AccountId: 011433970860
ContactId: 7e49c938-abd8-48c8-93cb-c418b4352cc0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 702010 ms
Total Talk Time (AGENT): 208384 ms
Total Talk Time (CUSTOMER): 163764 ms
Interruptions: 1
Overall Sentiment: AGENT=1.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/7e49c938-abd8-48c8-93cb-c418b4352cc0_20250530T14:18_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling APL this is how may I help you?
[CUSTOMER][POSITIVE] Thank you
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling from provider's office for claim status. Can you spell out your name, please?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] OK, [PII], good morning.
[AGENT][NEUTRAL] And [PII], what is your good morning, what is your callback number, sir? So I can help you with the claim status today.
[CUSTOMER][NEUTRAL] OK, sorry. My contact number is [PII].
[AGENT][NEUTRAL] Thank you, sir. And then may I have the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. [PII] will be the date of birth and the member's ID 1428975.
[AGENT][NEUTRAL] OK, let me pull that policy in for us.
[AGENT][NEUTRAL] And then may I have [PII]'s date of service and charge amount?
[CUSTOMER][NEUTRAL] [PII] with $135 even.
[AGENT][NEUTRAL] And then what was the charges after the primary insurance paid their part?
[CUSTOMER][NEUTRAL] $37.04 is the remaining balance.
[AGENT][NEUTRAL] Thank you, sir. And may I please have the name of the facility that you're calling from?
[CUSTOMER][NEUTRAL] Facility name is Cleveland Clinic Foundation.
[AGENT][NEUTRAL] OK, [PII], I'm gonna look up this claim for you. I'm gonna put you on a quick hold and I'll be right back, sir.
[CUSTOMER][NEUTRAL] OK. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you [PII] for holding for me. So looking on the data service of [PII] for [PII], I do not find a claim on file.
[CUSTOMER][NEUTRAL] OK, [PII], so may I know the patient effective and term dates?
[AGENT][NEUTRAL] Yes, sir. The effective date is [PII] and the policy is still active and current.
[CUSTOMER][NEUTRAL] OK. Is there a time limit to submit the, I mean the claim again, sorry?
[AGENT][NEUTRAL] No, there's not a timely filing limit you can resubmit.
[CUSTOMER][NEUTRAL] OK. Uh, could you please verify the mailing address? Uh, is it [PII]?
[AGENT][POSITIVE] Yes, sir. That's correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And uh.
[CUSTOMER][NEUTRAL] Uh, I do have one more patient. Can you help me with that?
[AGENT][NEUTRAL] Yes, what's the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Yeah, before that, what will be the caller number for this patient.
[AGENT][NEUTRAL] It will be my name, [PII] and today's date, and that's also gonna be the uh reference number for the next one too.
[CUSTOMER][POSITIVE] OK, [PII], thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And the next patient.
[CUSTOMER][POSITIVE] Yeah, it's my pleasure talking with you.
[AGENT][POSITIVE] Thank you, sir.
[CUSTOMER][NEUTRAL] And the uh next patient ID?
[AGENT][POSITIVE] Yes, I'm ready.
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] 021
[CUSTOMER][NEUTRAL] 49,690.
[AGENT][NEUTRAL] And the patient's name and date of birth, yes, go ahead.
[CUSTOMER][NEUTRAL] Patient name is [PII].
[CUSTOMER][NEUTRAL] Yeah, yeah, going on it. Uh, [PII], [PII].
[AGENT][NEUTRAL] OK, let me pull her policy in for us.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and may I please have the date of service and the charge amount?
[CUSTOMER][NEUTRAL] [PII] with $336 even.
[AGENT][NEUTRAL] And then after the primary paid their part, what is the balance?
[CUSTOMER][NEUTRAL] $60 even.
[AGENT][NEUTRAL] Thank you sir and then is it also for Cleveland Clinic?
[CUSTOMER][NEUTRAL] Yeah, Cleveland Clinic Foundation only.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK thank you sir. I'm gonna put you on a quick hold again I'm gonna look this one up for us and I'll be right back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, [PII].
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you so much [PII] for holding for me. So looking on the data service of [PII] for Ms. [PII], I do not find the claim on file, sir.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, [PII]. So for this member, what will be the effective and terminates?
[AGENT][NEUTRAL] On that policy, that policy that you gave me terminated, uh, let's look.
[AGENT][NEUTRAL] the effective date was [PII] and it terminated on [PII].
[AGENT][NEUTRAL] And then a new policy was issued.
[CUSTOMER][NEUTRAL] But our data service.
[AGENT][NEUTRAL] Then a new policy was issued, um, the policy number is 2300971.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It was issued on [PII].
[AGENT][NEUTRAL] And it lapsed on [PII].
[AGENT][NEUTRAL] And they do have a.
[AGENT][NEUTRAL] An active policy. Let me give you that policy number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It's 246-6999.
[AGENT][NEUTRAL] The effective date of the active policy is [PII].
[AGENT][POSITIVE] And it is active and current.
[CUSTOMER][NEUTRAL] So for our data service, patients have the active insurance and uh
[CUSTOMER][NEUTRAL] Policy number is
[CUSTOMER][NEUTRAL] Same, I think. Let me check.
[AGENT][NEUTRAL] It, it's 24669999.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That's the active.
[CUSTOMER][NEUTRAL] So we can consider as an active policy for the patient, right? So we can go ahead and even resubmit as we don't have DSL.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. The call reference number, same and mailing address is also correct, right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] OK, sorry. Thank you for providing me the information.
[AGENT][POSITIVE] You're very welcome, [PII].
[CUSTOMER][NEUTRAL] And do you have
[CUSTOMER][NEUTRAL] Uh, I have one thing to ask. Do we have any portal for this American life insurance? Is it still registerable?
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, let me give you the address to the portal.
[AGENT][POSITIVE] It is secured, [PII]
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. Got it.
[CUSTOMER][NEUTRAL] So we can register here, right?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][POSITIVE] OK. Thank you.
[AGENT][POSITIVE] You're welcome, [PII]. Is that everything I can help you with today before we go?
[CUSTOMER][POSITIVE] Yes. Nothing else. Thank you very much.
[AGENT][POSITIVE] OK, well you have a wonderful weekend sir and thank you for calling APL.
[CUSTOMER][POSITIVE] Happy weekend. Bye-bye.
[AGENT][NEUTRAL] Bye-bye.