AccountId: 011433970860
ContactId: f8396c6a-801e-42af-85fc-85cce81adda7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 787900 ms
Total Talk Time (AGENT): 420464 ms
Total Talk Time (CUSTOMER): 289715 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/11/f8396c6a-801e-42af-85fc-85cce81adda7_20250311T14:36_UTC.wav
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[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII], and I have a policy with American Public Life, and I had recently gone to the doctor. I was diagnosed with cancer twice, and I had gotten a uh bills that I had when I was diagnosed with bladder cancer, and I got a printout and I'm, I'm not sure if I was compensated for all of my uh expenses that I had when I was treated for bladder cancer. So if, what do I have to do to resubmit those bills if they had not been paid?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, OK, look, we can go ahead and get your policy pulled up. um, I can verify if we have received those claims and what additional information we might need, um, [PII] first, if you don't mind, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII] and it's [PII] not [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Oh, sorry about that.
[CUSTOMER][NEUTRAL] That's OK. It's been called [PII] a lot.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alrighty. And do you have your policy number?
[CUSTOMER][NEUTRAL] I thought I did.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, as a matter of fact, I didn't write it down on this information. Can you pull it up, please?
[AGENT][NEUTRAL] Uh, if it's easier I can search using your social.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, that was [PII]?
[CUSTOMER][POSITIVE] That's correct, yes.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Of this morning yeah all the way down to [PII] actually part of our viewing area all the way down to 38 degrees just about an hour ago. So we got a long way to go, but we are still expecting to getting around.
[AGENT][NEUTRAL] OK. I'm just gonna verify some information really quick. Um, can I get your date of birth, please?
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. Last thing I need is the email address we've got on file for you. uh, looks like it is a Yahoo account.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, yes. Thank you so much for verifying that information. OK, give me just a moment. Let me get this pulled up here.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Um, and you don't have to give me an exact date if you don't have it, um, but kinda sort of when was this, um, that you received treatment for the bladder cancer?
[CUSTOMER][NEUTRAL] OK, let me pull up, uh, when I got in.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] OK, let's see here.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right so.
[AGENT][NEUTRAL] Bear with me just a moment, just let me see if we've received any claims around that time we can kinda go from there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. So for your cancer policy, I'm not showing that we've received any claims um since [PII]. So you can absolutely file anything that's happened from then up until now.
[CUSTOMER][NEUTRAL] OK, so you don't have anything.
[AGENT][NEUTRAL] All right. Um,
[AGENT][NEGATIVE] Oh sorry.
[CUSTOMER][NEUTRAL] Since [PII], so that's the last time you talk to, OK, OK, so I had.
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] Yes, [PII] was the last claim that we received.
[CUSTOMER][NEUTRAL] OK, well, I'll now should I scan it or email it? uh, uh, what's the best process?
[AGENT][NEUTRAL] Um, I was, do you have access to a, uh, desktop or a laptop computer, [PII]?
[CUSTOMER][NEUTRAL] Let me let my daughter talk to you because she would be the one to do this. OK, hold on please.
[AGENT][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Kind of.
[CUSTOMER][NEUTRAL] this
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] Hold on, I'm going to another area.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] She said they hadn't received anything since [PII] and this was [PII] for the cancer policy. Yes, she's gonna ask to tell you what how she would suggest that you do it.
[CUSTOMER][NEUTRAL] OK, this is my daughter [PII].
[AGENT][NEUTRAL] OK. Hi, [PII], how are you?
[CUSTOMER][POSITIVE] Good, how are you?
[AGENT][NEUTRAL] Doing all right thank you. OK, so um first off, do you all have access to a desktop or a laptop computer?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK awesome so I will say um creating an account on our online portal and submitting claims that way uh is typically going to be the easiest and quickest way uh to file claims with us so whenever you are ready um I can give you that web address.
[CUSTOMER][POSITIVE] OK, I'm ready.
[AGENT][NEUTRAL] OK, so it's the word [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] That's secure [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, that is correct. So it does have to be on a desktop or a laptop it it doesn't really have support for mobile devices, um, works the best with Google Chrome, um, so you would create an account, all of the information that we verified, including that, uh, Yahoo account, um, that we have on file, that's what you would use to create the account um there is a spot that asks for a member ID or a social security number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, you would just put in her social, um, as there's the member ID is different than the policy number.
[CUSTOMER][NEUTRAL] OK, so where does it say member ID your social.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so once you create the account, uh, there's going to be a spot, uh, right on the main page where it'll say you can upload documents, um, and from there, uh.
[AGENT][NEUTRAL] You can also fill out the appropriate claim form, which of course would be the cancer.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then whenever you are ready, uh, are you writing it down just so I know that um that you're, so I can keep going. OK. OK, because it can be a bit confusing. All right. So first thing that we would need would be that original pathology report, uh, showing the first diagnosis of cancer.
[CUSTOMER][NEUTRAL] Yeah, I'm writing in it now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK and then um anything else we need the itemized statement.
[AGENT][NEUTRAL] That shows diagnosis and procedure codes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. And now, did she receive any um radiation or chemotherapy?
[CUSTOMER][NEUTRAL] No, no, not with that one.
[AGENT][NEUTRAL] OK, OK, um, so no chemo, no radiation, um, so that's really all we need for any, uh, treatment, uh, or procedures that she received just going to be that itemized statement showing those codes you can get that from wherever she went for treatment that provider or facility will have that information. Um, most of the time it does depend on the facility. uh, they should be able to just send you that information electronically and then of course you can just upload it from there.
[AGENT][NEUTRAL] But if for some reason they give you physical documents instead you can either scan them if you have a scanner or you can take a picture as long as it's clear and legible that's perfectly fine.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so we go to [PII]. You, you said that Google Chrome is, is the best, um, option. You said go ahead and create an account, uh, using the Yahoo account, uh, that she provided, um, which what the email address is that ma? OK, and then.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] You said um for the member ID you social so we need to go to the section for upload documents and we need to complete the cancer form and the documents you need is a pathology report and itemized statement with the diagnosis and the procedure code.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] That is it. Yes, ma'am.
[CUSTOMER][NEUTRAL] OK. And you said the last time a plan was submitted was in [PII]?
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] Correct, that's the last information we received for this policy, and of course it is still currently active, so anything from that point up until now, um, absolutely you can file those claims. There's no timely filing limit.
[CUSTOMER][NEUTRAL] OK. And in [PII], was that for the breast?
[AGENT][NEUTRAL] What was that? I'm sorry.
[CUSTOMER][NEUTRAL] The she wanna know in [PII] was that for the brand?
[AGENT][NEUTRAL] Uh, let me see that. Give me just a moment.
[AGENT][NEUTRAL] So the let's see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, it looks like uh for [PII] that claim that we received was for some uh preventative um so I see like uh mammograms and X-rays and things like that so I don't show.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That seems to be all that we have received because prior to that it was uh [PII] and they were um preventative uh.
[AGENT][NEUTRAL] Procedures
[CUSTOMER][NEUTRAL] OK, so I can, uh, I'm scheduled to have a mammogram soon, so should I get the uh mammograms that I've had since [PII] and submit those as well?
[AGENT][NEUTRAL] You can, um, let me verify because some of most of the time, uh, you get one of those covered per calendar year, um, but I'll I'm gonna go through your policy really quick just to verify that that's like that on this one.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][POSITIVE] And if you don't already have a copy, um, I can definitely send you a copy of your policy as well um it's very easy to read it's not just a bunch of jargon um but it does go through what is and is not covered, uh, dollar amounts frequencies. OK, awesome, OK.
[CUSTOMER][NEUTRAL] No, I have a copy. I have a copy.
[CUSTOMER][NEUTRAL] Well, my daughter said send one anyway, send one anyway, so she, no, just you're gonna put it in the mail.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Um, how I can, uh, mail you a paper copy or I can send you, I can email it to you if you'd like.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] That's a lot of people. OK, uh, I'd rather email it.
[AGENT][NEGATIVE] It's only, it's about 28 pages. Um, it's not terribly long.
[CUSTOMER][NEUTRAL] OK, but she said email it then that's what she said email, OK.
[AGENT][NEUTRAL] OK, sure, OK, I will go ahead and get that email.
[CUSTOMER][NEUTRAL] And the last, last, OK, again, the last one it was [PII] because I'm said you have a mammogram and I'll know what to request. Well you gonna check and see. OK, I'll wait.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, yeah, definitely, um, and then just to make sure, um, do you want me to send it to this Yahoo account, the [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Alright, bear with me just a moment.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Sure, sure.
[AGENT][NEUTRAL] OK, so it appears that this policy actually does not provide a wellness expense, um, so we didn't pay any benefits for that for those mammograms, so it doesn't look like that's going to be covered under this policy. Um, I am going to look because we do have something from [PII] that we did pay.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And what was that?
[AGENT][NEUTRAL] Did you have cancer at that time?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. OK. That looks like that was for the uh surgery.
[AGENT][NEUTRAL] That you had. OK. So yes, um, no preventative, uh, coverage, unfortunately. I apologize for that. Um, but yes, anything else regarding, um, you know, positive diagnosis of cancer and treatment of cancer, you can absolutely file those claims.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's
[CUSTOMER][NEUTRAL] OK, great. OK, I will be submitting that soon, very soon. I'll call the, uh, and get the diagnosis from the, the, uh, new, OK.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Perfect.
[AGENT][NEUTRAL] And then in this email I'm gonna uh send with the policy. I'll go ahead and include the link um just in case um for the website, the online portal just to make it a bit easier.
[CUSTOMER][NEUTRAL] OK, she's hearing what you're saying.
[AGENT][POSITIVE] OK awesome.
[AGENT][NEUTRAL] All right, that
[CUSTOMER][NEUTRAL] Anything else down there?
[AGENT][NEUTRAL] Yeah, that about does it unless you have any other questions.
[CUSTOMER][NEUTRAL] OK, with that
[CUSTOMER][NEUTRAL] No, I don't have any other questions.
[CUSTOMER][POSITIVE] Thank you very much.
[AGENT][POSITIVE] Oh, you are very welcome. I hope you all have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you bye