AccountId: 011433970860
ContactId: 465b702b-895e-4254-93ac-946889a10d3e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209220 ms
Total Talk Time (AGENT): 68938 ms
Total Talk Time (CUSTOMER): 91401 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/465b702b-895e-4254-93ac-946889a10d3e_20250508T20:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, how are you? My name is um I'm from Cleveland Clinic, and I don't know if you can hear me, but I have a patient and I need to verify if the patient is active.
[AGENT][NEUTRAL] OK, we can verify eligibility. What's their policy number?
[CUSTOMER][NEUTRAL] OK, we can verify it.
[CUSTOMER][NEUTRAL] Is 152-611.
[CUSTOMER][NEUTRAL] 0 M as Mike L as Lima 8.
[AGENT][NEUTRAL] Thank you. And then, what is the patient name and date of birth?
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] The name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. So, patient is active. Uh, the effective date on here is [PII].
[CUSTOMER][NEUTRAL] And there is no ammunition day, right?
[AGENT][NEUTRAL] Correct. Policy is still active and were the members secondary insurance, so this will cover deductible, co-pay, co-insurance, the primary does not.
[CUSTOMER][NEUTRAL] OK, perfect. I also I don't know if we can check if, well, I don't know if we can check if we are in network with the patient's plan.
[AGENT][NEUTRAL] There's no network required because it follows the pri primary.
[CUSTOMER][POSITIVE] There's no network required because it follows our primary. OK, perfect.
[AGENT][NEUTRAL] Is there anything else I can check on?
[CUSTOMER][NEUTRAL] So in this case.
[CUSTOMER][NEUTRAL] Yes, in this case if I have an authorization code, this, this I can say this with with you or is with the primary.
[AGENT][NEUTRAL] Well, so we're gonna pick up whatever the primary doesn't. Uh they being seen on an outpatient or an inpatient basis.
[CUSTOMER][NEUTRAL] Well, so we're gonna pick up whatever the primary doesn't is they being seen on an outpatient or an inpatient basis.
[CUSTOMER][NEUTRAL] But this one is going to see an outpatient.
[AGENT][NEUTRAL] So the member's benefit on the plan for outpatient is calendar day and the benefit max is $1000 a day.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][POSITIVE] OK perfect um.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Can we check a CPT code if for see if there is a, I don't know authorization required.
[AGENT][NEUTRAL] No prior authorization is required with this plan.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Perfect. And
[CUSTOMER][NEUTRAL] OK, and just for my records, I don't know if you can repeat, uh, repeat me your name.
[AGENT][NEUTRAL] My name is [PII], that's [PII] My last initial is [PII].
[CUSTOMER][POSITIVE] Perfect. Your reference number please.
[AGENT][NEUTRAL] Call reference is my name with my last initial and today's date.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][POSITIVE] Perfect thank you thank you so much for your help.
[AGENT][POSITIVE] You're welcome. Have a good day.
[CUSTOMER][POSITIVE] You too bye bye thank you