AccountId: 011433970860
ContactId: e8b85581-45c7-4107-8665-09d7f48d2aad
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1301300 ms
Total Talk Time (AGENT): 586217 ms
Total Talk Time (CUSTOMER): 522798 ms
Interruptions: 9
Overall Sentiment: AGENT=1, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/14/e8b85581-45c7-4107-8665-09d7f48d2aad_20250114T17:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII], and I'm calling in regards to my husband. I had called last year when he was diagnosed with uh lymphoma cancer and I've just been waiting, you know, to get everything I need to get. How do I file a claim because I'm ready to go ahead and do that I guess he's, he's finished.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, miss
[AGENT][NEUTRAL] Yes, go ahead.
[CUSTOMER][NEUTRAL] I'm sorry, he's finished with the, OK, he's finished with the chemo treatments now he still has the poor and we still have to go back, you know, for labs and some, uh, I think [PII] he's gotta go get another, uh, scan and so forth, but I just thought, well, I might as well file.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] I don't know how how this all works for sure.
[AGENT][NEUTRAL] Yes, ma'am. I understand and I can help you filing a claim. Um, can I please get your callback number, Ms. [PII], just in case our call is disconnected?
[CUSTOMER][POSITIVE] Oh good.
[CUSTOMER][NEUTRAL] Sure it's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And then what is the policy number, please?
[CUSTOMER][NEUTRAL] And, um, I knew you were gonna ask me that.
[CUSTOMER][NEUTRAL] Let me
[CUSTOMER][NEUTRAL] I said I, I don't actually have it it all together, OK? I just decided to sit down and call. Let me see if it's in here real quick. Hang on a second. I got, I tell you what.
[AGENT][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] I know I have it in here.
[CUSTOMER][NEUTRAL] We moved back in.
[CUSTOMER][NEUTRAL] You're in all the middle of this.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I do my.
[CUSTOMER][NEUTRAL] That's where I need it to be to.
[CUSTOMER][NEUTRAL] Be handy.
[CUSTOMER][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Yes, I can hear you.
[CUSTOMER][NEUTRAL] OK. Did you say you can't hear me?
[AGENT][NEUTRAL] I can also look it up with his social security. Yes, I can. I can also look up with his social security number if you want to give that to me, it'll pull it in for us.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Yeah, that would probably be easier um [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me try that way real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it might be under my name and he might be the sales because we worked together when we first got these um policies.
[AGENT][NEUTRAL] Yes, ma'am. I do show um.
[AGENT][NEUTRAL] I think I have it pulled up. Let me make sure.
[AGENT][NEUTRAL] Well,
[AGENT][NEUTRAL] What is his name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, let me see. Can you give me your social security number and let me see if he's on your policy?
[CUSTOMER][NEUTRAL] Yeah, I think that's the way it is uh [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, let me look.
[CUSTOMER][NEUTRAL] And if I need to, I can go out in the garage and get the policy. I think it's out there in the file cabinet.
[CUSTOMER][NEUTRAL] She
[CUSTOMER][NEUTRAL] I think the parts that I need I can get open.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I have it pulled up. Ms. [PII], can you please verify your date of birth for me?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then I'll also need for you to verify your address, phone number, and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] OK hopefully we moved in June but our address is [PII].
[AGENT][NEUTRAL] OK, it looks like I have your old address.
[CUSTOMER][NEUTRAL] Yeah, the old one was [PII], but that needs to be updated.
[AGENT][NEUTRAL] OK, and you said that
[CUSTOMER][NEUTRAL] Because we moved in July.
[AGENT][NEUTRAL] OK, and you said that new address is [PII]?
[AGENT][NEUTRAL] And that's in [PII]?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII] OK.
[CUSTOMER][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] OK, and then the phone number that you gave me to call back on if we're disconnected, is that your cell phone number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and then one last verification, can you give me your email address, please?
[CUSTOMER][NEUTRAL] Yes, LKF.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you. I appreciate you verifying the policy for me. Let me go in and fix that address for you real quick.
[CUSTOMER][POSITIVE] OK, no problem.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're very welcome. And would you like your policy number?
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, it's 176.
[AGENT][NEUTRAL] 5276.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Maybe you can, you'll have it close at hand.
[CUSTOMER][NEUTRAL] I need to put it in my phone under APL so that way I, I thought I had done that last time but I guess I didn't.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] That's OK. We found you.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] I mean, is it
[CUSTOMER][POSITIVE] Thank you. I'm gonna do it right now though while I'm talking to you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] We'll both update our information.
[CUSTOMER][NEUTRAL] 16 got you.
[CUSTOMER][NEUTRAL] OK, I got it.
[AGENT][NEUTRAL] Is [PII] spelled [PII]?
[CUSTOMER][NEUTRAL] Now it's [PII]
[CUSTOMER][POSITIVE] Yeah, I think you spelled it right. [PII]
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][POSITIVE] OK, I wanna make sure I get it in here right.
[AGENT][NEUTRAL] OK, I'm gonna.
[AGENT][NEUTRAL] Make sure that it took.
[AGENT][POSITIVE] It did good we've got you updated on your address.
[CUSTOMER][POSITIVE] Great, thank you so much.
[AGENT][POSITIVE] You're, you're very welcome.
[AGENT][NEUTRAL] OK, so, um, I'm going to refer you to a website.
[AGENT][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Like [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And on that website, if you click on claims and forms.
[AGENT][NEUTRAL] You're going to need to get the cancer form.
[AGENT][NEUTRAL] To fill out
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] When you first download that cancer form on the first page, it gives you everything that you need to send in. It gives you like scenarios of what happened. Like if it was chemo, you need to send in this. And that way, you won't miss anything.
[AGENT][NEUTRAL] But it's important that you send in the um itemized statement from.
[AGENT][NEUTRAL] The provider's office that you guys used.
[AGENT][NEUTRAL] And you'll also need the pathology report with the initial first diagnosis.
[CUSTOMER][NEUTRAL] OK now can I, can I get that information just by in my chart?
[CUSTOMER][NEUTRAL] Or do I need to.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] You can go to the provider's office and they should be able to give you everything that you need.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] From his medical chart.
[CUSTOMER][NEUTRAL] OK, and if I remember correct I said something about they pay mileage also for going back and forth.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, if it's more than 50 miles.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, because there was kind of a scenario there for a little bit when we were still living in [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And then we were
[CUSTOMER][NEUTRAL] Driving back, is that more than 50 miles ever from [PII] to?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] It's 150 or something, OK, yeah, so we were going to [PII]. We were having to drive back and forth and then we, so how does that, how do we do that? I mean, up until the time we moved, how does that work?
[AGENT][NEUTRAL] Uh, let me go to that website. I'm gonna pull up the cancer claim form and I'm gonna look and see what it says about that.
[CUSTOMER][NEUTRAL] You know what I'm saying, because we
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, great. Oh, OK. Let me see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Because he was in the hospital one time in [PII] because we were still living in [PII] after his first chemo.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] That we were driving to [PII] to have. And then the 2nd time after the 2nd chemo, he ended up back in the hospital and
[CUSTOMER][NEUTRAL] That hospital was in [PII].
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] But we were
[CUSTOMER][NEUTRAL] Ever or we already were we living here at that point when you got in the hospital the second time?
[CUSTOMER][NEUTRAL] OK, we were still over there weren't we?
[CUSTOMER][NEUTRAL] So yeah so we were driving back and forth, but how do you I don't.
[CUSTOMER][POSITIVE] And then they then they changed some of the chemo and it it he didn't have to go to the he didn't get infections anymore so.
[AGENT][NEUTRAL] OK. So, on, um, let's see.
[AGENT][NEUTRAL] I'm looking, I'm looking at.
[CUSTOMER][NEUTRAL] Been diagnosed with one.
[AGENT][NEUTRAL] Yes ma'am, you'll need to send all that information in which should be with um.
[AGENT][NEUTRAL] The provider should have all that information for you for you to send in.
[AGENT][NEUTRAL] The important key is having the itemized statement that um has the procedure codes and diagnosis codes on it and that first initial pathology report.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me see what it says about.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] On the cancer claim form, it'll have, um,
[CUSTOMER][NEUTRAL] Now since
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] It'll have non-local transportation and it says the begin, begin date of travel and the method of travel, and then you give the street address that you went to in the city and the state and the zip.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And if you need to, if.
[CUSTOMER][NEUTRAL] OK, so I'll need to call the
[AGENT][NEUTRAL] If you need more um room.
[AGENT][NEUTRAL] For adding the mileage, just add a separate page that has that information the same as on section C of the cancer claim form. And if you had to have any lodging, also include that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. Well, we're.
[AGENT][NEUTRAL] And, and
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So the first hospital visit, he was, he was in the Hillcrest system, but the first hospital visit since we were in [PII], they said go to the emergency room because he was real sick and we went to the emergency room in [PII] in [PII]. I mean, I've said that backwards we went to the [PII], the [PII]'s, um, or whatever they call it SSM Health. So what I call them to get all of that information like their office or something, uh.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Right, yes, you will.
[CUSTOMER][NEUTRAL] Because
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So and they can I guess email that to me and then I.
[CUSTOMER][NEUTRAL] Then do I
[CUSTOMER][NEUTRAL] Do I email the file to you or does it all need to be handwritten out or from the client?
[AGENT][NEUTRAL] Uh, you can actually download the claim form onto your computer and then you can type in the information. It's fillable and there's 3 different ways you can send in the claim.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] If you want to sign up for our online service center.
[AGENT][NEUTRAL] That website is secured S [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And you can sign up on the online service center, it's a direct portal to your policy. You can file your claims there on the online service center if you choose to do it that way. You'll have to download everything to your computer and then upload it into the online service center.
[AGENT][NEUTRAL] Or you can fax it in.
[AGENT][NEUTRAL] Let me give you that fax number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] 3659423
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or if you would like to mail it in, you can mail it in at APL claims.
[AGENT][NEUTRAL] And that is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And that's in [PII].
[AGENT][NEUTRAL] And then the zip code is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] what?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] OK, and that was [PII].
[CUSTOMER][NEUTRAL] [PII] is the fax number or mail it at [PII].
[AGENT][POSITIVE] Yes ma'am, that's correct.
[CUSTOMER][NEUTRAL] OK, OK, well I will start doing that now what happens when I do these, so I guess what I was hoping to do is just put everything in there up to [PII].
[AGENT][NEUTRAL] Mhm, yeah.
[CUSTOMER][NEUTRAL] And then everything after file another claim or how does that work?
[AGENT][NEUTRAL] Yes, so you'll need that claim form for everything that you're sending for this claim and then when you file your other claim you'll also need to download the claim form again for the the rest of it.
[CUSTOMER][NEUTRAL] OK, now how does this work exactly? Like say he was diagnosed in May and then.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] How do you is it by just however many claims you have for this first initial cancer diagnosis? Or how does that work?
[AGENT][NEUTRAL] Well, the way that it works is you fill, you know, you fill out all your information and you send it in. It takes 7 to 10 business days for the claims department to examine the claim.
[AGENT][NEUTRAL] And they go by um that itemized statement that has the diagnosis and procedure codes based on what that itemized statement says is how they pay the claim um that has to coincide with what your policy supports so it's it's a little process of of doing that and then um if there's ever anything that you need that you didn't send then you'll get a letter stating that you need to send in.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] This information that's missing or if you call, if you call after 7 to 10 business days, um we can also look at the claim and give you the remarks that the examiners put on it if there's anything that needs needs more.
[CUSTOMER][NEUTRAL] Something additional.
[CUSTOMER][NEUTRAL] OK, then I have
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Information on.
[CUSTOMER][NEUTRAL] OK, and I guess my next question is during this time he had a place on his back that he had to go and have taken out.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, not even taken out of biopsy.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh, squamous squamous cell, is that the same? I mean, how does that work? Is that, is that a diff?
[AGENT][NEUTRAL] That goes on the same claim form.
[CUSTOMER][NEUTRAL] OK, so anything that's happened in between.
[CUSTOMER][NEUTRAL] May and or anything to do with cancer I just put on that claim form OK so I'll need to call them to get the and you'll need the.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] So each claim form.
[AGENT][NEUTRAL] Each claim form is based on the kind of policy that you have with us. So the cancer claim form would be for the cancer policy. If you had our, our um Medlink policy, then the Medlink policy would be for the Medlik claim form. So we try to make it as simple as we can, um, because there's just so much stuff to do to be able to get the claim together when you're doing it yourself, definitely.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Now what's the med link but I tell you what's what's the med link form?
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] What is Medlink? I, I remember seeing I don't remember who that is.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] That's, that is, uh, Medlik is another type of insurance and I just used it as an example. Um, it's another, it was a gap in it's a gap insurance that we have, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I just used it as an example or if it was an accident, you would use the accident form, you know, those kinds of things. Um.
[CUSTOMER][NEUTRAL] OK, I remember Med now I think we had that when we were working through the company because we had a high deductible and we paid everybody's gap insurance. It was through Medin, yeah, and then when we, our company got bought and sold and everything, so that part got dropped. But yeah, I knew I recognized that. I did the insurance form.
[AGENT][NEUTRAL] Oh, yeah, yeah, yeah.
[AGENT][NEUTRAL] Uh-huh. OK. OK.
[AGENT][NEUTRAL] Yes, ma'am
[CUSTOMER][NEUTRAL] OK, I'm like, OK, so right now that's the only thing I mean, and he had any tests he had to do because he was on these high potent chemo drugs like he was having EKGs and ultrasounds and all this stuff, then that's and then what about pharma.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, send it all in.
[AGENT][POSITIVE] I would send everything in that you can, yes, I would send it all in.
[CUSTOMER][NEUTRAL] OK, and then pharmacy OK OK.
[AGENT][NEUTRAL] Because if anything is not covered on your policy, the examiners will find that out and they'll, they'll give a remark as to what's covered and what's not covered, but I would send in anything that you can.
[CUSTOMER][NEUTRAL] OK, so I would just call.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Definitely.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK and alright and it'll kind of tell me on that form what I'm looking for and everything, so alright, I will start now is cut off of when I need to have this done.
[AGENT][POSITIVE] Absolutely, yes, that first page.
[AGENT][POSITIVE] No, that's what's awesome um about our company is there's not a timely filing limit. So as long as you were covered on the date of service, you can file at any time.
[CUSTOMER][NEUTRAL] Well.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, well then that's what I need to do now let me ask you this because he, he had before previous to that, now this is a cancer form and it what about uh preventative um things like.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] PSA colonoscopy, that kind of stuff, does that?
[AGENT][POSITIVE] Yes, yes, definitely send it in, um, as, uh.
[AGENT][NEUTRAL] Uh, for the, for the cancer, that's preventative.
[CUSTOMER][NEUTRAL] OK, so pretty much anything that anything that wouldn't be they'll take it off or send a remark about it or whatever. So then, OK, OK, alright, well thank you very much.
[AGENT][NEUTRAL] Right. Yes, ma'am.
[AGENT][POSITIVE] You're so very welcome, Ms. [PII]. Is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, I sure appreciate everything that you're doing.
[AGENT][POSITIVE] You're very welcome. I enjoyed helping you and if you get stuck or or you need more help as you're trying to get through all this claim information, just pick up the phone and call us and we'll walk you through it.
[CUSTOMER][NEUTRAL] All right
[CUSTOMER][NEUTRAL] OK, your name was [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Alright [PII].
[AGENT][POSITIVE] OK. Well, I hope you guys have a blessed rest of your day and thank you so much for calling APL.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, well, the same to you thank you.
[AGENT][POSITIVE] Thank you, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] Mhm bye bye.