AccountId: 011433970860
ContactId: 5e6a7392-bbeb-4dbf-9d81-9fcd4f5029af
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 180199 ms
Total Talk Time (AGENT): 85461 ms
Total Talk Time (CUSTOMER): 61780 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/5e6a7392-bbeb-4dbf-9d81-9fcd4f5029af_20250204T17:16_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], and I'm calling from SSM Health. I have a claim to check status on.
[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] and I'm sorry, what was your name?
[AGENT][NEUTRAL] It's [PII], um, it's spelled [PII] and my last initial is [PII].
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Mm. No problem. And could I get the policy number, please?
[CUSTOMER][NEUTRAL] 02144068.
[AGENT][NEUTRAL] And please verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] B [PII].
[AGENT][NEUTRAL] OK, thank you. Now, I need the date of service and bill charges on the claim.
[CUSTOMER][NEUTRAL] [PII] $5,124.40.
[AGENT][NEUTRAL] You said that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm not showing that claim on file for [PII]. um, how was the claim submitted?
[CUSTOMER][NEUTRAL] Um, let me look.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It looks like it was mailed.
[CUSTOMER][NEUTRAL] And we have [PII].
[AGENT][NEUTRAL] Uh yes, ma'am. That's the correct mailing address. Um, claims can also be faxed in and we have a pair ID.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. Um,
[AGENT][NEUTRAL] Our fax number is, if you would like to resubmit one of those ways, um our fax number is [PII] and please attention it to the claims department.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And then the pair ID is 60801.
[CUSTOMER][NEUTRAL] OK, and can you tell me if the patient is still active?
[AGENT][NEUTRAL] OK, yes, ma'am, and just let me advise you that verification of coverage does not guarantee payment of claims. Um, the effective date on this policy was [PII], and the policy is still active.
[CUSTOMER][NEUTRAL] Active, OK, I will get that resubmitted and do you have a call reference number?
[AGENT][NEUTRAL] Yes, for the reference number, you can use my name and today's date. Um, is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No, that's it. Thank you very much.
[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] Mm