AccountId: 011433970860
ContactId: 4fcfa7a7-9b30-4b17-82ca-eadc423d69f1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 392679 ms
Total Talk Time (AGENT): 116530 ms
Total Talk Time (CUSTOMER): 191428 ms
Interruptions: 4
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/10/4fcfa7a7-9b30-4b17-82ca-eadc423d69f1_20250410T12:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII] calling from Cleveland Clinic Foundation. I need to check on patient eligibility and claim status.
[AGENT][NEUTRAL] OK, I didn't quite understand your name can you spell it for me?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, uh, [PII], and you said you're checking benefits?
[CUSTOMER][NEUTRAL] Benefits and claim status. No eligibility, not benefits.
[AGENT][NEUTRAL] Just eligibility dates, OK, and what's the policy number?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It's 02317115 M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] And what's a good call back number in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, I I got the [PII]. What were the first three digits?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. One moment.
[AGENT][NEUTRAL] And what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's [PII] and the, you just need the patient's date of birth, right?
[AGENT][NEUTRAL] Mhm. Their name and date of birth.
[CUSTOMER][NEUTRAL] On the date of uh it's.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Alright, thank you. I have the eligibility information. I'm showing an effective date of [PII]. Uh, the policy is active at this time, and did you have any other questions, [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh, may I know your primary insurance or secondary insurance?
[AGENT][NEUTRAL] Secondary.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] OK. And who is primary?
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Are you calling on behalf of the doctor's office or you're a third party?
[CUSTOMER][NEUTRAL] Calling on behalf of uh uh physician's office.
[AGENT][NEUTRAL] OK. I'm showing Aetna is the primary insurance, but you'll need to verify that with your patient as well.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. Uh, could you please check if any, yeah, could you please check if any, any claims are reviewed on [PII]?
[AGENT][NEUTRAL] Anything else?
[AGENT][NEUTRAL] OK, so now you're checking a claim status?
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the amount?
[CUSTOMER][NEUTRAL] It's uh
[CUSTOMER][NEUTRAL] $628 even.
[AGENT][NEUTRAL] And what was the service for?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Service.
[CUSTOMER][NEUTRAL] Uh, can you hold for a second?
[AGENT][NEUTRAL] And what is the name of the, the practice?
[CUSTOMER][NEUTRAL] Uh it's uh, it's Cleveland Clinic Foundation.
[AGENT][NEUTRAL] OK, so I'm not showing a claim on file for [PII] for $628.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, actually, we have submitted the claim through PayPal. Could you please check if you have received anything?
[AGENT][NEUTRAL] OK, so we've not received the date of service that you provided and what address was the claim mailed to?
[CUSTOMER][NEUTRAL] Any paper claims?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] We are mailed to [PII].
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, that's what how we submitted.
[AGENT][NEUTRAL] Oh, I thought you said 284. Yeah, I'm not showing that date of service for that charge for on file.
[CUSTOMER][NEUTRAL] This.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] OK. Uh, can, uh, can we submit the claim?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh, may I know the payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. Could you please check if you have received any claim for another data service for the same patient.
[AGENT][NEUTRAL] OK, go ahead and give me all the dates of service that you have, ma'am.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And the amount.
[CUSTOMER][NEUTRAL] It's $445 even. Yeah.
[AGENT][NEUTRAL] Same provider?
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm not showing this claim receipt on uh as of this date.
[CUSTOMER][NEUTRAL] This is also sent to the paper. Could you please check?
[AGENT][NEUTRAL] Yeah, I, I checked and it's not on file.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, thank you. Uh, the mailing address is, this is right, the mailing address, this is right, [PII]. Yeah.
[AGENT][NEUTRAL] All right. Anything else?
[AGENT][NEUTRAL] OK, do you wanna repeat the mailing address?
[AGENT][NEUTRAL] If you can repeat the mailing address please.
[CUSTOMER][NEUTRAL] It's [PII] [PII]. Oh, sorry, [PII].
[AGENT][NEUTRAL] It's [PII]
[CUSTOMER][NEUTRAL] So [PII].
[AGENT][NEUTRAL] Mhm [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, thank you. Could you please spell your name?
[AGENT][NEUTRAL] You'll use my name and today's date as reference for today's call [PII], first initial last name is [PII]. Anything else, [PII]?
[CUSTOMER][POSITIVE] No, it's enough. Thank you, [PII]. Thanks. Have a nice day. Bye-bye.
[AGENT][POSITIVE] You're welcome thanks for calling APL have a good day.
[CUSTOMER][NEUTRAL] Mm