AccountId: 011433970860
ContactId: c3a3c40a-c10d-4bb0-be7f-f99b78f6ba8f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 357239 ms
Total Talk Time (AGENT): 172920 ms
Total Talk Time (CUSTOMER): 117907 ms
Interruptions: 3
Overall Sentiment: AGENT=1.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/c3a3c40a-c10d-4bb0-be7f-f99b78f6ba8f_20250408T12:07_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII] and I'm calling from the Cleveland Clinic.
[AGENT][NEUTRAL] Hi, [PII]. How, how are you today?
[CUSTOMER][POSITIVE] I'm doing good and thanks for asking, [PII]. And how about yourself?
[AGENT][POSITIVE] I'm doing well, thank you for asking. So, how can I help you today, [PII]?
[CUSTOMER][NEUTRAL] Yes, [PII]. I just want to check whether any claim was received for a data service or not.
[AGENT][NEUTRAL] OK, so you're wanting to check to see if we have received a claim for a member, is that correct?
[CUSTOMER][POSITIVE] Yes, that's right.
[AGENT][POSITIVE] Yes, I can help, yes, I can help you with that, [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] Yes, that is [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please [PII].
[CUSTOMER][NEUTRAL] Uh, sure. That is 021349 05 M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] OK thank you one moment please while I get the member's information pulled up.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And just giving the information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, that is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her, please, [PII]?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, that is May, it's [PII] and the total charge is $221 even.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so [PII], there is no claim on file on this policy, um, that policy number termed prior to your data service.
[CUSTOMER][NEUTRAL] from.
[AGENT][NEUTRAL] This policy number you provided for me was active from [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Now, there is another policy number that went into effect, 912023 and is currently active.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That policy number, [PII].
[CUSTOMER][NEUTRAL] Oh, this moment, I one of the.
[AGENT][NEUTRAL] OK. Yes, you need to.
[CUSTOMER][POSITIVE] Yes, please go ahead. I'm sorry for the interrupt.
[AGENT][NEUTRAL] Oh no, that's OK. So the uh,
[AGENT][NEUTRAL] New policy number that is currently active is going to be 237-0301.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And if you'll give me a moment to get that information pulled up, uh, so that I can see if we received that on there, so just one moment please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, so [PII], you said that this, the date of service, I just want to re-verify one more time. It's [PII]. Is that correct?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Yes. Yes, that's right.
[AGENT][NEUTRAL] OK, so there is no claim on file on her active policy either for this data service.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. And I just want to verify the claim spelling address, that is [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][NEUTRAL] OK. And could you please provide me the electronic mail ID?
[AGENT][NEUTRAL] Now, we will
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, thank you.
[AGENT][NEUTRAL] Yes sir, now we will also have to have a copy of her primary insurance company's explanation of benefits along with the claim, [PII], because this is a supplemental policy and then once we have processed our claim, we do have a portal in which you should be able to check claim status and that website would be secured.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. And can I get a reference number?
[AGENT][NEUTRAL] Well, you're welcome. And is there anything? Sure, you would use my name along with today's date.
[CUSTOMER][NEUTRAL] No, that's all for today.
[AGENT][POSITIVE] And if there, and if that is all, then [PII] that I can help you with, thank you again for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You too. Take care. Bye-bye and thanks for assisting.
[AGENT][POSITIVE] Thank you. You're welcome.
[CUSTOMER][NEUTRAL] Bye bye. Mhm.
[AGENT][NEUTRAL] Bye-bye.