AccountId: 011433970860
ContactId: f64cca64-af94-4576-ac51-fc5757694a34
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 648830 ms
Total Talk Time (AGENT): 329619 ms
Total Talk Time (CUSTOMER): 304193 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/f64cca64-af94-4576-ac51-fc5757694a34_20250131T19:43_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] This may take a while, uh huh.
[CUSTOMER][NEUTRAL] [PII], my name is [PII]. Uh, a couple of months ago, my wife was diagnosed with, uh, uh, uterus cancer.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And uh they did all the you know uh.
[CUSTOMER][NEUTRAL] Medical stuff and she went to [PII], uh, that the Women's Hospital there and had a full hysterectomy.
[CUSTOMER][NEUTRAL] And they were able to get all the cancer. I need to make a claim and I've, I've got permission on the form, but I need some assistance.
[AGENT][POSITIVE] Well, it would be my pleasure to assist you, Mr. [PII]. Do you have the policy number?
[CUSTOMER][NEUTRAL] You need the uh
[CUSTOMER][NEUTRAL] Uh, this, this particular policy number is 488957.
[AGENT][NEUTRAL] Thank you. And do you mind verifying your date of birth, please, sir?
[CUSTOMER][NEUTRAL] My date of birth is [PII].
[AGENT][POSITIVE] I'm a July baby too. July babies are, are awesome, aren't they?
[CUSTOMER][NEUTRAL] Are you
[CUSTOMER][NEUTRAL] Uh, oh yeah, oh yeah.
[AGENT][NEUTRAL] Mr. [PII], do you mind verifying your current mailing address as well?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And what is your email and phone number please, sir?
[CUSTOMER][NEUTRAL] My email is [PII].
[AGENT][NEUTRAL] And your phone number just in case we get disconnected?
[CUSTOMER][NEUTRAL] OK, my phone number is area code [PII].
[AGENT][NEUTRAL] Y'all finally dig out from all that snow?
[CUSTOMER][NEUTRAL] Oh yeah, oh yeah, I, uh, my, uh, two daughters live in [PII] and, uh, um, [PII]. They got more snow than we did.
[AGENT][NEUTRAL] That's something, it's just been the strangest thing.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] But that's OK. They deserve a little snow too, don't they?
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] And OK, so now for the most important thing, is this for [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And how is she doing this? That's the most important thing.
[CUSTOMER][NEUTRAL] She's, she's mean as ever.
[AGENT][NEUTRAL] I'm not gonna tell her you said that.
[CUSTOMER][POSITIVE] Uh, she's, she's doing all right.
[AGENT][POSITIVE] Good and I'm, I'm so glad that they were able to get everything as you said it's uh that's wonderful. And I see that you have an active account on our portal.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] There is a claim form for cancer claim form.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, no, I, I copied it off and I've got uh.
[CUSTOMER][NEUTRAL] It's, it, it's kind of like a, a generic claim form.
[AGENT][NEUTRAL] Yeah, so
[CUSTOMER][NEUTRAL] And uh
[AGENT][NEUTRAL] And this is the cancer lump sum policy.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] Yeah, now at the bottom of this form I've got it's uh.
[CUSTOMER][NEUTRAL] Uh, CL form cancer 1222.
[AGENT][NEUTRAL] Mhm. That's right. So you're just gonna put in her information. What we will need in order to be able to pay that lump sum benefit is the pathology report.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Positively diagnosed her with cancer.
[CUSTOMER][NEUTRAL] OK, I've got the.
[CUSTOMER][NEUTRAL] Yeah, I got that.
[CUSTOMER][NEUTRAL] Um, but I'm not sure how to load it and, and do all that, so, uh, can I just mail this in or something? Now, uh, the hospital, uh, North Mississippi Health Services, they should have already, uh, sent y'all a breakdown of the actual, uh, hospital bill and everything whether you need it or not, I'm not sure but.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, we haven't received anything yet, so we've got, let's see, now that's the can, let me pull up the cancer policies. They might have sent it on that.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Well, I just, I just received mine. I just received mine yesterday, so it may take a day or two or something.
[AGENT][NEUTRAL] Yeah, we haven't received it. So with that, um, we're gonna need the biopsy report for the cancer lump sum policy, for the pathology report.
[CUSTOMER][NEUTRAL] Yeah, I've got that.
[AGENT][NEUTRAL] And then for the cancer policy, we'll need the pathology report on the cancer policy as well, along with itemized bills with the diagnosis codes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah. Now the cancer one,
[CUSTOMER][POSITIVE] That's the only thing, uh, cause I think my insurance is, uh, um, Blue Cross Blue Shield and Medicare has pretty much paid everything up. So we weren't even gonna bother with that, but if, if we're supposed to, then we can do that too.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] I will send in the benefit, I mean the, the bills just to make sure it, you know, your benefits and if it's payable, we'll be happy to pay those additional benefits.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, now you'll need, uh, uh, for that part of it, you'll need uh the report from my insurance won't you?
[AGENT][NEUTRAL] I mean,
[AGENT][NEUTRAL] So with, for that portion, only for the treatment, um, like if she was in chemo or radiation or hormone therapy?
[CUSTOMER][NEGATIVE] What what they paid and what they didn't.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] We would need it for that.
[CUSTOMER][NEUTRAL] No, she didn't have any of that.
[AGENT][NEUTRAL] But yeah, the biopsy of the pathology report and the itemized bills for the surgery.
[CUSTOMER][NEUTRAL] OK, we got that.
[AGENT][NEUTRAL] If it is, I mean, let them review it because what they're gonna do is they're gonna look for any possible benefits that are payable in the documentation.
[AGENT][NEUTRAL] That's sent and there's a hos hospital benefit on here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I mean, worst they can do is say no, right?
[CUSTOMER][NEUTRAL] Now on my farm that
[CUSTOMER][NEUTRAL] Yeah, now I'll, um, in that case I'll need to, uh, fill out two sets of forms.
[CUSTOMER][NEUTRAL] And uh then uh.
[CUSTOMER][NEUTRAL] probably the only thing I've got is his travel and that was 60 miles to [PII] and back, you know.
[AGENT][NEUTRAL] Yeah, so that could be eligible. So what we'll need for travel is the um facility address.
[AGENT][NEUTRAL] Where she went for treatment or for services.
[CUSTOMER][NEUTRAL] Yeah, that that.
[AGENT][NEUTRAL] And then they'll they'll um calculate it from your home address, but make sure that we have the physical facility address, not a PO box.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. All righty.
[AGENT][NEUTRAL] Now you can fax those documents.
[AGENT][NEUTRAL] Now if you want to upload them online, what you can do is save the information.
[CUSTOMER][NEGATIVE] I've already tried I've already tried that it's not user friendly.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Yeah, you know, um, I'm, I'm just, I'm right at the same age you are and most computer things are not user friendly to me.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah, well, my, my pro my problem there is how to get my uh hard copies on to a uh a file to put into that site.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] So my best thing there is that I printed off the uh forms uh of course I filled them out uh uh save them on on my desktop and then filled them out and just printed them so my thing is there I'm just gonna mail all of this into you guys.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And you can mail it or fax it. Do you have our [PII] City address for claims?
[CUSTOMER][NEUTRAL] I don't, uh, uh, uh, yeah, but I don't have a fax machine.
[AGENT][NEUTRAL] OK, but if you mail it, it will go to the [PII] City address, not [PII].
[CUSTOMER][NEUTRAL] OK, OK, um, then, uh, give me your address and fax number and I'll give that a try.
[AGENT][NEUTRAL] OK, so, and it should be on the claim form as well, but the address to send mail claims to is [PII].
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] And the zip code?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]. OK.
[AGENT][NEUTRAL] Mhm. And if you get access for a fax machine, you can fax that directly to our claims department and our fax number is [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] 942 [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] 42 3 OK.
[CUSTOMER][NEUTRAL] Uh, I'll, um, maybe I, I do have a copy or it says fax, but, uh, it may be one sheet at a time, but, uh, I'll give that a try and see.
[AGENT][NEUTRAL] Yes, sir. And
[CUSTOMER][NEUTRAL] Because we got that that.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I could take it to work and do it, but we've got so many restrictions they don't allow outgoing stuff.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] And also, um, so when we received the claims, if you go online to check the claim status, you'll see an open document meaning that we did receive documents. Once it's processed and paid, it will have a claim number.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then um it could take up to 24 hours to view it online, but we also have an option for direct deposit.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that is on that portal if you would prefer benefits go directly to your bank account.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Then you would just enter your direct deposit information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] I'll I'll I'll get back on there and see what I can do.
[AGENT][NEUTRAL] It's just options for you. If not, it'll come by check. It may go to [PII] before it gets to [PII] from, you know, but.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] We can mail it. You never know with the mail.
[CUSTOMER][POSITIVE] OK, yeah, you're right.
[AGENT][NEUTRAL] Not anything bad about our, our postal system, but sometimes they, Mel likes to take a detour of the, the scenic route.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] I'll give the uh I'll give the fax thing and then online and uh if it if fax doesn't do anything then I'll I'll go online and try something.
[AGENT][POSITIVE] Yeah, and if you need any help with anything, don't hesitate to give us a call. We'll be happy to assist you any way we can.
[CUSTOMER][NEUTRAL] And what was your name again?
[AGENT][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] And it's been a pleasure to assist you, Mr. [PII]. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK, no, I, I'm sure I'll be calling back.
[AGENT][POSITIVE] Please do. We're here to help you any way we can. And I'm so glad that Ms. [PII] is feeling better, but let us know if we can help in any way.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you. Bye-bye.
[AGENT][POSITIVE] Thank you for calling APL. Have a wonderful afternoon. Bye-bye.
[CUSTOMER][NEUTRAL] You too.