE] Good good thank you so very much for asking.
[AGENT][POSITIVE] Oh, well, how can I, yes, ma'am. Well, how can I help you today?
[CUSTOMER][NEUTRAL] OK, I have a policy with you all for um from an old job that I have and I still have it and I wanna keep it but I just wanted to ask a question about getting the form for the wellness visit to send in those that document.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] OK, so you're wanting to find out how to file a wellness claim on the policy?
[CUSTOMER][NEUTRAL] Yes, and then I probably need to get a copy of it as well and can you tell me what I have because I don't know.
[AGENT][NEUTRAL] Yes, ma'am, I'll be able to answer those questions for you, Ms. [PII]. You wanna know what you mean, what type of policy it is you have with APL?
[CUSTOMER][POSITIVE] Yes, I would.
[AGENT][POSITIVE] Yes ma'am. OK, yes ma'am, I can help you with both of those things. And so first off, what is a good call back number for you?
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And your policy number, please?
[CUSTOMER][NEUTRAL] Now I don't know that, so that's why I need to.
[AGENT][NEUTRAL] OK. What is your social and I can try and look it up that way.
[CUSTOMER][NEUTRAL] OK, it's [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you. So give me a moment to see if I can locate it with that.
[CUSTOMER][NEUTRAL] OK, and it's [PII], not [PII].
[AGENT][POSITIVE] Oh, I, my apologies. I'm sorry, Ms. [PII]. I'm so sorry.
[CUSTOMER][NEUTRAL] That's OK, that's OK.
[AGENT][POSITIVE] Yes, I am so sorry. I try to get names. I try to get names right.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] That's OK, that's OK.
[AGENT][NEUTRAL] OK, so first off, Ms. [PII], any information that I do provide for you would be a verification of benefits and not a guarantee of payment, and I will need to verify several things for security. So first off, if you could please verify your date of birth.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And your home mailing address, please?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you. Also your uh phone number that we have, we actually have two, well, the one of the phone numbers that we have on file is the same as the one that you gave me and we do also have another phone number. I don't know if maybe this is a landline possibly.
[CUSTOMER][NEUTRAL] Yes it is, it is [PII].
[AGENT][NEUTRAL] And what is that number? Uh-huh.
[AGENT][NEUTRAL] OK, thank you. And lastly your email address, please.
[CUSTOMER][NEUTRAL] First and last name [PII].
[AGENT][NEUTRAL] OK, give me one moment because I'm having trouble with one of my screens, so bear with me just one second, please.
[CUSTOMER][NEUTRAL] OK, OK, I will.
[AGENT][NEUTRAL] OK, and you said it was your first name, last name?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then [PII]?
[CUSTOMER][NEUTRAL] Uh-huh, [PII]. You're welcome.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, thank you. So Ms. [PII], have you ever set up your profile in our portal called the online service center?
[CUSTOMER][NEUTRAL] No, I have not.
[AGENT][NEUTRAL] OK, so.
[AGENT][NEUTRAL] This is a place where you can actually have access to your policy information. There's copies of your policy in the portal, you can also upload your wellness claim into the portal directly and I can email you the user guide for how to set up your profile and then it also gives, oh, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, can you
[CUSTOMER][POSITIVE] OK, no, I was just gonna say yeah that sounds good.
[AGENT][POSITIVE] Because that you can just complete the form online, the wellness claim form. You didn't, you don't have to submit other documentation any longer for wellness claims. Mhm, mhm. Yes, ma'am, not like in the past because you've had this policy quite a while with us and thank you for your business since [PII].
[CUSTOMER][NEUTRAL] Oh really?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][POSITIVE] But yes ma'am, it's a much simpler streamlined process for filing wellness claims now and again the user guide that I'm gonna send you will explain how to do that but if you have any questions or need any assistance you can.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] You can call us back and you'll also be able to see your policy number in there. Now your cancer policy number is 704.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, 704.
[AGENT][NEUTRAL] 775.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, and give me one second to do your email for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so I have just sent that to you and that email that you're gonna receive from me, Ms. [PII] will come from care team at [PII], and I did put APL online service center portal in the subject line for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So that's easy to recognize. And
[CUSTOMER][NEUTRAL] I see it and I won't be I won't be able to do it until later on this evening, but.
[AGENT][NEUTRAL] OK, so you have that policy of your cancer policy and you also have an intensive care.
[AGENT][NEUTRAL] Uh, critical illness policy with us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And you'll see that policy number in your portal as well, but if you want to take it down, it's almost identical to the one I just gave you, except instead of ending in a 5, it ends in the number 4.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, 704-774 OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK, now what, what is the significance of the one ending in 5?
[AGENT][NEUTRAL] That's a cancer policy.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That's, that's your cancer policy.
[CUSTOMER][NEUTRAL] So I mean what is, can you explain it to me cause I, I, I don't know, I was a little younger, I'm still old but I, I don't, I don't quite know what it is.
[AGENT][NEUTRAL] OK, so give me just a moment to get your policy information pulled up.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this policy would help you if you were, excuse me, positively diagnosed.
[AGENT][NEUTRAL] With, with cancer?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, and again, you have a, it's several pages of benefits on this plan. But this policy has benefits for hospital confinement, for medication, surgery.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, outpatient or inpatient?
[AGENT][NEUTRAL] It has anesthesia benefits. Uh, let's see. Um, transportation, if that were to be, you know, applicable, you know, in your circumstances for treatment, you have a radiation and chemotherapy benefit that's $10,000 per 12-month period.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] On this.
[CUSTOMER][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] Um, so yes, ma'am. I mean, do you have specific questions? Cause like I said, you, it's pages and pages of benefits. If there was
[CUSTOMER][NEUTRAL] OK, when, when I, well, that kind of answers answers it in a nutshell and then um I appreciate you explaining that to me uh and the the intensive care, what does that entail if I was to go into the intensive care they would cover something with that policy.
[AGENT][POSITIVE] Oh yes, ma'am, you're welcome.
[AGENT][NEUTRAL] And let me pull that, let me pull that policy information up because I have to look at them independently they're not under the same place, so just a moment, mhm.
[CUSTOMER][NEUTRAL] Mhm, yeah.
[CUSTOMER][NEUTRAL] Different.
[CUSTOMER][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] When you submit your taxes.
[CUSTOMER][NEUTRAL] They need a W-2 for kids in motion.
[AGENT][NEUTRAL] So this is an intensive care and coronary care policy. So on here you have uh benefits for an inpatient admission.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It would pay, it shows the benefit is $325.
[AGENT][NEUTRAL] A day for 1 to 30 days.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Let's see what else you have on this policy.
[CUSTOMER][NEUTRAL] Are you trying to
[AGENT][POSITIVE] And thank you for your patience because this one I have to look at it a little bit different.
[CUSTOMER][POSITIVE] No problem no problem I appreciate you looking at it for me.
[AGENT][NEUTRAL] OK, so you're welcome. So um
[AGENT][NEUTRAL] This one, for example, 5 or 650 for the daily benefit for confinement up to 30 days, that's what I just gave you and sickness for up to 45 days.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If it's an intensive care due to different named accidents that specified in the policy, you know, and then the benefit amount.
[AGENT][NEUTRAL] The double it would double the daily benefit amount when it's combined due to a named accident. There are benefits to for, you know, ambulance services and then.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All of these benefits, they would reduce by 50% at the age of [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You said they were reduced by the age of [PII]?
[AGENT][NEUTRAL] Uh, yes, ma'am. Once you turn [PII], all benefits would be reduced by 50%.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] On this policy.
[CUSTOMER][NEUTRAL] That's for both on that one, OK.
[AGENT][NEUTRAL] On this one, yes, ma'am. Uh-huh.
[CUSTOMER][POSITIVE] OK, I got you I got you.
[CUSTOMER][NEUTRAL] OK, well, let me ask you about the, uh, wellness, and I read it, you know, to once you come you're answering it in a nutshell for me and I do appreciate that again, um, but my uh question is what is the wellness benefit amount and um how long, how far can you go back?
[AGENT][NEUTRAL] There's no timely filing, so we don't have a limit on how far you can go back on that. Um.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me pull that policy back up.
[CUSTOMER][POSITIVE] OK, I'm sorry, I'm sorry.
[AGENT][NEUTRAL] Uh, that's OK.
[CUSTOMER][NEUTRAL] I got you going from back backwards and forwards.
[CUSTOMER][NEUTRAL] And the amount of the wellness too I need to know that too.
[AGENT][NEUTRAL] It's still trying to load your information, Ms. [PII], one moment.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] OK, so on this policy, your screening benefit is 45.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] $5
[CUSTOMER][NEUTRAL] How much?
[AGENT][NEUTRAL] Well, let me just look at one more thing. Uh, give me one second to look at one thing. I'm sorry.
[CUSTOMER][POSITIVE] OK, no problem.
[AGENT][NEUTRAL] OK, so your screening benefit is $45.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm. And it's one test per calend[PII] year.
[CUSTOMER][NEUTRAL] So now with you're not having to submit any documentation, what, what, what do you have to do you fill the form out or state where you win or something like that?
[AGENT][NEUTRAL] Yes, ma'am. There's certain questions on the, on the form.
[AGENT][NEUTRAL] For as far as the, what the test was, the provider's information, and then you will, you know, sign it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And submit that. You have to put the date of your service and what you had. Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK, OK, how was, so when was the last time that I did it?
[AGENT][NEGATIVE] Oh, I'm sorry, I couldn't hear you. Ms. [PII], your voice is not audible for me.
[CUSTOMER][NEUTRAL] Can you do that
[CUSTOMER][NEUTRAL] OK, when was the last time that I filed a wellness claim?
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Uh, for [PII], it appears it was [PII].
[CUSTOMER][POSITIVE] Oh wow.
[AGENT][NEUTRAL] For a mammogram.
[CUSTOMER][NEUTRAL] So can I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, so I can do 20 to 25?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, alright, well I.
[AGENT][POSITIVE] Yes, I'm OK.
[CUSTOMER][NEUTRAL] Alright, and you just I'll try to go in there and do that, um, set that up and then look at it when I, um, get home.
[AGENT][NEUTRAL] Mhm. And then you would just do one for each year that you've had your.
[AGENT][NEUTRAL] Your test.
[CUSTOMER][POSITIVE] OK, alright, well that sounds like a good plan and I, um, thank you so very much for helping me and talking with me today.
[AGENT][POSITIVE] Oh, well, you are certainly very welcome. It was my pleasure. And is there anything else that I could help you with?
[CUSTOMER][NEUTRAL] That's it at this time.
[AGENT][POSITIVE] OK, Ms. [PII]. Well, thank you again for calling APL and I hope you have a wonderful rest of your day.
[CUSTOMER][POSITIVE] You're welcome thank you and you do the same, OK?
[AGENT][POSITIVE] Yes, ma'am. Thank you too.
[CUSTOMER][POSITIVE] You're welcome bye bye bye bye.
[AGENT][NEUTRAL] Papa.