AccountId: 011433970860
ContactId: 52df1783-26c8-4730-a534-29eec6febf73
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345929 ms
Total Talk Time (AGENT): 134452 ms
Total Talk Time (CUSTOMER): 155470 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=2.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/52df1783-26c8-4730-a534-29eec6febf73_20250224T16:10_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APO. This is. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from the provider's office, Cleveland Clinic Foundation. I'm calling to check on a general claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, sir, definitely. And before that, uh, during your name, uh uh your voice broke, so could you please help me with your name?
[AGENT][NEUTRAL] Yeah, sure. That's [PII].
[CUSTOMER][NEGATIVE] Yeah, uh, still your voice broke.
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] Is this all, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Thank you so much, sir. And thank you so much for your patience. Uh, the callback number is?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's [PII] [PII].
[AGENT][NEUTRAL] OK. Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Yeah, sure, definitely. The policy number is 023.
[CUSTOMER][NEUTRAL] 126
[CUSTOMER][NEUTRAL] 35
[CUSTOMER][NEUTRAL] M as in Mike. L as in Lima. 8.
[AGENT][NEUTRAL] OK. Thank you. One moment.
[CUSTOMER][POSITIVE] You, you're welcome. Take your time.
[CUSTOMER][NEUTRAL] I don't know.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yes, sir. Uh, the name of the member is
[CUSTOMER][NEUTRAL] [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. May I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah, sure. Uh, the rate of service for the member is uh [PII].
[CUSTOMER][NEUTRAL] And the bill amount is uh $926 even 926.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, let me see if I can find this claim and for future, you can check claim status online through our website at [PII] and that's just optional.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] And that was a single date of service of [PII], correct?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, the claim is not on file.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Uh, we have submitted the claim, uh, on [PII], and the mailing address we use this [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That is the correct address, but we have not received that claim.
[CUSTOMER][POSITIVE] Thank you so much for the date of service of [PII] and for the bill amount of $926 even, you don't have the claim on file, right?
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] Thank you so much for the information. Could you please help me with the patient's policy effective date and term date?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah, sure, let me get that for you one moment.
[CUSTOMER][POSITIVE] Yeah, sure. Take your time.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] All right. The effective date of the policy is [PII] and it is active at the moment.
[CUSTOMER][POSITIVE] Thank you so much. And the mailing address I have provided to you is the correct one, right?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, it's [PII].
[CUSTOMER][POSITIVE] Thank you so much for the information. Could you please help me with the timely filing limit to submit the claim?
[AGENT][NEUTRAL] Yeah
[AGENT][NEGATIVE] We don't have timely filing limits.
[CUSTOMER][POSITIVE] OK. Thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with today?
[CUSTOMER][NEUTRAL] And yeah, could you please help me with the payer ID?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, uh, the payer ID is 60801. Again, that's 60801. Now this claim is preferably um sent by fax or mail due to the fact that we need the primary EOB attached to it.
[CUSTOMER][NEUTRAL] Yeah, sure, definitely. And could you please tell me with the fax number as well, please?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, that's [PII].
[CUSTOMER][NEUTRAL] So the last four digits of your wife [PII]. It's 877365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. And we can, uh, could you please give me the attention for the facts?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much. And there is no claim on file. There is no, there will be no claim number. Could you please help me with the call reference number, please?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's.
[CUSTOMER][POSITIVE] Thank you so much, uh, sure. And you are the secondary insurance, so while submitting, we need to submit to the primary UB, right?
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Correct, yes.
[CUSTOMER][POSITIVE] Thank you. Yeah, thank you so much, sir. Thank you so much for your patience and assistance. Thank you for assisting me today. That's all for today. Thank you so much for your patience and assistance. You have a great day. Thank you so much.
[AGENT][NEUTRAL] You
[AGENT][POSITIVE] You're welcome.
[AGENT][POSITIVE] You're welcome. You as well, Mr. [PII]. Bye bye.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, bye.