AccountId: 011433970860
ContactId: f6c5e627-77d4-46f8-af4f-4ee0e0b161cc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 674780 ms
Total Talk Time (AGENT): 320829 ms
Total Talk Time (CUSTOMER): 196540 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/f6c5e627-77d4-46f8-af4f-4ee0e0b161cc_20250522T19:50_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], and I'm actually calling about my cancer policy. I just have lots of questions and I don't know like which direction to go. Are you able to help me with that?
[AGENT][NEUTRAL] Uh, yes, I can help you with looking at your policy. Um, could I get your policy number, please?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes, give me just a sec.
[CUSTOMER][NEUTRAL] I just had it pulled up. Hang on.
[CUSTOMER][NEUTRAL] OK, try 229.
[CUSTOMER][NEUTRAL] 6056
[AGENT][NEUTRAL] OK, thank you. And can I get your first and last name and your date of birth?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, and then you have a good callback number, [PII], in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And what is your address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII] sorry.
[AGENT][NEUTRAL] And then last
[AGENT][NEUTRAL] Oh, you're fine. Uh, lastly, your email address.
[CUSTOMER][NEUTRAL] Um, I think you'll have my work email, and I think it's [PII].
[AGENT][POSITIVE] Yes, that's right. OK, and then how can I help you today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so, um, I was just diagnosed um with a lymphoma and I submitted and I, it was processed and I received that payment. But now what do I do now that we're traveling back and forth for treatment? And what, like what is paid for, what is, what can we receive help with? I just don't know where to go now.
[AGENT][NEUTRAL] OK, um, let me see, let me get this pulled up. Um, anything I quote is not a guarantee of payment. It's a basic outline of your policy.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So are they doing like chemo or radiation, or what type of uh treatment are you doing?
[CUSTOMER][NEUTRAL] Um, radiation.
[AGENT][NEUTRAL] Radiation, OK.
[CUSTOMER][NEUTRAL] Radiation.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me look and see.
[AGENT][NEUTRAL] OK, so for the radiation benefit, it pays $500 per calendar month of treatment.
[AGENT][NEUTRAL] And so what you would want to do is get the statement um or like an itemized bill for the treatment um that shows the codes that for radiation, the diagnosis code, you know, the date of service, how much they're charging, um, and then it would submit that and then we would pay that 500 per calendar month.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Um, and then you said
[CUSTOMER][NEUTRAL] OK, so like what.
[CUSTOMER][NEUTRAL] On the, on that part, so like, do you want something from my insurance or do you just want something from the hospital stating that's what I received? Like what kind of paperwork?
[AGENT][NEUTRAL] Um, the hospital would be fine. Um, just something that shows that basically that you're receiving the radiation, the diagnosis that you're being treated for, and what the charges are, and where that's being rendered, what hospital. So the hospital should be able to provide that for you, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then you said you are traveling, is that right?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] Um, how far away is the hospital?
[CUSTOMER][NEUTRAL] Um, it's in [PII] and I think it's about 250 miles one way.
[AGENT][NEUTRAL] OK, OK. So it looks like we've got, as long as you're at least 50 miles from your residence, um, you can submit for transportation. Are you staying overnight?
[CUSTOMER][NEUTRAL] OK, and what do I?
[CUSTOMER][NEUTRAL] Um, I will, I haven't yet, but I will have to start yet.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like um let me see.
[AGENT][NEUTRAL] that benefit.
[CUSTOMER][NEUTRAL] So what do I submit for the mileage?
[AGENT][NEUTRAL] So for the mileage, um,
[AGENT][NEUTRAL] Basically, uh, I believe so we have a claim form um have you loaded uploaded this online or do you have access to our portal?
[CUSTOMER][NEUTRAL] Um, I mean, I have an online account.
[AGENT][NEUTRAL] OK, so on the, yes, yeah, on the claim form there should be a transportation box. It'll ask you to input your address and then the address of where you're receiving treatment.
[CUSTOMER][NEUTRAL] Is that what you're talking about?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then basically it pays 5050 cents per mile round trip up to 1000 miles.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, lodging, so you'd want to like, if you're staying overnight, you would you would submit receipts for that and then it pays $100 per day, up to 100 days per calendar year.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, OK, so.
[CUSTOMER][NEUTRAL] That's just for treatment. Does it cover any like doctor's appointments and traveling for those doctor's appointments?
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] I don't believe so. I think it's just the actual treatment, but let me make sure.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, it looks like the only physician benefits gonna be if you're inpatient in the hospital. So if you've stayed more than 24 hours, there is a uh $30 per day for the attending physician.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, but not for the, for the officers.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] OK, um,
[CUSTOMER][NEUTRAL] What about like MRIs, PET scans, uh, bone marrow biopsies, like any of that kind of stuff?
[AGENT][NEUTRAL] Um, let's see, so.
[CUSTOMER][POSITIVE] I told you I had a lot of questions. I'm so sorry.
[AGENT][POSITIVE] Oh no, no, you're fine. That's what we're here for.
[AGENT][NEUTRAL] Let's see. So we've got, we do have a bone marrow slash stem cell transplant benefit.
[AGENT][NEUTRAL] So, I don't think is, let me make sure on the surgery part.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] OK, there is a surgical benefit.
[AGENT][NEUTRAL] Um, so if you have actual surgery.
[CUSTOMER][NEUTRAL] OK, because I did have a biopsy as well.
[AGENT][NEUTRAL] OK. Um, let me see if, what if it defines the surgeries.
[AGENT][NEUTRAL] Yes, it will, it will pay for a surgery if it's performed for diagnosed cancer.
[AGENT][NEUTRAL] Um, or reconstructive surgery. Um, so, was the biopsy, was that originally to diagnose the cancer?
[CUSTOMER][POSITIVE] Correct, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see.
[AGENT][NEUTRAL] Let me double check on that. I'm not sure. I think because it was to diagnose and you didn't actually have the diagnosis yet.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] I don't think that would be.
[AGENT][NEUTRAL] Any, any surgery after your actual diagnosis would be potentially reimbursed.
[CUSTOMER][POSITIVE] Covered OK.
[AGENT][NEUTRAL] Yes, but because the, because you did not go into the surgery with the actual diagnosis of cancer, the, the biopsy itself would not.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] What, uh, I think I asked, what about like MRIs, PET scans, none of those.
[AGENT][NEUTRAL] Oh yeah, yeah, let me look at that.
[AGENT][NEUTRAL] Um, diagnostic testing.
[AGENT][NEUTRAL] OK, let's see what we have here.
[AGENT][POSITIVE] Yeah, I definitely don't wanna miss anything. That's for sure.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][POSITIVE] I know I'm trying this is pulling us financially, so I'm just trying to get everything I can.
[AGENT][POSITIVE] Oh, absolutely, totally understand.
[AGENT][NEUTRAL] That's what it's here for, so.
[AGENT][NEUTRAL] OK, I don't see.
[AGENT][NEGATIVE] Yeah, I'm not seeing a benefit for that. Um, it, it pays for like a 2nd and 3rd surgical opinion benefit. We've got drugs and medicine, hospital confinement.
[AGENT][NEUTRAL] Anesthesia, if you have surgery once diagnosed.
[AGENT][NEUTRAL] Um, we talked about radiation.
[AGENT][NEUTRAL] Um, hormone therapy.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Experimental treatment benefit.
[AGENT][NEUTRAL] Uh, we do have a ground and air ambulance benefit.
[AGENT][NEUTRAL] We talked about your transportation and lodging.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] There is a home health care benefit if if by chance you needed home health care.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] Physical and speech therapy, that's covered as well.
[AGENT][NEUTRAL] Uh, yes, it does not look like for the MRIs that would be a benefit.
[CUSTOMER][POSITIVE] OK, alright, well I think that kind of covers it. Um, fortunately I only have to have two rounds of radiation and it's back to back days, so I'll only get the 500, but that more than better than what I was expecting, so I'll take that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And like the, the 50, the 50 miles or whatever, that's only for treatment, correct? That's not for like doctor's appointments, follow-ups, anything like, anything like that?
[AGENT][NEUTRAL] Yes, so it would be for the actual treatment of the diagnosis, yes.
[CUSTOMER][POSITIVE] OK, OK, well I appreciate it thank you.
[AGENT][NEUTRAL] OK. Anything else I can help with today, [PII]?
[CUSTOMER][POSITIVE] Um, not right now, thank you for answering my question.
[AGENT][POSITIVE] OK, well, thank you for calling APL and if you think of anything else, please don't hesitate to give us a call back.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.