AccountId: 011433970860
ContactId: ffb08c54-bd4b-4d7e-b6c0-ac749540ca80
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 547479 ms
Total Talk Time (AGENT): 217062 ms
Total Talk Time (CUSTOMER): 126276 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/06/ffb08c54-bd4b-4d7e-b6c0-ac749540ca80_20250206T20:18_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII], and I just submitted some forms into your online system for the cancer insurance deal. And I was wondering after I submit the forms, do I submit other things with those forms or just complete the forms?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Um, Ms. [PII], if it's for just wellness, um, that should be sufficient. I can, uh, check just to make sure that, um, we did receive it and it's all completed, but yeah, it's, it's just a claim form if it, if it's just for wellness.
[CUSTOMER][NEUTRAL] Yeah, and I went ahead and submitted all of them and I thought might apply during the duration that way I could just let y'all decide if they they they qualified or not and I just put the doctor's names and the dates.
[AGENT][NEUTRAL] OK, um, what is the policy number?
[CUSTOMER][NEUTRAL] Um, I don't have the policy number, but I can give you the social security number.
[AGENT][NEUTRAL] Bear with me just a second, um, let me go ahead and pull another system to use that social.
[AGENT][NEUTRAL] OK, go ahead.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Alright, and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and I need to verify um your date of birth, mailing address and email address on file for verification.
[CUSTOMER][NEUTRAL] Um, [PII], um, [PII].
[AGENT][NEUTRAL] What's your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] And you said you just submitted those?
[CUSTOMER][NEUTRAL] As soon as than yesterday.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, um.
[AGENT][NEUTRAL] So how many data service did you put in there?
[CUSTOMER][NEGATIVE] What I, I don't understand the question.
[AGENT][NEUTRAL] OK. So the wellness test is once per year. So how many years he was trying to get? Was it just one year or was it more than one year?
[CUSTOMER][NEUTRAL] I was trying for more than one year, but also according to the insurance deal, they had a for follow ups that said that it was another amount and I had wellness and then I had a follow up and I also had a biopsy this year.
[CUSTOMER][NEUTRAL] Like this year, I had a biopsy and last year I had a follow up from the year before last is um Pap smear.
[AGENT][NEUTRAL] OK, uh, because it looks like they're processing already for that wellness for [PII], um.
[AGENT][NEUTRAL] Let me see what happened to the rest of it.
[CUSTOMER][NEUTRAL] Yeah, and then [PII] on Monday I also had a biopsy.
[CUSTOMER][NEUTRAL] Which was a follow up from that one from [PII].
[AGENT][NEUTRAL] OK. The biopsy, did it came back to be uh positive for cancer or, or it was benign?
[CUSTOMER][NEUTRAL] I don't have the results yet.
[AGENT][NEUTRAL] Not yet. OK, yeah, because we're gonna need, if it's a biopsy, we're gonna need more than just that wellness claim form. That wellness claim form is just for the wellness, so it's for Pap smear, for mammograms, for ultrasounds, those stuff. But if it's like any other tests like diagnostic testing, follow-up test, that's gonna be under the claim form, the cancer claim form, OK?
[AGENT][NEUTRAL] Um, and we need documents for those, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me check on this. Yeah, it looks like they process for the mhm go ahead.
[CUSTOMER][NEUTRAL] If, if you would, um,
[CUSTOMER][NEUTRAL] The process for which one?
[AGENT][NEUTRAL] For [PII] and they're ready to send that check out and that payment out.
[CUSTOMER][NEUTRAL] I put in a direct deposit deal into the system, but it gave a diff when I put in the routing number it gave, uh, instead of saying extra code it gave it a different name of the bank, but the address is correct, but I did put my checking information into the system so they could do a um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] A direct deposit.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, there it's just processing. When it's just processing, it will not tell me if it's gonna go out check or it's gonna go out direct deposit is just saying that it's processing and it looks like it's gonna pay, so it doesn't really tell me how they're gonna send it just yet because they are just processing today, um, so I do see that they're gonna pay for that day.
[CUSTOMER][NEUTRAL] And how much will that be?
[AGENT][NEUTRAL] $50.
[CUSTOMER][NEUTRAL] Which, how much are they paying? How much? 50?
[AGENT][NEUTRAL] The Pap smear? Uh-huh.
[CUSTOMER][NEUTRAL] OK, and do I need to provide additional documentation for the biopsy for Monday? Do y'all need like.
[AGENT][NEUTRAL] Yes. For the biopsy, we're gonna need an itemized bill with the diagnosis codes and procedure codes.
[AGENT][NEUTRAL] And um that has to go through the cancer claim form. So it's gonna be the cancer claim form instead of the wellness claim form.
[CUSTOMER][POSITIVE] Is there any way that you could look at these and just send me an email just letting me know like hey this one needs this that way I can make sure everything's correct because you'll have my email on file.
[AGENT][NEUTRAL] I can send you the claim form and the instructions on what's needed to send in for the claims. Um, we don't do processing claim we don't process claims. um, we're the care team and we just go, um, and look at the information that the examiner when they receive the claim and they process the claim, that's what they, um, put in the system.
[AGENT][NEUTRAL] So basically they're, they're working on your claim again today. So it has not been finalized yet, but the only thing I see that it's been, it's gonna pay is gonna be that Pap smear which I see that it's gonna pay. The rest, it, it doesn't look like it's gonna pay, um, but again, it's because it's not a wellness. Um, so what I can do is send you the claim form with the instructions of what you need to send in depending on what type of service you have done. Is that OK?
[CUSTOMER][POSITIVE] OK, and then um I'll just check back in the system later. Thank you.
[AGENT][NEUTRAL] All right
[AGENT][NEUTRAL] OK, so let me go ahead, if you don't mind holding for me, let me go ahead and send this email to you with the claim form and the instructions right now before I let you go, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.