AccountId: 011433970860
ContactId: 2f5b7873-bb5d-4915-ad42-46b54e22190d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 160160 ms
Total Talk Time (AGENT): 70952 ms
Total Talk Time (CUSTOMER): 35280 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/2f5b7873-bb5d-4915-ad42-46b54e22190d_20250408T20:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling with SSM Health. I'm calling to check the status of a claim.
[AGENT][NEUTRAL] I'm sure, [PII], I can assist you with claim status. Um first, could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. Now I need the policy number, please.
[CUSTOMER][NEUTRAL] 02006180
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] 213 $25 for $529.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, thanks for your patience. Yes, I'm showing that we received that claim on [PII]. It processed on [PII] and I'm showing that it's denying because, um, well, the first line is denying because co-pays for office visits is not covered under the policy.
[AGENT][NEUTRAL] And then the other two lines are denying because we need the EOB from the primary insurance company. So the claim can be submit resubmitted along with the EOB from primary insurance.
[CUSTOMER][NEUTRAL] Does it show you there who the primary is?
[AGENT][NEUTRAL] Um, no, ma'am, we don't keep that information on file. Um, we don't know who the primary is until we receive the claim actually from you guys, the providers, when you guys, um, file the claim along with the EOB mhm.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. That, that, that helps me out. I will reach out to the patient and see if they have other insurance and get them added.
[AGENT][NEUTRAL] Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] No, there's not.
[AGENT][POSITIVE] OK, thank you, [PII], for calling APL. You have a great rest of your day. Mm bye.
[CUSTOMER][POSITIVE] Thank you. You too. Bye-bye.
[AGENT][NEUTRAL] Hm