AccountId: 011433970860
ContactId: 174bc167-f433-4f43-a128-7806e2e646bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 213979 ms
Total Talk Time (AGENT): 121016 ms
Total Talk Time (CUSTOMER): 71930 ms
Interruptions: 1
Overall Sentiment: AGENT=1.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/174bc167-f433-4f43-a128-7806e2e646bd_20250408T16:56_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Um, yes, I'm calling from the Cleveland Clinic in [PII]. I was trying to verify eligibility for a patient.
[AGENT][NEUTRAL] OK. Do you need just eligibility or do you also need benefits as well?
[CUSTOMER][NEUTRAL] Um, just eligibility.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name's [PII].
[AGENT][POSITIVE] Thank you. And [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] 01966705 M like Mary L like Larry 7.
[AGENT][NEUTRAL] OK, thank you, [PII]. One moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK, thank you. So she is the subscriber on the policy. Now, the policy number that you provided for me is an older policy that's no longer active. It was active from [PII].
[CUSTOMER][NEUTRAL] So.
[AGENT][NEUTRAL] 211 [PII] and the new policy number that she has for her active coverage is 246.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 2626.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] And this policy is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, it's 246-262-6.
[AGENT][NEUTRAL] Yes ma'am, that is correct, and [PII], um, because this is a supplemental policy to her primary insurance, when the claim is submitted to us for review, we will also have to have a copy of her primary insurance company's explanation of benefits for review.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then once we have processed our claim here we do have a portal in which you should be able to check claim status by going to secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] AM [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII], does that also show benefits or just claims?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, ma'am. That would just show you claim status once the claim has been processed. Yes, ma'am. Uh-huh.
[CUSTOMER][NEUTRAL] Uh, just a few claims.
[CUSTOMER][NEUTRAL] OK, OK, is the billing address still the [PII]?
[AGENT][POSITIVE] That is, yes, ma'am, that is correct.
[CUSTOMER][NEUTRAL] OK, and can I get the ETI number?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][POSITIVE] One, OK, all right, thank you [PII].
[AGENT][POSITIVE] You are certainly very welcome. And is there anything else that I can help you with?
[CUSTOMER][POSITIVE] Um, no, that's it, thank you.
[AGENT][NEUTRAL] OK, well, you're welcome. Thank you for calling APLS.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, and have a good day.
[AGENT][POSITIVE] You have a great afternoon.
[CUSTOMER][POSITIVE] Thank you bye.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Bye-bye.
[AGENT][POSITIVE] You're welcome. Bye