AccountId: 011433970860
ContactId: f1e7e264-c88c-4794-916a-8252bbc16475
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 423320 ms
Total Talk Time (AGENT): 97378 ms
Total Talk Time (CUSTOMER): 214417 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/f1e7e264-c88c-4794-916a-8252bbc16475_20250414T20:56_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon, [PII]. I have, um, I was diagnosed with breast cancer in November of last year and I've um submitted the diagnosis, um, earlier or end of last year.
[CUSTOMER][NEUTRAL] And then my surgeries were this year and I've submitted hospital um stuff and proof of everything and then it said my insurance has lapsed which we changed my company changed insurances as of [PII], but I was diagnosed last year.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] But I'm showing I keep getting information saying it's not covered.
[AGENT][NEUTRAL] Do you have your policy number?
[CUSTOMER][NEGATIVE] I do not offhand. I'm sorry I'm just getting out of hyperbarracks and um I was afraid I would not be able to reach you guys by the time I got home with the time difference.
[AGENT][NEUTRAL] Oh, OK, yeah, no worries. Um, I can look it up by your last name or social security number.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Um, that was [PII], sorry.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And your first name?
[CUSTOMER][NEUTRAL] It's [PII]
[AGENT][POSITIVE] Thank
[AGENT][NEUTRAL] Get that pulled up.
[AGENT][NEUTRAL] OK, do you have a good callback number just in case I lose you?
[CUSTOMER][NEUTRAL] You bet
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you. And just need a few pieces of information. What is your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And your address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And then lastly, your email address.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, and so it looks like, yeah, it looks like the policy term 1125, so there were claims prior to that that you that we had denied, is that correct?
[CUSTOMER][NEUTRAL] Yes, I was, I was diagnosed in [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I submitted all that documentation.
[CUSTOMER][NEUTRAL] So then I've had surgery. I've had two surgeries uh this year.
[CUSTOMER][NEUTRAL] That was claim that said um.
[CUSTOMER][NEUTRAL] Said 0 for, you know, any money coming back for overnights of hospital stay and all that.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I sent the
[CUSTOMER][NEUTRAL] So but we changed companies um [PII] with my work, but I thought since I was diagnosed in November that this would all be still covered through this company.
[AGENT][NEUTRAL] Um, so it's based on the date of service, um, that's what would be covered under, yeah, um, unfortunately.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, they kept telling me otherwise, um, and I now I've spent all this time sending stuff to APL OK.
[AGENT][POSITIVE] Yeah, sorry about that, yeah.
[CUSTOMER][NEUTRAL] OK um.
[CUSTOMER][NEUTRAL] Well it's not your fault so I just hopefully I don't get lip on the other end.
[AGENT][NEUTRAL] Yeah, um, I mean, typically you have a like a year to file on most plans, um, for us there's no limit, but a lot of the times it's, it's a year, so hopefully you're within that time frame.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, while I have you on the phone, I did have an MRI that, um, uh, breast MRI. Is there any kind of, because I thought I sent that in, and I don't think, I think it was denied.
[AGENT][NEUTRAL] You know what date that was?
[CUSTOMER][NEUTRAL] Uh, I know it was last year, the end of last year, um.
[CUSTOMER][NEUTRAL] Uh, probably early December.
[AGENT][NEUTRAL] OK. Let me see if I can find anything.
[AGENT][NEUTRAL] Was it MRI in a hospital or like a physician's office?
[CUSTOMER][NEUTRAL] Uh, it was an office.
[CUSTOMER][NEUTRAL] Or in um uh where that's all they do is MRI stuff or uh outpatient facility.
[AGENT][NEUTRAL] OK, um, let's see.
[AGENT][NEUTRAL] Um
[AGENT][NEUTRAL] I don't have anything in December. Do you know, maybe it could have been November?
[CUSTOMER][NEUTRAL] It could have been.
[CUSTOMER][NEUTRAL] How late are you open? Are you open for like another 1 hour or 2 hours, or like once I get home I can find a better.
[AGENT][NEUTRAL] Sure. Um,
[CUSTOMER][NEUTRAL] Number the exact date.
[AGENT][NEUTRAL] We're open till [PII] Central Standard Time, so 4 hours.
[CUSTOMER][NEUTRAL] 00, OK, so I'm at [PII], I'm only at [PII]. I'm in [PII], so that gives me more time than I thought. So what I could do is I'll go home and then I'll call back.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK, yeah, um, yeah, that would help because I then I could look at, I've got quite a few claims so that way um we can look at the specific date, yeah.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][POSITIVE] Yeah, I submitted everything thinking yeah to do that so now that I know data service unfortunately our advocate told me otherwise, so I'll let her know she's really sweet so because I we probably don't change companies very often so.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] She probably just said no, so, OK, well I really appreciate your time and then I will just call back um when I get home.
[AGENT][POSITIVE] OK, perfect. Well, thank you for calling APL. I hope you have a good afternoon.
[CUSTOMER][POSITIVE] OK, thank thank you you too alright bye bye.
[AGENT][POSITIVE] Thank you.