AccountId: 011433970860
ContactId: 74cca698-1fb0-4309-bec9-34c3d1480e7e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 536099 ms
Total Talk Time (AGENT): 230681 ms
Total Talk Time (CUSTOMER): 290725 ms
Interruptions: 6
Overall Sentiment: AGENT=1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/24/74cca698-1fb0-4309-bec9-34c3d1480e7e_20250624T15:17_UTC.wav
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[AGENT][NEUTRAL] And thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII], uh, calling from Cleveland Clinic Foundation. How are you doing?
[AGENT][POSITIVE] I'm good, [PII]. How are you today?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][POSITIVE] Uh, thank you for asking us. I'm doing great. Meanwhile, uh, yeah, this call is regarding to get the patient coverage effective and term date.
[AGENT][POSITIVE] Good. Well, how can I help you today?
[AGENT][NEUTRAL] OK, you're needing eligibility law for a member, is that correct?
[CUSTOMER][NEUTRAL] Yeah uh
[CUSTOMER][NEUTRAL] Yes, yes, to get an eligibility and meanwhile to get whether this coverage is primary for the patient or not. OK. So, what information is required from my end?
[AGENT][POSITIVE] Yes, ma'am. I can help you with.
[AGENT][NEUTRAL] OK. And what is your callback number?
[AGENT][NEUTRAL] First off, what is your callback number?
[CUSTOMER][NEUTRAL] Yeah, before that, my callback number is, yeah, sure. My callback number is [PII].
[AGENT][NEUTRAL] Thank you. And the member's policy number, please?
[CUSTOMER][NEUTRAL] Yeah, sure. For American Public Life Insurance, the member ID is 01463092.
[AGENT][NEUTRAL] OK, thank you one moment [PII], while I get the member's information pulled up please.
[CUSTOMER][POSITIVE] OK, take it, ma'am. Not an issue.
[AGENT][POSITIVE] Alright, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK [PII], any information that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient's date of birth, which is on [PII], and the patient's name over your uh first name is [PII], and which is [PII].
[CUSTOMER][NEUTRAL] [PII]. The patient's last name is [PII], which is [PII].
[AGENT][NEUTRAL] OK, thank you. Now, on this particular policy number that you gave to me, um, she was the spouse of the subscriber. This is an old policy number though that is no longer active. They do have another policy that is active under a different number, but the policy number you gave me, it was active from [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Your name, please?
[AGENT][NEUTRAL] And the current, yes, but again, as I stated, there is another policy that is active.
[CUSTOMER][NEUTRAL] That
[AGENT][NEUTRAL] With a different policy number?
[AGENT][NEUTRAL] And the current AA policy is 02.
[CUSTOMER][NEUTRAL] Pa
[AGENT][NEUTRAL] 589452.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And this policy is active with an effective date of [PII].
[AGENT][NEUTRAL] Now, this is not this is not the primary insurance, [PII]. This is a supplemental plan to their primary insurance.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Supplemental for primary. OK. So,
[AGENT][NEUTRAL] Correct. So when if you all will be filing.
[CUSTOMER][NEUTRAL] As per your things.
[AGENT][NEUTRAL] Go ahead.
[CUSTOMER][NEUTRAL] Yeah, yeah, uh, like, as what you're saying, the American Public Life Insurance is a supplemental plan for some other primary coverage. Is that right?
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. For this coverage, like supplemental coverage is effective from this [PII], which is [PII]. Is that right?
[AGENT][NEUTRAL] That is for the policy number that you gave me.
[AGENT][NEUTRAL] 01463092. Mhm. That is correct.
[CUSTOMER][NEUTRAL] OK, that's the, that's the thing.
[CUSTOMER][NEUTRAL] Yeah, for American Life Insurance. OK.
[AGENT][NEUTRAL] Right, and then I gave you another policy number that is active.
[CUSTOMER][NEUTRAL] Uh, like
[AGENT][NEUTRAL] With a, the new policy number.
[CUSTOMER][NEUTRAL] Could you please let me know?
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Once again, the policy number, please.
[AGENT][NEUTRAL] Of the active policy.
[CUSTOMER][NEUTRAL] Uh, no, right, right now, we have only one, like one, some other policy is patient is having another one policy which is uh American Public Life Insurance. As you said, this is a supplemental plan for the primary, right?
[CUSTOMER][NEUTRAL] So as for your things, patient is having some other coverage for active for those, which is a data service over here which is on uh [PII]. So in accordance to the date of service, could you please let me know what other coverage this patient is having?
[AGENT][NEUTRAL] OK. So for the coverage for that data service, if it's for [PII], you would use the policy number that you gave me.
[AGENT][NEUTRAL] As her supplemental policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Because as I told you, the policy.
[CUSTOMER][NEUTRAL] OK, not a, uh, not a policy number. OK. The policy number which you have, OK, that's fine, that's, OK, that's fine. So the policy number which you have.
[AGENT][NEGATIVE] Not the new one.
[AGENT][NEUTRAL] I didn't realize that your service date was an old.
[CUSTOMER][NEUTRAL] The policy number which you have provided is not required right now, right? For [PII]?
[AGENT][NEUTRAL] Not for your data service, no, ma'am.
[CUSTOMER][NEUTRAL] OK, that's fine. Not an issue. We are uh looking over your onl[PII] for the date of service coverage. Not an issue, that's fine. So the policy number which you have given, like when was it effective and term date?
[AGENT][NEUTRAL] Her new policy or the one you gave me? For your data service.
[CUSTOMER][NEUTRAL] Yeah, new policy, new policy.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] The new policy number that I gave you went into effect [PII] and is active, but that would not be the policy number to use for the data service you gave me.
[CUSTOMER][NEUTRAL] Then it's not an issue?
[CUSTOMER][NEUTRAL] OK, I got your point completely. The policy number which you have given is not coinciding with the date of service. So as for the member ID which I have given is being active for the date of service but it's not a primary coverage. It's a supplemental coverage for the primary. Am I right over all statements?
[AGENT][NEUTRAL] Mhm
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK, fine. Your name, please?
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] My name is [PII]. You will use my name in today's date is your call reference number, and [PII], if you all will be filing a claim with us for this number.
[AGENT][NEUTRAL] You will also need to send us a copy of the primary insurance company's explanation of benefits along with the claim for review.
[AGENT][NEUTRAL] And also once we have processed the claim here at APL we have a portal that you should be able to check claim status in and the website that you would go to that, go to for that is located at [PII].
[CUSTOMER][NEUTRAL] OK. Like, uh,
[CUSTOMER][NEUTRAL] OK, got the point completely of all your statements like [PII], could you please spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] [PII], that is correct.
[CUSTOMER][NEUTRAL] The ACA?
[CUSTOMER][NEUTRAL] OK. Like as you're saying, I can use your name and date over here. So, in case if you are, if from our end, if you are billing to American Life Insurance, like from our end, uh, we have to provide you the explanation of benefits, right?
[AGENT][NEUTRAL] That is correct. The primary, you will need to send the primary in.
[CUSTOMER][NEUTRAL] In case if you are willing.
[CUSTOMER][NEUTRAL] In case if you are, from our end, if you are billing the American Life Insurance, we are supposed to provide you the explanation of benefits. Is that right?
[AGENT][NEUTRAL] From the primary insurance company along with your claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Fine, got it. OK, [PII]. First of all, uh thank you for letting me to get the information from your end. First of all, thank you for providing all this information in a very patient manner. Meanwhile, thank you for your assistance and have a nice day. Bye-bye, [PII].
[AGENT][POSITIVE] You're very welcome.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Oh, you're very welcome. So that's all I can help you with, [PII], thank you again for calling APL and I hope you have a very nice day also.
[CUSTOMER][POSITIVE] Yeah, you too as well bye bye thank you so much.
[AGENT][POSITIVE] Thank you. Oh, you're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] Yeah bye bye.