AccountId: 011433970860
ContactId: fe967d27-cc65-4594-a7c0-f86324cf6202
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 702409 ms
Total Talk Time (AGENT): 363068 ms
Total Talk Time (CUSTOMER): 335463 ms
Interruptions: 8
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/fe967d27-cc65-4594-a7c0-f86324cf6202_20250117T17:41_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, yes, good morning. um, I need to get some information on how to file a claim on my cancer policy.
[AGENT][NEUTRAL] OK, yeah, I can help you file a claim. Uh, what was your name?
[CUSTOMER][NEUTRAL] Mhm. [PII]
[AGENT][POSITIVE] Thank you and [PII] can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] Alright, thank you. Do you have your policy number?
[CUSTOMER][NEUTRAL] Yes, it's 731-916.
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] Alright, and [PII], just gonna verify some information really quick. Can I get your date of birth, please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] Um, it could, it's either [PII]. I think that's what I have, but I do need to change. I do need to make a change on my address. Yeah, that's correct, but, um, uh, we had that we have that box, but it was while we were moving. We have a mail at our house, so I wanna update my address.
[AGENT][NEUTRAL] Yes, that's it.
[AGENT][NEUTRAL] Is that correct?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, what was that correct address?
[CUSTOMER][NEUTRAL] OK, the correct address, but for now, um, it was the [PII]. Now it is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, that was [PII] I'm sorry [PII].
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] OK, and this is where you're going to be receiving mail, correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][POSITIVE] OK awesome I will get that changed um last thing I need [PII] is the email address that we've got on file for you.
[CUSTOMER][NEUTRAL] Uh, it should be [PII].
[AGENT][NEUTRAL] That's correct. OK, thank you so much for verifying that information. OK, so to file claims you've got a few different options. What I always recommend is if you're able to use our online portal that's going to typically be the quickest and easiest way to get claim information to us. Do you have access to a desktop or a laptop computer?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK perfect um the reason I ask is the website really doesn't have support for mobile devices like phones or tablets um so if you use a desktop or a laptop um I can give you that link you're going to use all of this information that we just verified uh to create your account.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let's see.
[AGENT][POSITIVE] And then from there there's a spot um right on the main page where you can upload documents.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then whenever you're ready I can tell you what kinds of uh documents we need the necessary information.
[CUSTOMER][NEUTRAL] OK. OK, so, um,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So OK, so I set up an account on this online portal. What is the um what is your website?
[AGENT][NEUTRAL] The web address? Yes, the web address is, so it's the word secured with an ED.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, so I go to that address, set up an account.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And go through the online portals to make claims, is that correct?
[AGENT][POSITIVE] Yes ma'am, um, if you have any difficulty or anything like that feel free to give us a call we'll do what we can to help you out. We do have other methods, of course, um, a mailing address, fax number it's just that this one it gets to us instantly, so it'll just process that much quicker for you and you'll be able to view the status and things like that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][POSITIVE] Oh yes, yes.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK, OK, now you said there was is that there were 3 options. What is the 3rd 1?
[CUSTOMER][NEUTRAL] Both the 1 and 2, just 1 and 2.
[AGENT][NEUTRAL] Oh, you mean to send uh claim information to us?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah, I can give you our mailing address.
[CUSTOMER][NEUTRAL] OK, I probably have that.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh, the [PII].
[AGENT][NEUTRAL] No, ma'am, um, so this one is going to be in [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, well, I think I'm just gonna go with the online because I'm sure that's easier to, and then how does that like do they pay directly to the provider or to me and then we pay that?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Yeah, if you're the one filing the claim we're gonna send that payment to you um so on the website there's an option you can set up direct deposit for payments if direct deposit is not set up we'll just mail you a paper check um of course I do recommend direct deposit if you're comfortable with that. If you can't locate those settings, I can also send you a form.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I can email it to you and you can set up direct de fill out the information for direct deposit and then email it right back to us that way, of course it just gets into your account that much faster.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, OK, OK, so, and, but that is the standard procedure is the providers don't file. I do, is that correct for this?
[AGENT][NEUTRAL] Correct, um, yes, I know sometimes depending on the provider they can, um, and they if they do then we would of course send the payment information directly to them if you're the one filing the claim we're gonna send it to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, OK, um, alright, so.
[CUSTOMER][NEUTRAL] So, OK, I think that's all. OK. So I just, uh, when I look at those claim things, there's different options for like lab work, mammograms, PSA and all those types, right?
[AGENT][NEUTRAL] Yes, yes. So let me ask you, [PII], if that's all right. Um, were you diagnosed with cancer?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm mhm.
[CUSTOMER][NEUTRAL] Um, well, I did a blood test that's CA 125 and it showed elevated levels. So, um, I almost had a hysterectomy. Um, my gynecologist was gonna do a hysterectomy, but when he
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Oh goodness.
[CUSTOMER][NEUTRAL] he's a laparoscopic, but he said it was not just gonna be a simple uh hysterectomy. He saw some suspicious cells. So he's done a biopsy. I don't have the biopsy results yet, but I just wanted to touch base on all this to, yes, yeah.
[AGENT][NEUTRAL] Oh, I see. OK. You're just getting your ducks in a row. Absolutely. I, OK, that being said, obviously, I sure hope that nothing happen. If it came back, or if it comes back, um, and it is a diagno a positive diagnosis of cancer.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah,
[AGENT][NEUTRAL] Before you file any other claims we would need that pathology report first so as soon as you can get that send that right to us and then you can file any claims necessary.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] I'm writing all this down so I don't forget something. OK. OK. Now, as far as like I've already had that CA 125 test. So can I, because there were some diagnostic tests that when I read through the information, it says that they uh paid like on a mammogram, a PSA, a colonoscopy, and the CA. I mean, those are just the ones I picked out that we knew we had had.
[AGENT][NEUTRAL] Yes, it's a lot.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So how do I go about filing claims?
[AGENT][NEUTRAL] Uh, that were covered under your policy?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, um, OK, so to file those claims, all we would really need is, of course you'll be able to fill out the correct claim form, the cancer claim form on the website, um, and then we would need an itemized statement.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] From the provider
[AGENT][NEUTRAL] That shows any diagnosis or procedure codes and procedures codes, excuse me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] They will have that information um and then you can just upload that and that that's it.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. OK. Now, how far back can I, cause like I know I did the CA 125 was like in October or November. Um, I had a mammogram.
[AGENT][NEUTRAL] Mhm. Oh yeah, your policy has been active. Yeah, your policy's been active since [PII], so any anything, yeah, there's no timely filing limit, so you can go back and file any of those claims.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and do you know approximately, oh, so I have a copy of the schedule of benefits that they pay, has that been updated like since [PII]?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Or is it basically the same?
[AGENT][NEUTRAL] Let's see, not since [PII], no, ma'am. I am looking at it too.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] OK, OK, OK, I just, I mean, I just was curious to see if, OK.
[AGENT][POSITIVE] Oh yeah, of course.
[CUSTOMER][NEUTRAL] OK. All right. So,
[CUSTOMER][NEUTRAL] and no time. OK, alright then that's the information I need, so I just need to go to that website and um set up the account. mhm OK.
[AGENT][NEUTRAL] Mhm create that account yes ma'am um and then of course if you have trouble locating anything, um, particularly the direct deposit I know uh some people have a little bit of difficulty finding where that is on the website um you could just give us a call and we can just email that form to you if that's easier.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] But I would send paper checks also if I don't get that figured out.
[AGENT][NEUTRAL] Yes, if you opt to not set up direct deposit, we would simply be mailing a paper check, yes.
[CUSTOMER][NEUTRAL] OK, OK, alright, so I just need to.
[AGENT][NEUTRAL] Oh, really quick, [PII], I'm sorry. I want to update your address. Um, I just wanted to verify the zip code for [PII]. That was [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, it's not, it's saying that's not a, it's not matching it.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I mean my, no, no, I'm sorry, that's the sibli zip code is [PII]. Sorry about that.
[AGENT][NEUTRAL] [PII]. OK.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEGATIVE] That's, that I gave you the wrong one.
[AGENT][NEUTRAL] That's OK. I think that's what yeah that's what we had before.
[CUSTOMER][NEUTRAL] That was for the, that was for the old one, yeah.
[AGENT][POSITIVE] There we are, OK, so that's all good and updated so you can uh use that information uh when you go to create your account that's all gonna be accurate.
[CUSTOMER][NEUTRAL] Yes, it is. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK alright well I will start checking into that thank you.
[AGENT][NEUTRAL] Alright, yeah, did you have any other questions for me, [PII]?
[CUSTOMER][NEUTRAL] Um, I do have, so we have a heart and stroke policy also is this, it's through the same company, isn't it?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Let's take a look.
[CUSTOMER][NEUTRAL] Don't have that policy number in front of me, but.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] No, you have your cancer policy and then you've got a dental policy with us.
[CUSTOMER][POSITIVE] Dental, yes, OK, OK, that's it. OK, OK, that's what I needed to check on. thank you very much.
[AGENT][POSITIVE] Yes ma'am, of course, yeah, thanks for giving us a call. I hope you have a great weekend. Let us know if you need anything else.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you bye bye.