AccountId: 011433970860
ContactId: 5e37f110-0892-42d2-ab66-87b588604976
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 529619 ms
Total Talk Time (AGENT): 125448 ms
Total Talk Time (CUSTOMER): 379636 ms
Interruptions: 2
Overall Sentiment: AGENT=2.4, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/5e37f110-0892-42d2-ab66-87b588604976_20250220T14:18_UTC.wav
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[AGENT][POSITIVE] Good Morning thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I work for Cleveland Clinics, um, customer service, and I'm trying to, um, I have a patient on my back line that's, um, claiming he's got you guys a secondary insurance, and I couldn't validate it within one source. So you guys medical insurance?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] We do have medical insurance, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, so can you, can we go through and validate and see if I'm able to build these dates of services? Um, one of them is an older data service. I told him I said I'm, I'm not sure if I can build that because it might be timely filing, and that would've been on his part because he never submitted it to us, OK, um, but I have another date that was in January.
[AGENT][POSITIVE] I'll be happy.
[AGENT][POSITIVE] All right, well, I'll be happy to assist you with eligibility, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] Um, [PII]. I'm sorry.
[AGENT][NEUTRAL] All right. Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Um, he gave me 02, um, 02505687.
[CUSTOMER][NEUTRAL] For [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what is [PII]'s date of birth, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][POSITIVE] And it'll be my pleasure to help you with that eligibility, [PII]. His policy is active. Effective date is [PII].
[AGENT][NEUTRAL] There's no tell me filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] There's no timely filing?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Alright, OK, so let me just do a couple things, OK, because I, I have to put this information in with you because the case of service I'm looking for for 6-23-2024 and then [PII] of this year, so I'm able to file those then, correct?
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Absolutely. Yes, ma'am. Now, we will need the primary EOB. We are secondary to his major medical insurance.
[CUSTOMER][NEUTRAL] OK, in which we would know that if we're gonna send that. OK, so let me just um do something else and um and then the name of your, I, I don't know, I couldn't find it anywhere, [PII] and then we'll put [PII] and then [PII], do you have happen to have a reference number for this call?
[AGENT][NEUTRAL] It would be my name in today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] OK, I put today's date [PII] if you could just, I just, it might just take me a minute, but I wanna be able to get all this information and billing information to in just a moment, OK? um.
[AGENT][NEUTRAL] Sure.
[AGENT][POSITIVE] Not a problem at all.
[CUSTOMER][NEUTRAL] Yeah. All right, so let me just um let me just, can you mind holding for just a moment while I check in with the patient, let him know I'm speaking to somebody.
[AGENT][POSITIVE] Sure, that'll be fine. Uh take your time. You're welcome.
[CUSTOMER][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] All right, OK, I'm back thank you alright and then let's go put this over here called.
[CUSTOMER][NEUTRAL] Call to validate.
[CUSTOMER][NEUTRAL] Coverage for dates of services, uh, reps stated, insurance.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Effective [PII] and no timely filing, right? Penalties.
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] And would need EOB to process claim.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] From primary insurance, OK, and then let's do that. And then yes, we're gonna do uh one IU to add this insurance and yes, of course, I would read the notes. Why would I never do that, right? Um, OK, so.
[CUSTOMER][NEUTRAL] All right, yeah, uh, I know, I know it's just like some of the questions are redundant. I don't know about you. I'm just like, OK, OK, so now we're gonna actually add it, which will get them to bill it, OK? So let's do this and let's do no and A. These are the accounts we need to bill. Did you check to see if we, yes, I did, um, add in secondary.
[AGENT][POSITIVE] I'm right there with you. I understand.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And what is it currently none.
[CUSTOMER][NEUTRAL] Listed um and then is the correct name just APL?
[AGENT][NEUTRAL] It is. It stands for American Public Life. We're the same, but we go by APL.
[CUSTOMER][NEUTRAL] American.
[CUSTOMER][NEUTRAL] Public.
[CUSTOMER][NEUTRAL] Life.
[CUSTOMER][NEUTRAL] All right, and then, um, no, OK, OK, then we'll put.
[CUSTOMER][NEUTRAL] [PII] all right for your last name [PII] and [PII].
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] And then that's gonna be um [PII] so primary.
[CUSTOMER][NEUTRAL] Is [PII] and secondary is [PII] effective date [PII] and the ID number is 0250687, right? 025056887.
[AGENT][NEUTRAL] Mhm. Right.
[CUSTOMER][NEUTRAL] Right, so 0 I'm gonna read back 02505687. Is there a group number or no?
[AGENT][NEUTRAL] Group number is 16944.
[CUSTOMER][NEUTRAL] OK, 16944 and then where do we need to mail this this claim?
[AGENT][NEUTRAL] You can mail it to [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], [PII] OK. Ok, [PII], [PII].
[AGENT][POSITIVE] That's right.
[CUSTOMER][NEUTRAL] [PII] State, right? OK. And what's, what's the zip code?
[AGENT][POSITIVE] That's right.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] You can
[CUSTOMER][NEUTRAL] OK, [PII], what is that [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, OK, so it's [PII], correct?
[AGENT][NEUTRAL] That's correct. And you can also fax claims directly to our claims department.
[CUSTOMER][NEUTRAL] And what's the fax number?
[AGENT][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Claims can also be faxed right and then uh a good provider number I mean um I dialed [PII] is that a good number to call or do you guys have a different provider number?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, that is our uh.
[AGENT][NEUTRAL] Phone number.
[CUSTOMER][NEUTRAL] OK, OK, then [PII] and I hit option one.
[AGENT][POSITIVE] That's right.
[CUSTOMER][POSITIVE] For that, OK, and then it was, uh, you guys, it was, listen, I'd rather call you guys than anybody else because it was quick it was quick and very efficient. So some of these, I don't know if you have the problem, but some of them are just really hard, especially anthem to get through to with the with the automated. So I was like when I got you right away I was like, oh my goodness, this is so nice. I'll call them any time. So please pass that on. I call.
[AGENT][POSITIVE] Good.
[AGENT][NEUTRAL] Oh yeah
[AGENT][NEUTRAL] Well, you just call us if you need us.
[CUSTOMER][POSITIVE] Yeah, yeah, it, but it's nice to be able, you know, some of them you have to go through all this rigor more and it was really nice calling you you guys. So I was like, OK, let's try to call him and I told the patient I said it might be a little bit and then, but it was quick, so I never know when I call insurance, yeah, but to pass that along. It was really pleasant so and then you've been wonderful so thank you. Alright, so.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I like to hear that.
[AGENT][POSITIVE] It's my pleasure.
[CUSTOMER][POSITIVE] Yeah, and so we, we always, I'll tell the patient that sometimes it takes up to 30 days for us to like submit payment and then hear back from insurance. So I'm gonna submit this request and someone may be in contact with the patient if they need any additional information, but I really appreciate you helping me today, [PII], OK?
[AGENT][POSITIVE] It's been such a pleasure to assist you, [PII]. Thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You have a wonderful day too, OK? Take care. Bye, bye-bye.
[AGENT][POSITIVE] Thank you. Bye-bye. You too.