AccountId: 011433970860
ContactId: d6f49131-83f9-4a59-8ccf-32c653fde88d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 247380 ms
Total Talk Time (AGENT): 86202 ms
Total Talk Time (CUSTOMER): 72958 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/d6f49131-83f9-4a59-8ccf-32c653fde88d_20250213T14:54_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] from the Cleveland Clinic Foundation. I'm trying to patients eligibility benefits and the network participation.
[AGENT][NEUTRAL] OK, sure, I can assist you with eligibility benefits and network. And may I have a callback number just in case we get disconnected. [PII].
[CUSTOMER][NEUTRAL] Call number [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yep, what I have here it is.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] That's our payer ID. Do you see a policy certificate number?
[CUSTOMER][NEUTRAL] Um, let me check.
[CUSTOMER][NEUTRAL] Is the one that says outpatient benefit cert number I guess.
[AGENT][NEUTRAL] Mhm, yes.
[CUSTOMER][NEUTRAL] 01861694.
[CUSTOMER][NEUTRAL] M for Mike, L for Lima, 8.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII]'s date of birth, [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Alright, and OK, what type of service is being render for benefits?
[CUSTOMER][NEUTRAL] Yeah, this is just for a specialist visit outpatient.
[CUSTOMER][NEUTRAL] Billing facility.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, alright, and before I give you any benefit information, I need to let you know that this is not a guarantee of payment just a verification of coverage and that's just a disclaimer.
[AGENT][NEUTRAL] And we have an effective date of [PII].
[AGENT][NEUTRAL] It is active at the moment and this is one of our secondary supplemental plans to the major medical. So there is no network, we follow primary.
[AGENT][NEUTRAL] And let's see what uh huh.
[CUSTOMER][NEUTRAL] OK, sorry, you told me this is a, sorry, excuse me, and this is secondary supplemental plan?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, this is a secondary supplemental plan to the major medical.
[CUSTOMER][NEUTRAL] OK, do you know what is the primary.
[CUSTOMER][NEUTRAL] Uh, plan for the pigeon.
[AGENT][NEUTRAL] Um, I can check.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] I had to pull the group. It's gonna be a minute, OK?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, the major medical carrier for this group is Humana.
[CUSTOMER][NEUTRAL] Humana.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, well that's what I needed. Can I get the call reference number?
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information, Mr. [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] Well that's what I needed uh thank you so much and have a great day.
[AGENT][POSITIVE] You as well. Thank you for calling APL. Bye-bye.