AccountId: 011433970860
ContactId: f1684539-2c5a-44ae-808b-bc85b2a6dfe3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 759919 ms
Total Talk Time (AGENT): 389525 ms
Total Talk Time (CUSTOMER): 353736 ms
Interruptions: 10
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/03/f1684539-2c5a-44ae-808b-bc85b2a6dfe3_20250403T20:26_UTC.wav
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[AGENT][POSITIVE] Good. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], uh, good afternoon. Uh, this is [PII] calling, and I'm calling to, to ask a couple of things, please, ma'am. Uh, first of all, what do you need my name, number, Social Security, what do you need from me?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK, Mr. [PII], so you have some client you, I'm sorry, you have some questions related to your coverage with APL? Is that correct?
[CUSTOMER][NEUTRAL] Yeah, uh, uh, I, I, I want to know first of all, um, if I file a claim for [PII] for my cancel policy.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That's one thing I want to know. And the other thing is, uh, with my wife, I want to see that I follow any wellness, uh, for [PII] yet.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK, so you're wanting to see if some claims have been filed for [PII] and then for your wife for [PII] for wellness. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am, yes ma'am. I know I hadn't filed in it for myself, OK.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] OK. Yes, sir. I can help you with that, Mr. [PII]. And first off, what is your callback number?
[CUSTOMER][NEUTRAL] Uh, [PII]. Again, that's [PII], ma'am.
[AGENT][NEUTRAL] OK, thank you. And what is your policy number, please, Mr. [PII]?
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] Policy number, policy number see if I have that.
[CUSTOMER][NEUTRAL] I know I got a claim number, that's the same thing but uh OK, group policy, group policy.
[AGENT][NEUTRAL] No, sure, that would be.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Uh, I, I, I got one for accounts is 749047749047.
[AGENT][NEUTRAL] 749-047. Is that correct?
[CUSTOMER][NEUTRAL] 749-047, that is correct, ma'am.
[AGENT][NEUTRAL] Alright, thank you. So give me a moment please, Mr. [PII] to get your information pulled up and I will have to verify several things with you first, excuse me, for security and also any information I provide would be a verification of benefits and not a guarantee of payment.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] You're welcome. So first off, if you could please verify your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you and also your home mailing address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. The phone number we have on file for you, one of them is the same as the one you gave me, that is your cell number, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am, uh, the one that I gave you is my cell phone number and, and the one that you might have on file is my landline number which is area code [PII].
[AGENT][NEUTRAL] OK, thank you, we also do have that number for you and the last thing to verify for security is gonna be your email address.
[CUSTOMER][NEUTRAL] OK, and uh that should be [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm sorry, yeah, [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying all of your information. OK, so for the first question that you had regarding [PII], is that for you?
[CUSTOMER][NEUTRAL] And that's for me, yeah, for my my cancer, uh, that I filed my cancer claim.
[AGENT][NEUTRAL] OK, uh, what would the date of service be for that, for me to search to see if we received that?
[CUSTOMER][NEUTRAL] Uh, the date of service would have been, well, it was a whole package I sent in, uh.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I guess I was down. I was down in [PII].
[CUSTOMER][NEUTRAL] Uh, I can't remember the exact date, but it was [PII].
[CUSTOMER][NEUTRAL] Uh, around the [PII], somewhere like that and the [PII].
[CUSTOMER][NEUTRAL] I don't have that information in front of me.
[AGENT][NEUTRAL] OK. So I, now I see some claims. Uh, we did process a claim for you related to your chemotherapy. I can see that.
[CUSTOMER][NEUTRAL] Motion detected at ongoing.
[AGENT][NEUTRAL] There's several claims for.
[CUSTOMER][NEUTRAL] Now, this would have been, I did, uh, this is one I did for MRI or either a CAT scan.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Back in [PII].
[CUSTOMER][NEUTRAL] And I didn't know if I sent all that stuff in or not.
[AGENT][NEUTRAL] OK, so let me.
[AGENT][NEUTRAL] I see, I do see claims for your chemo.
[AGENT][NEUTRAL] There were some claims, yes, sir, for uh imaging done at MD Anderson.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, those 4.
[CUSTOMER][NEUTRAL] And [PII] then I'm gonna send a.
[AGENT][NEUTRAL] Mhm. For most, there were a couple of different dates of service for the imaging.
[AGENT][NEUTRAL] For [PII] that we did receive claims for mhm.
[CUSTOMER][NEUTRAL] So y'all did receive the claims for [PII].
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Uh-huh. And those, let's see, yes, because you had more than one image done. You had, I can see a claim for [PII] and also one for [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so I probably set that 23 package in there, so I just need not to submit the one for 24.
[AGENT][NEUTRAL] Um, yes, so I don't see, yes, sir, because we haven't received, you haven't sent us anything since [PII], and that was all of your information for dates of service.
[CUSTOMER][NEUTRAL] Is that correct?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And [PII] and [PII]. I don't see a [PII] data service included in that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Most recent claim process.
[CUSTOMER][NEUTRAL] OK, so
[CUSTOMER][NEUTRAL] OK, so now I'll just, I, I'll need to get the claims for 1920 I mean 192025, uh 2024.
[AGENT][NEUTRAL] Uh, yes, I know what you meant. Yes, sir.
[CUSTOMER][NEUTRAL] Yeah, OK. Now what about the, what about the wellness? Did I sit and think for wellness for my wife, which is [PII] would have been in 24.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Let me get her information pulled up, Mr. [PII]. Just one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] Oh, you're welcome.
[AGENT][NEUTRAL] Do you know when she went for her wellness?
[CUSTOMER][NEUTRAL] Uh, I'm looking at one day here, uh, this one says.
[CUSTOMER][NEUTRAL] 7 26 24.
[CUSTOMER][NEUTRAL] A screening for mammogram.
[AGENT][NEUTRAL] OK, let me check that data service. That would be easier to check the data service. 726.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes ma'am, 24.
[AGENT][NEUTRAL] Now, I don't
[AGENT][NEUTRAL] Yes, sir. I don't see a claim on file for that particular data service for her.
[CUSTOMER][NEUTRAL] So that would be that so that would have to be cloud on this end, um.
[CUSTOMER][NEUTRAL] Uh, bone density, and is that, is that considered part of wellness?
[AGENT][NEUTRAL] Mm, let me pull your policy information up to see specifically what's included on your plan.
[CUSTOMER][NEUTRAL] I got to, I got to get me another one of the policy manuals.
[AGENT][NEUTRAL] And actually,
[CUSTOMER][NEUTRAL] Do y'all don't send those out anymore, do you?
[AGENT][NEUTRAL] Well, we can, but you are set up in the online service center. So you have access to all of your claims information and your policy information. It's in that portal.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Sometime I, sometime I'll, hey, sometimes my computer may, sometime my computer may or may not work and, and this internet service, Lord, have mercy, it's terrible.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Yes, sir. I, I can understand that as well.
[CUSTOMER][NEUTRAL] I mean it it's probably working right now but.
[CUSTOMER][NEGATIVE] If you said go pull it up, it probably won't be working.
[AGENT][POSITIVE] No, I'll be happy to request the policy be mailed to you if you would like.
[AGENT][NEUTRAL] Um, if you're, yes, sir, and that'll take it.
[CUSTOMER][POSITIVE] I would thank you so very much. Uh, and, and, and do you also have the, do, do you have the new forms as well?
[AGENT][NEUTRAL] Well, the forms are online and you ask for, for your wellness if you log into the portal to do those, then you don't even have to send us I mean you do it all just online, you just complete the wellness form and answer the questions about the test and fill in the provider, you know, the information and just electronically sign it and submit it that way.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yeah, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, OK, now with the, with the, now with the cast the info, but with all this stuff for camp, I got to send all this into you though haven't, yeah.
[AGENT][NEUTRAL] Uh, you can or it can be uploaded into your portal from the computer and I can email you if you would like. I can email you the user guide. It not only explains how to set up your profile, OK, it explains how to set it up.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, do that for me please.
[CUSTOMER][NEUTRAL] OK, do that.
[AGENT][NEUTRAL] But it also explains how to upload things. OK, so now on the, uh, let's see.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What tests did you want to know would be considered under your diagnostic or prevention benefit?
[CUSTOMER][NEUTRAL] I was asking what, what like.
[CUSTOMER][NEUTRAL] I was asking about bone density.
[AGENT][NEUTRAL] Bone density? OK. I do not see that as one of the tests that's listed.
[CUSTOMER][NEUTRAL] OK. Uh, so, mainly we just been submitting on her, the mammogram and, uh, then if we do like a colonoscopy, we didn't do it this year. Uh.
[AGENT][NEUTRAL] Right. That's, yes, sir, that would be on there. Um, if you were to have a PSA test, that is something that you could, yes, sir, so that's one of the
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] I do.
[CUSTOMER][NEUTRAL] I, I, I
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEGATIVE] I, I do. In fact, they won't pay, they won't pay for one. I got 3 already. I'm looking at.
[AGENT][NEUTRAL] That is.
[AGENT][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Y'all just, y'all just do for one. I think that's what I was told.
[AGENT][NEUTRAL] Uh, yes, sir. It's one test per year. Mhm, that is correct.
[CUSTOMER][NEUTRAL] Is that correct?
[AGENT][NEUTRAL] For a screening test, yes.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK. Well, I think I pretty much, some of it I know, but I have to kind of refresh myself.
[AGENT][POSITIVE] Oh, I know, I totally understand.
[CUSTOMER][NEUTRAL] To make sure I'm I'm, I'm doing.
[AGENT][NEUTRAL] No, sir. I understand completely.
[CUSTOMER][POSITIVE] You know, when you get to that age, you have to do that. OK, thank you very much, ma'am. I look forward.
[AGENT][NEUTRAL] I don't think there's a certain age.
[AGENT][NEUTRAL] Oh
[CUSTOMER][POSITIVE] It's not OK, look here, I look forward to getting this information from you. Thank you very much.
[AGENT][NEUTRAL] No, sir.
[AGENT][NEUTRAL] OK, well, I will send you the email. The email, Mr. [PII], will come from [PII]. And then as far as your policy being mailed, I'm going to be sending it in just a couple of minutes, but then the policy request, that can take up to 2 weeks, you know, to 10 business days for you to receive that in the mail.
[CUSTOMER][NEUTRAL] Oh, you say you sent that already?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEGATIVE] That's fine. I'm not going anywhere.
[AGENT][POSITIVE] Certainly hope not. You're welcome. And if that's all then that I can help you with, Mr. [PII], thank you for calling.
[CUSTOMER][POSITIVE] Thank you very much.
[CUSTOMER][NEUTRAL] OK, now, wait, let me ask you, let, let me, let me, let, let me, let, let me ask you one other thing I might get you to send me something else. They, they want I have one with the life insurance, uh, and, and that's policy number 1022335.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] The 10 year renewable convert insurance, convert term.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 1022335.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] And you're wanting a, yes, sir, and you're wanting a copy of that one mailed to you as well?
[CUSTOMER][NEUTRAL] Do you see that?
[CUSTOMER][NEUTRAL] Yeah, could you, could you, could you put that in the mail too, please?
[AGENT][NEUTRAL] I will resend that request also now the policies will come separately they will not be, you know, coming together, so you may not receive them on the same day, but, but I will put that in.
[CUSTOMER][POSITIVE] OK, that'll be fine. OK, OK. Uh thank you so very much and you have a great day, ma'am.
[AGENT][POSITIVE] Well, I hope you do too, Mr. [PII]. And again, is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, ma'am, that's it for today. Thank you.
[AGENT][POSITIVE] OK. You're welcome and thank you for calling APL. Have a wonderful evening. Yes, sir.
[CUSTOMER][POSITIVE] Have a good day.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Papa.