AccountId: 011433970860
ContactId: e66d0499-fcfa-4ca4-a0f2-26168bce387b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 382359 ms
Total Talk Time (AGENT): 153875 ms
Total Talk Time (CUSTOMER): 211115 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/30/e66d0499-fcfa-4ca4-a0f2-26168bce387b_20241230T19:08_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII].
[CUSTOMER][NEUTRAL] Um, I have a cancer policy with you, and I was just needing to ask a couple of questions about, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Inform uh what uh information on the file, let's put it that way.
[AGENT][NEUTRAL] Alright, I can assist you with the benefits on your cancer policy. Can I have a callback number?
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] It is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] May I have your policy number, please?
[CUSTOMER][NEUTRAL] Um, yes ma'am, it is um 25.
[CUSTOMER][NEUTRAL] 33036
[AGENT][NEUTRAL] Alright, one moment please while I pull up your policy. While I'm doing that, could you verify your date of birth, your address and email address please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh date of birth is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And address is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And my email is [PII].
[AGENT][NEUTRAL] All right, and this will be your work email address that we have.
[CUSTOMER][NEUTRAL] Uh [PII]. That's my work email.
[AGENT][NEUTRAL] [PII], thank you so much for verifying that information. Um, while I pull up your policy, this is a verification of your coverage and not a guarantee for payment. You have some questions on what to file for your cancer policy.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Is that what you're asking? What?
[CUSTOMER][NEUTRAL] Yeah, I, um, I had breast cancer. Uh, I, I had, um, last year I was diagnosed with breast cancer. And I take, and now I take a, um,
[CUSTOMER][NEUTRAL] I'm gonna say it wrong, but it's a, and a something, it's a medicine that I, I have to take. It's a hormone blocker that I had to take. Um, and I, my oncologist switched my hormone blocker switched that medication, um, on me last year, or at the end of last year, and I started, um, my period. I have not had a period in over a year cause I'm not supposed to on that medicine. Anyways, to make a long story short, I went to my OBGYN.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, of course, he did a Pap smear, which I looked in to see if a Pap smear was covered. Um, but he did a Pap smear, he did an ultrasound, a vaginal ultrasound. They attempted to do a biopsy and endometrial biopsy in the office. They were unable to do that. Um, so he scheduled me to go in to have a, I'm gonna say it wrong, a hysterectomy.
[CUSTOMER][NEUTRAL] His hysterectomy with um biopsy, not a hysterectomy, it's just a hysterectomy where they go in with the camera and look and clean, uh it was a hysterectomy D and C with biopsy. And um my, my iron, I mean my um
[AGENT][NEUTRAL] Hysterectomy. mhm. mhm.
[AGENT][NEUTRAL] OK, OK, OK.
[CUSTOMER][NEUTRAL] Blood count was so low that I was extremely anemic, so I had to go to the emergency room and have a blood transfusion. And then I had to go in for the surgery to have this done. And so they did biopsies with, you know, uh, you know, they did biopsies while I was there, removed polyps. I just needed to know if any of that because it was, you know, um, due to the change in my, my medication for the cancer, if any of that was covered under this policy.
[CUSTOMER][NEUTRAL] That kind of makes sense. I mean, I know that was a lot of information. I just threw at you. I'm sorry. I just, I, I was trying to see.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] So, the only
[AGENT][NEUTRAL] If
[AGENT][NEUTRAL] If the only thing that it will only cover if it's due to your cancer. So if you had to have
[AGENT][NEUTRAL] Surgery due to the cancer, not because of the medicine, but due to the can.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I guess it just depends on, and you will have to submit documents stating that.
[CUSTOMER][NEUTRAL] Are you there?
[AGENT][NEUTRAL] It was due to the cancer. Can you hear me?
[CUSTOMER][NEUTRAL] Yeah, I, I, I, I lost you there for a second. I think I hit, I hit the whole button. Um, my fat sheet hit the whole button on my phone.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] What I was stating was.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] Um, you would have to submit documents stating.
[AGENT][NEUTRAL] That it was due and we will have to send that off to be reviewed because like the surgery is only covered if you're having surgery because of the cancer.
[AGENT][NEUTRAL] Um, and because it's.
[CUSTOMER][NEUTRAL] So not necessarily because of the medicine that I take for the cancer.
[AGENT][POSITIVE] Exactly, exactly.
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] And and that's why I was calling to ask because I wasn't sure if.
[CUSTOMER][NEUTRAL] You know, it was all due to the medicine that I take for the breast cancer, but it, you know, I mean, it's not directly to the breast, if that makes sense.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, it, yeah, so, um, that would.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, I mean, you could submit it and but you would definitely have to submit supporting documents along with it um stating that, you know.
[AGENT][NEUTRAL] You have to have this because of your breast cancer and it has to be reviewed by a physician.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So, yeah, that's that on the surgery part.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But of course, you know, the hormone drug is covered under your policy.
[CUSTOMER][NEUTRAL] Yeah, I need to. I usually do those 3 months at a time.
[AGENT][NEUTRAL] And the Pap smear.
[AGENT][NEUTRAL] And the Pap smear is covered as, you know, you only get wellness once a year, so that's covered under the diagnostic.
[CUSTOMER][NEUTRAL] Um, what about the, um, vaginal ultrasound?
[AGENT][NEUTRAL] That's diagnostic, that's diagnostic as well, so that's the wellness, that's covered under wellness. You only get like 111 a year.
[CUSTOMER][NEUTRAL] Are those usually covered?
[CUSTOMER][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] One a year, right, right.
[AGENT][NEUTRAL] Mhm, mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right, [PII], is there anything else I can verify for you on your policy?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, no, I think that's it. I just wanted to kinda check to see if.
[AGENT][NEUTRAL] OK. All right.
[CUSTOMER][POSITIVE] Alright well thank you for your help.
[AGENT][POSITIVE] You're welcome. Thank you for calling APL. Have a great day. Bye bye.
[CUSTOMER][POSITIVE] You too. Thank you.