AccountId: 011433970860
ContactId: 5eca09d3-fddf-418c-98bb-d3c6362f79a0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 237869 ms
Total Talk Time (AGENT): 72182 ms
Total Talk Time (CUSTOMER): 106912 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/14/5eca09d3-fddf-418c-98bb-d3c6362f79a0_20250314T17:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. Good afternoon. My name is [PII], and I'm calling for the Cleveland Clinic Hospital to check on the claim status.
[AGENT][NEUTRAL] Sure, I can check on a claim for you. I'm sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] I could
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][POSITIVE] OK thank you and then can I get a good call back number from you in case we're disconnected please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] 256
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] Alright, thank you, and then did you have that policy number?
[CUSTOMER][NEUTRAL] Yeah, sure. Uh, the member ID is 019.
[CUSTOMER][NEUTRAL] 306-81
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, number 8.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what was the name and date of birth for the patient, please?
[CUSTOMER][NEUTRAL] It is [PII] and the date of birth is [PII].
[AGENT][POSITIVE] Perfect, thank you for verifying that and what was the date of service for this claim?
[CUSTOMER][NEUTRAL] It is [PII], but the total bill amount is $2,818.45.
[AGENT][POSITIVE] Got it thank you one moment please.
[CUSTOMER][NEUTRAL] the
[CUSTOMER][NEUTRAL] Really
[AGENT][NEUTRAL] OK, so we did receive this claim, uh, it looks like we're missing a copy of the primary EOB.
[CUSTOMER][NEUTRAL] So, may I know who is the primary insurance for this member?
[AGENT][NEUTRAL] I don't know if this is their uh secondary medical so I can't see that information.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] So, what is the family funding limit to submit the uh primary UV?
[AGENT][NEGATIVE] There's no timely filing limit.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So when I, because I could see in the primary, I could see this United Healthcare.
[CUSTOMER][NEUTRAL] So whether this is the primary
[CUSTOMER][NEUTRAL] Just to confirm from you guys.
[AGENT][NEUTRAL] Oh yeah you can send that to us um I've got a fax number if you'd like to send it that way or I've got a mailing address.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, thank you.
[CUSTOMER][NEUTRAL] OK. And what is the fax number?
[AGENT][NEUTRAL] It
[AGENT][NEUTRAL] Yes, that fax number is 877.
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] OK. And uh there is no time limit for the, uh, to send the UP, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. But I could see we have already submitted the along the claim with the UB. I could see the document control number if you need.
[CUSTOMER][NEUTRAL] Shall I give you that?
[AGENT][NEUTRAL] We have not received the primary EOB. If we have, it may not have been a detailed EOB that shows uh what was contributed to co-pay, deductible or co-insurance.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, because they have transferred the amount for uh non-covered service as for the patient responsibility.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] What was that? I'm sorry, it's a little bit difficult to hear you.
[CUSTOMER][NEUTRAL] No, uh, primary insurance has already transferred the amount with the non-covered service with $409.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, yeah, so we just need that information sent to us.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] OK, yeah, thanks for calling ATL. Have a great rest of your day.
[CUSTOMER][POSITIVE] You too. Happy weekend. Bye.