AccountId: 011433970860
ContactId: 1f1b6a73-9d05-4a72-87b0-40ee6f24618c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 431589 ms
Total Talk Time (AGENT): 166214 ms
Total Talk Time (CUSTOMER): 199559 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/21/1f1b6a73-9d05-4a72-87b0-40ee6f24618c_20250421T14:53_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][POSITIVE] Hi [PII], good morning. How are you doing?
[AGENT][POSITIVE] I'm doing well. How are you doing this morning?
[CUSTOMER][POSITIVE] Good. Thank you so much for asking. I have a quick question for you.
[AGENT][POSITIVE] Very well.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] So I received something in the mail that says this is not a bill and it showed it looks like oh it's an explanation of benefits and it says.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] It says this product does not have a provider participation network benefits have not been reduced, and then I see a note. I do have an outstanding amount and I think it says oh for me to please provide copies of your explanation of benefits from your primary insurance carrier. There's a remark, but I don't understand what that is.
[AGENT][NEUTRAL] OK, alright, I can help you with the explanation of benefits. May I please get your name and your callback number?
[CUSTOMER][NEUTRAL] There's the number.
[CUSTOMER][POSITIVE] Great.
[CUSTOMER][NEUTRAL] Sure. It's [PII] and my number is [PII].
[AGENT][NEUTRAL] OK. And then is this for yourself, Ms. [PII], or are you with the facility calling about a patient? OK. And then what is your
[CUSTOMER][NEUTRAL] Yeah, for myself.
[CUSTOMER][NEUTRAL] No, it's for myself.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is your policy number?
[CUSTOMER][NEUTRAL] Um, let's see, my policy number is 01802550.
[AGENT][NEUTRAL] OK, let me look that policy up real quick.
[AGENT][NEUTRAL] OK, Ms. [PII], for security reasons, can you please give me your date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then I'm also going to need for you to verify your address, phone number and email address that we have on the policy for you.
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Um, and what else did you need?
[AGENT][NEUTRAL] Your email address?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Thank you and I do see that the phone number that you gave me to call you back on is that your cell phone?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, thank you very much I appreciate it. All right, so let's look at this um what is the claim number that you see on the explanation of benefits?
[CUSTOMER][NEUTRAL] 3582476
[AGENT][NEUTRAL] OK, let me look up that claim.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] So with this claim.
[AGENT][NEUTRAL] The only thing that I can see that it, it really needs is the explanation of benefits from your primary insurance carrier that will need to be sent in so that the claim can go.
[CUSTOMER][NEUTRAL] Could you tell me which claim that is though?
[CUSTOMER][NEGATIVE] OK, I wanted to send it in, but I just couldn't.
[AGENT][NEUTRAL] It's 35824.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, let me tell you who it's from.
[CUSTOMER][NEUTRAL] I'm sorry. I think our phone is breaking up.
[AGENT][NEGATIVE] Oh no.
[CUSTOMER][NEUTRAL] I'm sorry, could, could you tell me which, because all it has is a number, so I couldn't send the explanation because I don't know what this is for. Could you tell me what doctor what it's for?
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, I
[AGENT][NEUTRAL] It's for Cleveland Clinic Foundation.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And it's for procedures 76641.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And I do have, mhm, mhm.
[AGENT][NEUTRAL] And then the charge amount.
[AGENT][NEUTRAL] Would you like the charge amount so you'll know which one? It's $2,326.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] $2,326.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] D2
[CUSTOMER][NEUTRAL] OK. Hopefully, I do have an explanation of benefits from Cleveland Clinic. Some of them is 0, but one of them.
[CUSTOMER][MIXED] Is $60 as far as my out of pocket, but it's hard, oh yes, $2,132.86.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, I have it. Where can I send this?
[AGENT][NEUTRAL] Uh, you can send it by fax. Let me give you the fax number.
[CUSTOMER][NEUTRAL] Mhm, can I email it or is it best by fax?
[AGENT][NEUTRAL] It's [PII]
[AGENT][NEUTRAL] We don't accept them by email just because it's not secure um but you can send it by fax the um fax number is [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 365.
[CUSTOMER][NEUTRAL] I'm sorry, we broke up. 877.
[AGENT][NEUTRAL] Not
[AGENT][NEUTRAL] Yes, 365.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Yes ma'am, that's correct.
[CUSTOMER][NEUTRAL] OK, can I send this over by fax with the explanation of benefits from you or do I need to put a cover?
[AGENT][NEUTRAL] I would just refer to the claim number if you can put that on the cover of the claim number.
[CUSTOMER][NEUTRAL] Well, I'm going to email it with your explanation of benefits that have the claim number and that number with my name, so I'm gonna send back, you know, your paper with all the information with the, with my explanation of benefits. Is that OK?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, that sounds perfect. Yes, ma'am.
[CUSTOMER][NEUTRAL] But everything, OK, alrighty. Do I need to call and check back or do I need to do anything?
[AGENT][NEUTRAL] It will take, once we receive it, it will take 7 to 10 business days to process and you can call and check on it at that time.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK. OK, great, will do. Thank you so much for your help.
[AGENT][POSITIVE] You're very welcome is there anything else I can help you with before we go?
[CUSTOMER][POSITIVE] No, that's all. Thank you.
[AGENT][POSITIVE] OK, well, you have a wonderful week and thanks for calling APL.
[CUSTOMER][POSITIVE] You as well. Take care.
[AGENT][NEUTRAL] Mhm. You too. Bye-bye, ma'am.
[CUSTOMER][POSITIVE] Bye bye. Thanks. Bye bye.