AccountId: 011433970860
ContactId: 0fb2d7df-ad15-462a-bb45-123a79815402
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 139100 ms
Total Talk Time (AGENT): 66662 ms
Total Talk Time (CUSTOMER): 48599 ms
Interruptions: 0
Overall Sentiment: AGENT=2.1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/0fb2d7df-ad15-462a-bb45-123a79815402_20250320T18:12_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm with SSM Healthcare Group. [PII], I'm trying to check on a claim.
[AGENT][POSITIVE] Well, [PII], it would be a pleasure to assist you with claim status. What is a good call back number in case we get disconnected?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you and the policy number for the patient please ma'am?
[CUSTOMER][NEUTRAL] 02006173
[CUSTOMER][NEUTRAL] From [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh 73-75 date of birth.
[AGENT][POSITIVE] All right, thank you, and it would be a pleasure to help you with that claim status for [PII]. What is, let me get that pulled up. I apologize.
[AGENT][NEUTRAL] What is the data service?
[CUSTOMER][NEUTRAL] 124 24 for 190.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the facility name?
[CUSTOMER][NEUTRAL] SSM Healthcare Group.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Medical group. Mhm.
[AGENT][NEUTRAL] Got it, thank you. Let me get that received date for this claim.
[AGENT][NEUTRAL] I do see it on file.
[AGENT][NEUTRAL] [PII], we received that claim on [PII]. It was processed on [PII].
[AGENT][NEUTRAL] The claim was denied as office visits are not covered under the patient's plan, and I can provide that claim number if you would like.
[CUSTOMER][NEUTRAL] OK, I just it's just not covered under the plan.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What, what kind of plan is this uh um.
[CUSTOMER][NEUTRAL] Limited benefits.
[AGENT][NEUTRAL] Yeah, it's a secondary gap policy to his major medical.
[CUSTOMER][NEUTRAL] OK. OK, go ahead with the claim number.
[AGENT][NEUTRAL] The claim number is 342.
[AGENT][NEUTRAL] 1009.
[CUSTOMER][POSITIVE] Thank you so much, [PII] and have a great day.
[AGENT][POSITIVE] It's my pleasure to help you with that claim status, [PII]. And before you go, is there anything else I can help you with today?
[CUSTOMER][POSITIVE] That's it for now. Have a good one.
[AGENT][POSITIVE] All right. Thank you for calling APL. You have a wonderful day too.