AccountId: 011433970860
ContactId: 7515e37f-75c7-4c8d-8a28-f47b6960d2c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 233009 ms
Total Talk Time (AGENT): 90319 ms
Total Talk Time (CUSTOMER): 72935 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/7515e37f-75c7-4c8d-8a28-f47b6960d2c4_20250226T16:43_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, hello, this is uh [PII], and I'm calling from Cleveland Clinic Florida, and well it's to check eligibility and benefits for a patient.
[AGENT][NEUTRAL] OK, I can help you with eligibility and benefits for the patient. And what was your name again, please?
[CUSTOMER][NEUTRAL] Sure, it's [PII] is [PII]
[AGENT][NEUTRAL] OK, En, what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, sir. And then what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] The name is [PII]. Date of birth is [PII].
[CUSTOMER][NEUTRAL] And the policy number is 02555994.
[AGENT][NEUTRAL] OK, let me look up her policy real quick.
[AGENT][NEUTRAL] All right, I do show that [PII] does have an active policy. Her effective date is [PII].
[AGENT][NEUTRAL] And this is just to verify her coverage. It's a guarantee of payment. She has an inpatient benefit amount uh of $7500 and an outpatient benefit amount of $7500 for deductible, co-pay or co-insurance. This is a secondary insurance. It's billed after the primary.
[CUSTOMER][NEUTRAL] OK, so for example, uh, office visit will be processed once the primary sends the claim to your office, right?
[AGENT][NEUTRAL] The primary is processed first and and we're processed second.
[CUSTOMER][NEGATIVE] There is no.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, yes, and there is no accumulators or the of is.
[CUSTOMER][NEUTRAL] Like a copay deductible.
[AGENT][NEUTRAL] Uh,
[AGENT][NEUTRAL] Let me look and see. No, ma'am, no, sir, I do not see a deductible.
[CUSTOMER][NEUTRAL] OK, and does the plan has a network?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] So it's open access, I believe.
[AGENT][NEUTRAL] Right, it, it, um, when, when they bring in their primary medical insurance card, they bring this one too. So it, um, it's based on.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The primary paying first.
[AGENT][NEUTRAL] Because it's just a gap insurance.
[CUSTOMER][NEUTRAL] OK, and well, question, a gap, OK, and about those 7500, how much has been used?
[AGENT][NEUTRAL] Let me check for you.
[AGENT][NEGATIVE] Nothing has been used for the year of [PII].
[CUSTOMER][POSITIVE] OK, well, perfect, thank you so much so this is all for now. I just need a conference number please.
[AGENT][NEUTRAL] Yes sir, you can use my name and today's date. My name is [PII].
[CUSTOMER][POSITIVE] Yes sir you can
[CUSTOMER][POSITIVE] OK, got it. Thank you so much.
[AGENT][POSITIVE] You're very welcome. You have a good day and thank you for calling APL.
[CUSTOMER][POSITIVE] Likewise thank you goodbye.
[AGENT][NEUTRAL] Bye-bye, sir.