AccountId: 011433970860
ContactId: a62e2037-6581-4821-a69f-baf9e0895002
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 299910 ms
Total Talk Time (AGENT): 124451 ms
Total Talk Time (CUSTOMER): 93392 ms
Interruptions: 4
Overall Sentiment: AGENT=1.3, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/a62e2037-6581-4821-a69f-baf9e0895002_20250415T17:59_UTC.wav
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[AGENT][POSITIVE] Good. 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, Florida, checking on claim status.
[AGENT][NEUTRAL] OK, [PII], so you're needing to check claim status for a member, is that correct? Yes, ma'am, I can help you with that. And what is a good call back number for you please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII] no extension.
[AGENT][NEUTRAL] Thank you and you only have one claim to check status on, is that correct?
[CUSTOMER][NEUTRAL] Yes, mhm.
[AGENT][NEUTRAL] Yes, ma'am, I can help you. And what is the patient's policy number?
[CUSTOMER][NEUTRAL] Policy number is 02549402.
[AGENT][POSITIVE] Thank you one moment please.
[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] Patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for employees [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Billed amount $39,06.35.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, so I do show that this claim has been received. The receipt date on the claim was [PII].
[AGENT][NEUTRAL] It was processed and the benefit paid on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is going to be 356-441-3.
[AGENT][NEUTRAL] And would you like the check number that it was paid on?
[CUSTOMER][NEUTRAL] Um, how much did the client, um, pay?
[AGENT][NEUTRAL] $1,111.
[CUSTOMER][NEUTRAL] OK, um, did anything deny out?
[AGENT][NEUTRAL] I'm sorry, what did you ask, [PII]?
[CUSTOMER][NEUTRAL] Was, was, was there a denial on the claim?
[AGENT][NEUTRAL] No, ma'am. No, ma'am. This policy is designed to help with co-pays, deductibles, and co-insurance amounts of coverage services.
[CUSTOMER][NEUTRAL] OK, so let me see policy.
[CUSTOMER][NEUTRAL] Only
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Deductible and coinsurance.
[CUSTOMER][NEUTRAL] OK, and let me see, I think that would be all.
[CUSTOMER][NEUTRAL] OK. And then, um, yes.
[AGENT][NEUTRAL] And if you should, I'm so, oh, I'm sorry. Go ahead with what you were gonna ask before I tell you what I was gonna tell you.
[CUSTOMER][NEUTRAL] No, I was gonna say no check numbers needed.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Alright, and then if you should need a copy of this explanation of benefits we do have a portal that you should be able to use with that claim number to get that and our portal website is located at secured.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] A public [PII]. OK, I got it. OK, so I wanna thank you so very much.
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] All right. And is there anything else?
[CUSTOMER][NEUTRAL] Um, do you guys give out reference numbers?
[AGENT][NEUTRAL] Yes ma'am, you would just use my name that I gave you along with today's date.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] Yeah, [PII]. Thank you so very much, [PII], and I hope you have a wonderful day. Thank you. Bye-bye. Thanks.
[AGENT][POSITIVE] Yes. Oh, you're welcome.
[AGENT][POSITIVE] I hope you do too, [PII]. Yes, ma'am, and thank you for calling APL.
[CUSTOMER][NEUTRAL] Uh huh bye bye.
[AGENT][NEUTRAL] Bye bye.