AccountId: 011433970860
ContactId: 18c84a2f-30eb-445c-8bee-b6293a59c53a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 526099 ms
Total Talk Time (AGENT): 205885 ms
Total Talk Time (CUSTOMER): 158218 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/18c84a2f-30eb-445c-8bee-b6293a59c53a_20250117T14:03_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning my name is [PII]. I am calling to check on the claim status.
[AGENT][POSITIVE] [PII], it would be a pleasure to assist you with that claim status today. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] 01792085
[AGENT][NEUTRAL] Thank you, [PII], and the patient's name and date of birth please, ma'am.
[CUSTOMER][NEUTRAL] First name is [PII] or [PII] Last name is [PII]
[AGENT][NEUTRAL] And date of birth, I would have spelled it to you.
[CUSTOMER][NEGATIVE] I'm like, oh, let me just spell it because I'm gonna mess that up altogether.
[AGENT][NEUTRAL] I would do.
[CUSTOMER][NEUTRAL] Her date of birth is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright thank you and I can help you with that clean status. What is that data service?
[CUSTOMER][NEUTRAL] Day of services [PII].
[AGENT][NEUTRAL] The bill amount.
[CUSTOMER][NEUTRAL] $388.
[AGENT][NEUTRAL] Thank you and what is the facility name?
[CUSTOMER][NEUTRAL] SSM Health Medical Group.
[AGENT][NEUTRAL] Is that also for [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Alright, well, [PII], we did receive that claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It was processed on [PII].
[AGENT][NEUTRAL] And it was denied as office visits are not covered under the patient's plan.
[CUSTOMER][NEUTRAL] And do you have a claim number?
[AGENT][NEUTRAL] I do. The claim number is 351.
[AGENT][NEUTRAL] 6117.
[CUSTOMER][NEUTRAL] And [PII], I'm sorry, um, is it possible I can get a copy of the EOB?
[AGENT][NEUTRAL] I can fax you a copy here. We also have a provider portal.
[AGENT][NEUTRAL] And on that portal you'll have instant access to EOBs.
[CUSTOMER][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] And I can help you create an account if you need to real quick. And
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] And that.
[AGENT][NEUTRAL] OK, you can go to
[CUSTOMER][NEUTRAL] It's Friday.
[AGENT][NEUTRAL] It is so Friday.
[AGENT][NEUTRAL] I got it secured and that's [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, let me do it.
[AGENT][NEUTRAL] And then go in as new user once you're there.
[CUSTOMER][NEUTRAL] Actually,
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] Have access.
[AGENT][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] But it didn't let me bring anything up, so maybe I did something wrong. Let me look.
[CUSTOMER][POSITIVE] I'm so glad today is Friday.
[AGENT][NEUTRAL] Oh, girl.
[AGENT][POSITIVE] I am ready.
[CUSTOMER][NEUTRAL] OK, yes, I do have access when.
[CUSTOMER][NEUTRAL] I go in to look at a claim status for a patient.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I thought I put something in here. I think I went by her name and her date of birth.
[CUSTOMER][NEUTRAL] Under the quick access tab.
[CUSTOMER][NEUTRAL] But if it's, I don't have a claim number.
[CUSTOMER][NEUTRAL] When it asks for provider's patient account number, what goes through the patient's ID number?
[AGENT][NEUTRAL] That's the account number listed in box 26 on the HIPA. It's the patient account number with your facility.
[CUSTOMER][NEUTRAL] That's why nothing came up.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Got you. OK, that's why nothing came up because I put in her ID number. I was like, why is it not bringing anything up? OK, I got it.
[AGENT][NEUTRAL] You got the EOB now?
[CUSTOMER][NEUTRAL] I'm doing it now.
[AGENT][POSITIVE] Make sure you get it that way. I wanna make sure you're taken care of. We're gonna end this week with a bang.
[CUSTOMER][POSITIVE] Exactly.
[CUSTOMER][NEUTRAL] Mm, first name, maybe I'm putting in the wrong first name.
[CUSTOMER][NEUTRAL] Since she has a
[AGENT][NEUTRAL] Yeah, it's [PII] is how we have it listed.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] I just put the first name in there.
[CUSTOMER][NEGATIVE] Still not bringing it up.
[AGENT][NEUTRAL] You know, these computers, they have to have everything just right.
[CUSTOMER][NEGATIVE] Yeah, it's not bringing anything up.
[CUSTOMER][NEUTRAL] Let me see. You said LAI space or is it a hyphen?
[AGENT][NEUTRAL] It's just a space.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And you put the claim number in?
[CUSTOMER][NEUTRAL] No, I'm gonna do that next.
[AGENT][NEUTRAL] Cause you should be using the first option, just put the claim number in and then her first name.
[AGENT][NEUTRAL] And then the date of birth, [PII].
[AGENT][NEUTRAL] 66. It has to have [PII].
[CUSTOMER][NEUTRAL] Yeah, it's not bringing anything up. I actually went in with the quick access and put in her claim number, her first name with the space in between and her date of birth, and it didn't bring anything up.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh well, at least we tried.
[AGENT][NEUTRAL] I'm gonna fax it to you. Hang on just a second.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], do you spell your, how do you spell your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, just wanted to make sure. What's the fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] All right, give me just one quick moment. Let me get this taken care of for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] I like to do it while I'm on the phone because if I don't, while I'm on the phone with you, it may be.
[AGENT][NEUTRAL] Hours before you get
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] It take me just a quick second.
[AGENT][NEUTRAL] Yeah, I'm not sure why that's not coming up. I wonder if it's.
[AGENT][NEUTRAL] I wonder, well, we have our first name [PII] Hmm.
[AGENT][NEUTRAL] That's uh
[AGENT][NEUTRAL] Claim number 3516117.
[AGENT][NEUTRAL] Well, you know,
[AGENT][NEUTRAL] Sometimes these computers can be a little temperamental, can't they?
[CUSTOMER][NEUTRAL] Um, yeah.
[AGENT][NEGATIVE] They just get rude sometimes.
[CUSTOMER][NEUTRAL] That they do.
[AGENT][NEUTRAL] And just to verify that fax number, I'm sending this to [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] All right, [PII], that is on the way for you.
[AGENT][POSITIVE] It's been a pleasure to assist you with that claim status. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] Uh, just a reference number for the call.
[AGENT][NEUTRAL] It's gonna be my name in today's date and I spell my name [PII].
[CUSTOMER][POSITIVE] Alrighty well thank you so much, [PII].
[AGENT][POSITIVE] And thank you for calling APL [PII]. You have a very happy weekend.
[CUSTOMER][POSITIVE] You too thank you bye bye.
[AGENT][POSITIVE] Stay warm. Bye-bye.