AccountId: 011433970860
ContactId: e3ce09c4-7ae9-4ec2-8b78-3f1e8fbd21f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 190240 ms
Total Talk Time (AGENT): 78944 ms
Total Talk Time (CUSTOMER): 106380 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/e3ce09c4-7ae9-4ec2-8b78-3f1e8fbd21f4_20250505T18:18_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you today?
[AGENT][POSITIVE] Doing well [PII] thank you how are you?
[CUSTOMER][NEUTRAL] It's all right, thank you. I just had a question for you and it sounds silly, but I just wanted confirmation. Um, so this guy's got a cancer policy and he's had, I guess, multiple biopsies, uh, on his prostate, and he was asking, we got the initial pathology report, he got his lump sum benefit, but as he continues getting um.
[CUSTOMER][NEUTRAL] Biopsy done. His question was, does he need to keep sending like a pathology report, like proving that it is indeed for the same cancer? Cause I guess his initial was from about 4 years ago and he was still getting surgeries um to, you know, just last week.
[AGENT][NEUTRAL] OK, let me um have his policy number here.
[CUSTOMER][NEUTRAL] Sure, yeah, that's 1,386,480.
[AGENT][NEUTRAL] And this is for [PII].
[CUSTOMER][NEUTRAL] Yes, and I'm not showing uh any instances where that might have been an issue.
[CUSTOMER][NEUTRAL] So I don't know if he's just wanting to verify that or not but.
[CUSTOMER][NEUTRAL] I wouldn't think so, but I thought I would ask just because I wanna make sure.
[AGENT][NEUTRAL] No, he's
[AGENT][NEUTRAL] Yeah, he
[AGENT][NEUTRAL] As long as we, now he's saying like for other benefits other than the biopsy or?
[CUSTOMER][NEUTRAL] He specifically stated the biopsy itself. Um, you know, as, you know, he's aware that, uh, we don't pay for surgeries if it's not, uh, due to a positive diagnosis of cancer. So he didn't know if he had to continue sending that as the original pathology report was again from about 4 years ago.
[AGENT][NEUTRAL] What
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] OK, so he doesn't have an updated pathology report. He's just referring to the one he had from 4 years ago, right?
[CUSTOMER][NEUTRAL] I don't believe so. Correct. And that's what he's wondering if, if he needs to continue, if he would need to continue uh sending an updated pathology report with every biopsy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't believe so. Um, I, I would think that that, as long as it's that same diagnosis, so he would need to send in that itemized bill that, you know, that of course includes procedure and diagnosis codes. So if that diagnosis code, as long as its corresponds with what that pathology we have on file, I don't believe he would need to send any uh additional, um, but it, it also, yeah.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] That was my thought process as well.
[AGENT][NEUTRAL] It can't hurt, um, to, uh, of course, that way he can just be certain that it, that his claim doesn't get delayed for any reason. Um, but I don't believe that that's that, you know, necessary. It's like I said, as long as we have that diagnosis that corresponds with that pathology that we have on file.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] That tells us what we need to know. Got it. OK. I just wanted to make sure. I really appreciate your help, [PII]. Thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You're welcome here any time.
[CUSTOMER][NEUTRAL] All right, bye bye.
[AGENT][POSITIVE] Have a great day. Thank you. Bye bye.
[CUSTOMER][NEUTRAL] You too.