AccountId: 011433970860
ContactId: f47b6db3-82ef-4667-a324-076960621739
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 863229 ms
Total Talk Time (AGENT): 299077 ms
Total Talk Time (CUSTOMER): 357742 ms
Interruptions: 1
Overall Sentiment: AGENT=2.1, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/f47b6db3-82ef-4667-a324-076960621739_20250408T18:24_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, ma'am. Uh, my name is [PII], and I am uh with Webster, retiree with Worcester Parish School Board in [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I was calling to get some information. I think I need some assistance with uh filling out a claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, for cancer and this, it deals with for cancer screening.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Uh, I have, uh,
[CUSTOMER][NEUTRAL] My wife has had her mammogram.
[CUSTOMER][NEUTRAL] Uh, and go on scope.
[CUSTOMER][NEUTRAL] And I've had a PSA.
[CUSTOMER][NEUTRAL] Uh, can we file all of those?
[AGENT][NEUTRAL] I can definitely get your policy pulled up [PII] and make sure that those are covered, uh, diagnostic tests under your cancer policy. Uh, can I first get a good callback number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes, uh, uh, [PII]. I'm sorry, [PII].
[AGENT][POSITIVE] That's all right.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Got it, thank you. And then do you have your policy number?
[CUSTOMER][NEUTRAL] Let me see, I don't, that's just one minute, let me see if we can find it.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Oh, the policy number, American, just a moment, we get trying to get the folder right now.
[AGENT][NEUTRAL] No, you're fine if it's easier I can start using your social as well.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] and my social is [PII].
[CUSTOMER][NEUTRAL] [PII] [PII] the Folder please.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm so sorry, [PII], could you repeat was that your, uh, social?
[CUSTOMER][POSITIVE] Yes, that was I told you. I'll give it to you again.
[AGENT][POSITIVE] If you wouldn't mind, thank you.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Turn it to you.
[CUSTOMER][NEUTRAL] What you doing baby?
[AGENT][NEUTRAL] All right, well I'm just gonna verify some information really quick. Can I get your uh date of birth, please?
[CUSTOMER][NEUTRAL] And wait a minute.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, um, [PII].
[AGENT][POSITIVE] Thank you. And then can I get
[CUSTOMER][NEUTRAL] That's [PII].
[AGENT][NEUTRAL] Yes sir thank you yes sir alright and then if you would, can you verify your uh the mailing address we've got on file for you?
[CUSTOMER][NEUTRAL] You got it?
[CUSTOMER][NEUTRAL] The mailing address you have should have for me is [PII].
[AGENT][NEUTRAL] Sorry, that's what we've got. Thank you. Last thing I need is the email address we've got on file for you and look at the [PII] account.
[CUSTOMER][NEUTRAL] Mind you, my look, my computer is uh down and uh but you uh you have uh for me, you should have [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. Yes, sir.
[AGENT][NEUTRAL] That's it. OK, thank you for verifying that. I just wanted to make sure we have was correct. Alrighty, give me just a moment, let me get that policy pulled up.
[CUSTOMER][NEUTRAL] That's it. OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] I didn't even, I, I didn't even feel like one of these to me when I had surgery.
[CUSTOMER][NEUTRAL] Yeah that's over here.
[CUSTOMER][NEUTRAL] Yes I
[CUSTOMER][NEUTRAL] We didn't have to file a claim.
[CUSTOMER][NEUTRAL] You didn't know what.
[AGENT][NEUTRAL] Alright, bear with me just a moment while it is thinking about it.
[AGENT][NEUTRAL] Give me just a moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] I appreciate your patience. It's just thinking about it. Just bear with me a moment please.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Way back in [PII]
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] OK, I am so sorry about that wait. Well, it took me a while to get to those. OK, so,
[AGENT][NEUTRAL] Uh, per your policy.
[AGENT][NEUTRAL] Let's see, we would pay a 75 the maximum of $75 per calendar year, and here are the covered tests, so that would be you did say a mammogram colonoscopy is covered and then you said a a PSA test correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, so those are all going to be covered, uh, benefits under this policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK, we did say we said mammogram, colonoscopy, and PSA.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, I, I only have one form here.
[CUSTOMER][NEUTRAL] I'm saying when I'm saying one form, I'm talking about a form that's requesting for benefits.
[AGENT][NEUTRAL] Uh, uh, the claim form you mean?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah, the claim form.
[AGENT][NEUTRAL] Oh, sure. Would you like me to send you, um, I can send them to you, um, let's see, I can email that to you if you'd prefer or I can have them mailed to you.
[CUSTOMER][NEUTRAL] Uh, my computer is down, so I think I would need you to mail those to me.
[AGENT][NEUTRAL] Sure, OK.
[CUSTOMER][NEUTRAL] If you would, I
[AGENT][POSITIVE] Absolutely I can get those sent to you. How many did you need?
[AGENT][NEUTRAL] Just the 2
[CUSTOMER][NEUTRAL] would I need one for each of these claims?
[AGENT][NEUTRAL] Um, was it for, it was one for you and then one for, um, give me just a moment I was just there.
[CUSTOMER][NEUTRAL] Yeah, 11 would be for me and one would be for my, one would be for my wife.
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] Yeah, OK, so yeah, I can send you a couple.
[CUSTOMER][NEUTRAL] OK, now, I only, in other words,
[CUSTOMER][NEUTRAL] Uh, I have like, for instance, PSA, so I just, I just filed for PSA on my form and she has coloscope and a mammogram and she put those two on hers. Am I correct?
[AGENT][POSITIVE] That is perfectly fine, yes.
[CUSTOMER][NEUTRAL] Alright, OK, let me see, I'm trying to see, what else do I need to attach with that?
[AGENT][NEUTRAL] Yes, so we would simply need um the itemized statement that shows any.
[CUSTOMER][NEGATIVE] And itemized state
[AGENT][NEUTRAL] Yes sir, that shows any diagnosis or procedure codes.
[CUSTOMER][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Uh, procedure code.
[AGENT][NEUTRAL] Yes sir and you can get that from uh wherever it was that y'all received treatment at.
[CUSTOMER][NEUTRAL] Oh, OK. I'm, I'm trying to make sure that what you said to make sure when we talk to them that they could make sure that they show procedure codes.
[AGENT][POSITIVE] Absolute diagnosis and procedure codes. Yes, sir.
[CUSTOMER][NEUTRAL] And, and I
[CUSTOMER][NEUTRAL] Diagnosis, OK.
[CUSTOMER][NEUTRAL] OK. All right. What else?
[AGENT][NEUTRAL] That's it. That is all we need and then of course that correct claim form filled out.
[CUSTOMER][NEUTRAL] And this form, fill out the claim form.
[AGENT][NEUTRAL] Yes sir, and what I'm gonna get that those mailed to you.
[CUSTOMER][NEUTRAL] OK, let me ask this now for, for the.
[CUSTOMER][NEUTRAL] Uh, statement, yeah, we, uh, I mean we have Medicare. Could we, uh, normally send uh monthly.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, uh, the medical.
[CUSTOMER][NEUTRAL] The teachers or things that we have had. Could I send a copy of that? Would that take the praise of that itemized statement?
[AGENT][NEUTRAL] Typically no um I couldn't tell you for sure though [PII] without seeing it myself um I would say it would just be just to make sure that you do get us the correct information I would reach out to the provider for that information.
[CUSTOMER][NEUTRAL] You would reach out to the provider.
[AGENT][NEUTRAL] Yes sir, I definitely would um only because if you're going to be mailing that information to us it can be a bit time consuming to get to us and then of course to process it.
[AGENT][NEGATIVE] And I hate to for you to have to go through all that if that was the incorrect information.
[CUSTOMER][NEUTRAL] Oh, I see what you're saying, right. OK. I need to contact the provider and ask them. I, I, I guess I want you to give me specifics on directing when I reach out to the provider. What should I say to that, to the provider?
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] I would say regarding you know um your PSA test and then your wife's uh mammogram and colonoscopy if you could receive a copy of those itemized statements.
[AGENT][NEUTRAL] That shows diagnosis and procedure codes.
[AGENT][NEUTRAL] And you can say it's for a claim, and if they need any information, they're more than welcome to call us as well as on the same number that you called.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, we need a copy of the itemized statement.
[CUSTOMER][NEUTRAL] Showing procedure codes.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And diagnosis codes.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] And diagnostic codes.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] I that that OK.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] For a claim.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] I got you and that's, and I'll have to just send that, uh, send that letter I'll call them and request that this information to be mailed to us and then we mail it attach it to your to the claim form that you're sending us and then we mail it to you, am I correct?
[AGENT][NEUTRAL] Correct, yes sir, and if you would like, was, I don't know how long, you know, if your computer might be out of commission for a while, I can send you several copies of this claim form just so you have extras. Would you like me to send you about maybe like 5 or so?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] Yes ma'am, I would appreciate it.
[AGENT][POSITIVE] Absolutely. OK, just so that you've got them just in case so I will get those sent to you, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I, I, I'd appreciate it. And you know what I was gonna ask you something else if you don't mind, if you would send us some extras and if you would scan that form and put it out there online so when my when I get the geek boys to repair my deal, then I can print out my own.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Yes, it is online yes sir it is online it's on our website um I can give you that website whenever you're ready.
[CUSTOMER][NEUTRAL] At this
[CUSTOMER][NEUTRAL] You got
[CUSTOMER][NEUTRAL] Uh right
[CUSTOMER][POSITIVE] OK, let me write just one minute. Let me get some write it on the back of this. I'm, I'm ready.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so it's [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the word [PII], so [PII]
[CUSTOMER][NEUTRAL] Got it.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, and right at the top of that website you'll see a tab that says claims and forms and you'll see all of them listed there.
[CUSTOMER][NEUTRAL] OK, right at the top it's gonna say claims.
[AGENT][NEUTRAL] Yeah, claims and forms. Yes, sir.
[CUSTOMER][NEUTRAL] And form
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The top of website, OK.
[CUSTOMER][NEUTRAL] Alright, let me, let me, before you leave me, make sure I have it right. It's [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Yes sir, that's correct.
[CUSTOMER][NEUTRAL] That's it.
[CUSTOMER][NEUTRAL] OK, but you're gonna send me some extra forms in the mail.
[AGENT][POSITIVE] Absolutely, yes, sir. Absolutely.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] And once you get it uh your computer up and running, if you have any trouble or difficulty locating that, definitely give us a call and we can walk you through it.
[CUSTOMER][NEUTRAL] OK, and that's all we
[CUSTOMER][POSITIVE] Thank you so very much. You've been so kind.
[AGENT][POSITIVE] Of course. Was there anything else I could help you with? Absolutely.
[CUSTOMER][NEUTRAL] Uh, you know, can you think of anything? No, no, I was asking my wife if she can because normally she files this for.
[AGENT][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Yeah, she said no, we think we got it now.
[AGENT][POSITIVE] All right, well if you think of anything else feel free to give us a call right back. I hope y'all both have a great rest of your day.
[CUSTOMER][NEUTRAL] Uh, we
[CUSTOMER][POSITIVE] Thank you so much. Yes, ma'am, bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah