AccountId: 011433970860
ContactId: 9f9f08c7-4e81-4e4e-adac-24ad5bd11e50
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 262859 ms
Total Talk Time (AGENT): 111155 ms
Total Talk Time (CUSTOMER): 79574 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=1.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/04/9f9f08c7-4e81-4e4e-adac-24ad5bd11e50_20250204T14:25_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, [PII]. My name is [PII], and I'm calling with SSM Health and Anthony Hospital on a recorded line. I'm calling to get status of a claim. I'm not sure if it was received.
[AGENT][NEUTRAL] OK, [PII]. So you're needing to verify if the claim was received and also get status on it if we have it. Is that correct?
[CUSTOMER][POSITIVE] Correct. Yes.
[AGENT][POSITIVE] Yes ma'am, I can help you with that. And what is your callback number, [PII]?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] That is 024.
[CUSTOMER][NEUTRAL] 93439.
[AGENT][POSITIVE] Thank you. One moment, please.
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] You're fine.
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide would be a verification of benefits and not a guarantee of payment. What is your patient's name, please, and date of birth?
[CUSTOMER][NEUTRAL] This is for [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Thank you. And the date of service and total bill amount for her?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the bill amount is $4,41 even.
[AGENT][NEUTRAL] 4041, is that correct? For 124?
[CUSTOMER][POSITIVE] Mhm. Correct.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do not have a claim on file for her, [PII] for that data service and total bill amount.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. It was submitted electronically for what I see. Oh.
[CUSTOMER][NEUTRAL] It looks like the payer ID is not correct. What's the correct payer ID or address to send the claim?
[AGENT][NEUTRAL] Our mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[AGENT][NEUTRAL] The electronic payer ID is 60801.
[AGENT][NEUTRAL] And because this is a 60801, and because this is a supplemental policy to the primary healthcare insurance, we must also receive a copy of her primary insurance company's explanation of benefits along with the claim for review.
[CUSTOMER][NEUTRAL] 080.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And then once we have processed our claim, [PII], we do have a portal in which you should be able to check claim status.
[AGENT][POSITIVE] And that portal website is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][POSITIVE] OK. Well, thank you very much for your help. That was all for today. I will go ahead, yeah, I will go ahead and resubmit that claim. I will just need a call reference number.
[AGENT][NEUTRAL] Well, you are certainly there.
[AGENT][NEUTRAL] You would just choose my name that I gave you along with today's date.
[CUSTOMER][POSITIVE] OK, perfect. Thank you very much and I hope you have a great rest of your day.
[AGENT][POSITIVE] OK. I hope you do too, [PII], and thank you again for calling APL.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um,