AccountId: 011433970860
ContactId: 4b14f666-6843-4f42-a8db-a38b2d240e7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1232420 ms
Total Talk Time (AGENT): 242749 ms
Total Talk Time (CUSTOMER): 237839 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=-0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/16/4b14f666-6843-4f42-a8db-a38b2d240e7b_20250516T19:46_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 my is [PII] calling from provider's office to check on a claim status. If you don't mind, could you please spell your name for me?
[AGENT][NEUTRAL] That's [PII], last initial [PII]. May I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] May I have the name of the facility you're calling from?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Cleveland Clinic Foundation, CCF Weston, MOB [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] 2,473,050.
[AGENT][POSITIVE] Thank you, one moment.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] with the bill amount $336 even.
[AGENT][NEUTRAL] No, it's [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm gonna try one more time.
[AGENT][NEUTRAL] I don't have a claim for that date of service.
[CUSTOMER][NEUTRAL] OK. May I know the member effective and term dates, please?
[AGENT][NEUTRAL] Mhm, sure.
[AGENT][NEUTRAL] Effective date is [PII]. It is active at the moment.
[CUSTOMER][NEUTRAL] OK, thank you. May I know the payer ID please?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] Thank you. May I know the mailing address, please?
[AGENT][NEUTRAL] [PII], [PII]. Zip code is [PII].
[CUSTOMER][NEUTRAL] OK, thank you. May I get the timely firing limit, please?
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] We don't have timely plan limits.
[CUSTOMER][POSITIVE] OK, thank you. Uh,
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have 3 more claims to check. Can you provide the status, please?
[AGENT][NEUTRAL] Same member, different members?
[CUSTOMER][NEUTRAL] I, I only say one to the same number and
[CUSTOMER][NEUTRAL] Two other members are different.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the next policy?
[CUSTOMER][NEUTRAL] It is 2,473,050. It is on the same patient.
[CUSTOMER][NEGATIVE] But it is under different bill amount.
[AGENT][NEUTRAL] OK, what's the amount?
[CUSTOMER][NEUTRAL] Give me a moment. 336, it is also same bill amount only.
[AGENT][NEUTRAL] Same date or different date?
[CUSTOMER][NEUTRAL] Uh, it is on a different date.
[AGENT][POSITIVE] That's great.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, the claim is not on file for [PII]?
[CUSTOMER][NEUTRAL] And may I know the member effective and term dates? It is same like [PII] to active, am I right?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Just give me a moment while I provide you the details.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, sorry, ready for the next policy ID?
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] 02377454 M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII] with the bill amount $135 even.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] I'm waiting on the system.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] Waiting on the system.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][NEUTRAL] Can you verify the procedure code?
[CUSTOMER][NEUTRAL] 97,110.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we received the claim [PII], processed [PII].
[AGENT][NEUTRAL] And we send a benefit amount of $27.37 to the provider.
[CUSTOMER][NEUTRAL] Uh, allowed amount is $27.31. Am I right?
[AGENT][NEUTRAL] 2737.
[CUSTOMER][NEUTRAL] 37. OK. May I know paid the amount?
[AGENT][NEUTRAL] 2737.
[CUSTOMER][NEUTRAL] OK. Is there any member responsibility?
[AGENT][NEUTRAL] None that I can see.
[CUSTOMER][NEUTRAL] And is it paid under EFT or cash? Check?
[AGENT][NEUTRAL] Is a check, single check, paper check?
[CUSTOMER][NEUTRAL] OK, single shack. May I know single amount, please?
[AGENT][NEUTRAL] That is
[AGENT][NEUTRAL] OK, the same amount, 2737.
[CUSTOMER][NEUTRAL] OK. Give me a moment, please.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. May I get the check number, please?
[AGENT][NEUTRAL] insurance number is 1869305.
[CUSTOMER][NEUTRAL] 1869305. Am I right?
[AGENT][NEUTRAL] 1869305.
[CUSTOMER][POSITIVE] OK, thank you so much. May I know pay to address, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, I'll have to pull that information, bear with me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so, um, the check went to [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And may I know when was the check issued and clear date, please?
[AGENT][NEUTRAL] The issue date is the same as the process date.
[CUSTOMER][NEUTRAL] Same as the process date and
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] When was the check clear date?
[AGENT][NEUTRAL] I don't see a clear date.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] I don't see a clear date.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you fax me the UP please?
[AGENT][NEUTRAL] Mhm. What's the fax number?
[CUSTOMER][POSITIVE] Yes, I'm providing you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII]. And attentio[PII] to number [PII], [PII].
[AGENT][NEUTRAL] OK, let me repeat this back to you. That's [PII] is the fax number.
[AGENT][NEUTRAL] And the attention to is [PII] as in [PII] [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, you're right.
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][NEUTRAL] OK, sure.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] You
[AGENT][POSITIVE] Thank you for holding and being patient for me. Yeah, I went ahead and send that over to you. It should be there in a few minutes, Miss [PII].
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] I went ahead and send that over to you should be there in a few minutes.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] Hello, can you hear me?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] Thank you for holding, Ms. [PII]. Can you hear me?
[CUSTOMER][NEUTRAL] Yes, I'm there.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes you're audible now.
[AGENT][NEUTRAL] OK, um, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, I will ask one more member to check.
[AGENT][NEUTRAL] OK, um,
[AGENT][NEUTRAL] What is the policy number?
[CUSTOMER][POSITIVE] Yes, I'm providing you.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 24, sorry, it is 2341084. M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][NEUTRAL] OK, what's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] [PII] with the billed amount $690 even.
[AGENT][NEUTRAL] OK, let me see if I can find this one.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What is the procedure code?
[CUSTOMER][NEUTRAL] 20,610.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I don't have that claim on file.
[CUSTOMER][NEUTRAL] OK. May I know member effective and term dates, please?
[AGENT][NEUTRAL] Mhm, yes.
[AGENT][NEUTRAL] Effective date is [PII] and it's still active at the moment.
[CUSTOMER][NEUTRAL] OK, thank you so much. And well, I got a required info from you today. Can you provide me the call reference number for all these claims?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date.
[CUSTOMER][POSITIVE] OK, thank you so much. And uh it was nice talking to you. Have a nice day ahead and stay safe. Happy weekend. Bye-bye.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] You as well thank you for calling bye bye.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Mm.