AccountId: 011433970860
ContactId: 7d426ddf-feaa-4502-b7aa-2ce9f20e3b0c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 300160 ms
Total Talk Time (AGENT): 148727 ms
Total Talk Time (CUSTOMER): 93527 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/7d426ddf-feaa-4502-b7aa-2ce9f20e3b0c_20250408T12:14_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]. My name is [PII] calling from Cleveland Clinic Foundation. I want to check on patient eligibility.
[AGENT][NEUTRAL] OK, [PII], you only need eligibility and not benefits, is that correct?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am, I can help you with that. and [PII]. My name is [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][POSITIVE] OK, thank you. OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, got it.
[AGENT][POSITIVE] And [PII], yes, ma'am. I can help you with eligibility. What is a good callback number for you, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And your extension?
[CUSTOMER][NEUTRAL] Uh, it's a direct line.
[AGENT][NEUTRAL] OK, and the patient's policy number, please, [PII].
[CUSTOMER][NEUTRAL] Yeah, sure. It's uh 02317115, M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] OK thank you one moment while I get the member's information pulled up please.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And any information that I do provide for you today, [PII], would be a verification of benefits and not a guarantee of payment. What is your patient's name and date of birth?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Patient's name is [PII], and the date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Uh, I
[CUSTOMER][NEUTRAL] I know the
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, so I, and again one more time, any information provided today, [PII] would be a verification of benefits and not a guarantee of payment. I do show she is the spouse.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Of the subscriber on this supplemental policy and it is active with an effective date of [PII].
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And if you all will be filing a claim with us for her, we will also have to have a copy of her primary insurance company's explanation of benefits as well.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And then once we process our claim here at APL, we do have a portal that you should be able to check claim status in.
[AGENT][NEUTRAL] And that website for our portal is located at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Patient is uh still current active, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Uh, you're the second insurance, right?
[AGENT][NEUTRAL] Why isn't anyone
[AGENT][NEUTRAL] Why
[AGENT][NEUTRAL] Pardon me?
[CUSTOMER][NEUTRAL] Uh, you are the secondary insurance, right?
[AGENT][NEUTRAL] That is correct. That is why we must uh have a copy of her primary insurance company's explanation of benefits along with her claim for review.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, OK. Uh, may I know who's primary insurance?
[AGENT][NEUTRAL] According to our records for her husband's employer, it's Aetna, but she would have to contact them for detailed information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK, got it. Like may I know the claim's mailing address?
[AGENT][NEUTRAL] For APL it is [PII].
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] That's [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And the zip code is [PII].
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] OK. May I know the uh payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK. Thank you, [PII]. May I know the call reference number for today's call?
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Yes, ma'am, you would use my name along with today's date.
[CUSTOMER][POSITIVE] OK. Thank you, [PII]. Thank you. Have a nice day. Bye-bye.
[AGENT][POSITIVE] Well, you're welcome. So if that is all I can help you with then, [PII], thank you again for calling APL and I hope you have a very nice day.
[CUSTOMER][NEUTRAL] What
[CUSTOMER][NEUTRAL] Mm. You too, bye-bye.
[AGENT][POSITIVE] Thank you, bye-bye.
[CUSTOMER][NEUTRAL] Yeah