AccountId: 011433970860
ContactId: f9162769-cc79-4489-ac4e-45f0d56fabf2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 607960 ms
Total Talk Time (AGENT): 217995 ms
Total Talk Time (CUSTOMER): 406768 ms
Interruptions: 4
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/f9162769-cc79-4489-ac4e-45f0d56fabf2_20250213T18:30_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good afternoon. My name is [PII], and I'm helping my daughter filing some of her claims with American Public Life. And I got a little confused on the claims address. And the only reason why I'm asking that, I looked at
[CUSTOMER][NEUTRAL] Some of the rider, uh, information in like the contract itself and it's showing like there's a [PII] address for riders and I'm confused as to whether I need to send the cancer claim form to [PII] or to the [PII] address.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] OK, all right, Ms. [PII], I can help you with the address. Uh, first, can I get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the policy number?
[CUSTOMER][NEUTRAL] The policy number, there's 2 of them because there's 2 different years um that we're submitting claims for and my daughter's here if you need to talk to her by the way um so.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yes ma'am, thank you.
[CUSTOMER][NEUTRAL] The first policy number um is 2411885.
[AGENT][NEUTRAL] OK, let me pull that policy up real quick.
[CUSTOMER][NEUTRAL] And that's the one that I'm gonna be using for the cancer claim form anyway. I'm not gonna use the previous one. We used the previous one just for a wellness one and that was it.
[AGENT][NEUTRAL] OK. All right, I understand. Is Miss, uh, you said Ms. [PII] is there for me to be able to just confirm it's OK to discuss the policy?
[CUSTOMER][NEUTRAL] To just a
[CUSTOMER][POSITIVE] Yes ma'am, I'm here uh huh.
[AGENT][NEUTRAL] Thank you. Hi, Ms. [PII], this is [PII]. I just need to um have you verify your policy information for security reasons. Can you give me your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you so much. And then what is your address, phone number and email?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mail address that we have on the policy for you.
[CUSTOMER][NEUTRAL] [PII] [PII] and then the [PII].
[AGENT][POSITIVE] OK, I appreciate it. Thank you so much, Ms. [PII], for doing that for me. OK, um, Ms. [PII], the address that you're going to send all claims to.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] They
[AGENT][NEUTRAL] Is the [PII], [PII] address, the [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] OK, you know what? um.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] When I did
[CUSTOMER][NEUTRAL] [PII] right [PII]?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, that's what I put on the envelope. I just wanna make sure [PII].
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, that's perfect.
[CUSTOMER][NEUTRAL] And that's for everything, any claims that you have, right? Is there any, like on the cancer claim form and I can go back and look to make sure I printed all the documents, but a little different than the wellness form, but it only has two pages to it, right? On the cancer claim form.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Uh, let me, let me, let me go look on our website and pull up that claim form and make sure.
[CUSTOMER][NEUTRAL] I was
[CUSTOMER][POSITIVE] And I'll work with you.
[AGENT][NEUTRAL] OK, let me look.
[AGENT][NEUTRAL] Yes, well, actually if you go on our website at [PII].
[AGENT][NEUTRAL] [PII]
[AGENT][NEGATIVE] I'm sorry, [PII]. Uh, when you download the cancer, uh, claim form, there's 2 pages that are like the first page is everything that you need. It's a cheat sheet. There's 4 pages total.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] I'm there.
[CUSTOMER][NEUTRAL] Right, OK, OK, so, but the actual claim form itself is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I guess you don't have to like identify what it is that you're claiming on that they'll go through the paperwork that you've gotten they'll know how to do that, right?
[AGENT][POSITIVE] Absolutely.
[CUSTOMER][MIXED] I guess that's a silly question, but yeah, it's a little tricky because I'm glad because I don't wanna have to write everything out because the, the claim form looks pretty basic enough and then, yeah, OK, and then the second form where she signed at the bottom, so it's really even though there's 4 pages we're only gonna mail in page 2 and then page 4 those are the only things that pertain to her on the claim itself.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, that'll work thank you so much I appreciate your time.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Well, you're very welcome and we appreciate you guys calling today. I enjoyed talking to you. I hope you have a wonderful day and.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, and for.
[CUSTOMER][NEGATIVE] Yeah, just kinda, you know what I did think about something, so I, I did try to do this online, but we found out yesterday I think I spoke to another rep and we inferred that I possibly couldn't do in helping [PII] the online claim for her because these are lapsed policies um, she, she actually, but you know this is, this is confusing to me and this is where I don't understand. She went back to work after her cancer treatment.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] She struggled. They let her go on [PII], but I had spoken to somebody once and they said her policy lapsed on [PII], and I didn't understand that, uh, of [PII], which we don't have claims that pertain to that anyway, but I'm thinking wouldn't they go with the last date of her termination, you know, date?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Well, in this case no and and let me explain to you why the reason why it lapsed on [PII] is because the group that she worked for the employer switched companies and they they didn't do their cancer policies through our company anymore.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0000, that makes sense. Oh yes, OK. And so yeah, we weren't, we weren't pacing, we weren't paying that close attention to who the new company was, um, we were just trying to get her healthy and back to work. I wasn't even thinking about claims, but that makes perfect sense. So as long as she's got everything covered underneath up until that date, so OK, and so will they.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] You know, we are, we've spent a lot of time organizing explanation of benefits we're trying to get as much itemized billing statements as we can from the medical providers in the event that you guys are missing something, do you reach out with a phone call or do you email her? How should we be looking for that? Because somebody said if you don't have it, if it's not processed within 10 days, they deny it and then we'll probably have to submit again, so I'm confused by that. How do they notify her if she's missing anything?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] They should send her a letter in the mail stating um.
[AGENT][NEUTRAL] The findings and it'll state on the letter what it is that she's missing.
[CUSTOMER][NEUTRAL] Yeah, sometimes the, the letters take forever and then you're all of a sudden at the 10 day point.
[AGENT][NEUTRAL] Well, that's OK.
[CUSTOMER][NEUTRAL] So I'm like, oh, OK, yeah.
[AGENT][NEUTRAL] That's OK because there's not a timely filing limit on her policies, so you can file at any time if, if you guys um want to check back from the day that you sent sent it, give it 24 hours.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And 7 to 10 business days from then, you can call and check on the claim status.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] OK, yeah, because we're mailing it, yeah, that's fine. We're mailing it and I'm OK with that because I, I know it's more work on your end because you guys got scan it and everything, but the system won't allow us to do that because of the lapsed coverage and it just wasn't very friendly. I couldn't even download a direct deposit form using the directions that they gave me because it wasn't an active policy. I found it under your regular website which she's filling out now and we'll just put it in with the claim paperwork so.
[AGENT][NEUTRAL] That'll be a double.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] But OK, that's great, [PII].
[AGENT][NEUTRAL] Let me, let me also tell you that we do have a claims fax line. If you guys can get to a fax machine, you can also fax in the claim. Would you like that number?
[CUSTOMER][NEUTRAL] Um, isn't it on one of the paperworks, but you know, by the time you're faxing all these pages, we don't have a fax machine ourselves. It's gonna cost her probably quite a bit of money to do that. Yeah, does, is it faster by fax? I mean, don't you have to scan it by fax?
[AGENT][NEUTRAL] Oh OK.
[AGENT][NEUTRAL] OK. Gotcha. I understand. Yes, ma'am.
[AGENT][POSITIVE] It just gets to us quicker.
[CUSTOMER][MIXED] It does get to you quicker. I'll see. Maybe I'll do one of them like that. I don't care about the wellness one, but I guess, you know, what a wonderful representative from your office was explaining some of the different things, and I was like, well maybe I should look at the schedule of benefits so I understand what you can really claim for and I didn't even realize that the internal cancer first current writer was like a $2500.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Uh, benefit amount, um, when she's diagnosed with cancer for the first time, I'm like shocked. I was like, wow, that's wonderful. So yeah, that I might try that, yes.
[AGENT][POSITIVE] Correct. Yes, it is a, it's a good policy.
[CUSTOMER][MIXED] Yeah, that's a good policy. You know what? Had I known about that, we were just so fried last year when she was going through getting over the shock. They're trying to figure out what doctors to get to. You don't even think about this stuff, but that money sure could have come in handy for her right in the beginning, so it's OK.
[AGENT][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Oh right well that's perfect thank you I appreciate your time.
[AGENT][POSITIVE] You're so welcome. You're so very welcome and um I wish you guys well and I hope you have a blessed day and we appreciate you calling APL Ms. [PII].
[CUSTOMER][POSITIVE] All right, thank you, Miss. [PII]. Have a good one. Happy Valentine's Day to you. All right, thank you. You're welcome.
[AGENT][POSITIVE] You too. Hey, thank you. Happy Valentine's Day to you too. Bye-bye.
[CUSTOMER][POSITIVE] Thank you bye bye.