AccountId: 011433970860
ContactId: a00125e6-c287-418b-89a6-c03ee229bd52
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 661570 ms
Total Talk Time (AGENT): 263671 ms
Total Talk Time (CUSTOMER): 216978 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=1.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/a00125e6-c287-418b-89a6-c03ee229bd52_20250623T15:29_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 [PII], I was trying to speak with someone regarding a claim.
[AGENT][NEUTRAL] OK, you're needing to check claim status. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII]. I'm a provider. I'm calling from SSM Health Medical Group.
[AGENT][NEUTRAL] OK, [PII]. And how do you spell your [PII]?
[CUSTOMER][NEUTRAL] Um, it is spelled [PII]
[AGENT][NEUTRAL] OK, thank you. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII] that's also a direct line.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, thank you. And yes, I can help you with claim status. What is the member's policy number?
[CUSTOMER][NEUTRAL] The member's policy number is 02597992.
[AGENT][NEUTRAL] 97992. Is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And [PII], any information that I do provide for you today will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] The name is [PII]. Last name is [PII] or [PII]. Date of birth, I'm gonna spell the last name, sorry, [PII] Date of birth is [PII].
[AGENT][NEUTRAL] Thank you. And what is the date of service and total bill amount that you're inquiring about?
[CUSTOMER][NEUTRAL] 319 of 2025 with a total charge $1,514.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And just to be, um, just to give you a little bit of information on this claim, um, I had spoke with the rep back in June, or was it June now, but in the beginning of June, um, she stated that the claim had uh got denied due to the tax discrepancy. So I ended up faxing updated W9 to the fax number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] And I spoke with the rep named [PII]. She stated that I could fax over the updated W9 so the rep can be corrected and to get this claim to the claims office.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so you do you do already have the claim number, is that correct?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, was it the 358-6541?
[AGENT][POSITIVE] Yes, ma'am, that is correct.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, I did receive that um I was just calling to see if it was a follow up or if it was, um, any new details regarding the updated W9 that I faxed over, um, with, uh, the claim form attached as well.
[AGENT][NEUTRAL] OK, so let me uh let me just look up a few things, right? OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Hm
[AGENT][NEUTRAL] It's gonna take me just a few minutes to look through some things on here, OK?
[AGENT][NEUTRAL] So give me just a second, [PII].
[CUSTOMER][NEUTRAL] Oh, no, you're fine.
[AGENT][NEUTRAL] OK, so according to the remark on this claim for you all, it states that um OK, so you know the denial remark and we were unable to accept assignment of benefits for the claim due to a discrepancy reported to us by the IRS.
[AGENT][NEUTRAL] That is in combination of the name and the taxpayer of the tax ID number on the account.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] So it explains through uh go to the IRS website for additional information on how to resolve the issue.
[AGENT][NEGATIVE] And stop back up with holding and once this issue is resolved with the IRS to contact us with a copy of the updated information.
[AGENT][NEUTRAL] So you're stating that was done, the discrepancy with the IRS has been rectified?
[CUSTOMER][NEUTRAL] OK, so we
[CUSTOMER][NEUTRAL] Well, when I spoke with the rep named [PII], she had called me back to tell me that the rep stated that, well, she stated that you guys have received multiple claims with that tax ID and it was with the name [PII].
[CUSTOMER][NEUTRAL] So, she stated for me to just fax and updated W9.
[CUSTOMER][NEUTRAL] To the fax number [PII] so the records can get.
[CUSTOMER][NEUTRAL] Updated well it can be corrected and to get this claims to the claims office that's all uh the rep has.
[CUSTOMER][NEUTRAL] told me
[CUSTOMER][NEUTRAL] And then that's how I ended up faxing over the claim form and the W-9.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So you're stating that we need to reach out to the IRS.
[AGENT][POSITIVE] Yes, according to the information that I have, yes, that that is correct. That is what generated that.
[AGENT][NEUTRAL] Um, that comment is it's a discrepancy reported to us by the IRS.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] So it would have to, you would have to contact them first.
[CUSTOMER][NEUTRAL] So I
[AGENT][NEUTRAL] And then once that has been resolved with the IRS to contact us and send us a copy of the updated information.
[CUSTOMER][NEUTRAL] OK, so we need to reach out to the IRS first and then once we resolve that with then we can reach out to you guys.
[AGENT][POSITIVE] Correct.
[AGENT][NEUTRAL] Right, then you would send us a copy of the updated information.
[AGENT][NEUTRAL] Because again it's some form it's a discrepancy due to us that was reported in combination of the name and the taxpayer ID number.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] Got you. So basically me faxing over that updated W-9 was pointless because we need to reach out to the IRS first.
[AGENT][NEUTRAL] That is, that is correct. That is the information that I have to report on, you know, this, this remark that was, you know, placed on this claim. Yes, ma'am. Mhm.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Got you OK.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alrighty, well, if you don't mind, [PII], is there a reference number for this call?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, you would use my name along with today's date.
[CUSTOMER][POSITIVE] Alrighty well thank you I appreciate your help. oh go ahead sorry.
[AGENT][NEUTRAL] And then
[AGENT][NEUTRAL] Oh, you're welcome, [PII]. No, I, no, I was just gonna say I don't know if anyone has given you, um, our portal website also that in the future that you all should be able to check claim status in once we have processed the claim here at APL but that website, if you just wanna take it down is secured.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Let's see. [PII].
[AGENT][NEUTRAL] [PII]. Make sure to put a D on it. [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. Well, is there anything else at the moment that I could help you with?
[CUSTOMER][POSITIVE] All righty.
[CUSTOMER][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] Oh, I do have one question. When I do sign up for this, do I need the registration code or no?
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] No, you will, it's a self registering portal, but again this is for checking claim status, so it's going to ask for specific information and if we don't have a claim on file, you may also get a, you know, an error message stating that there's no record of this because, you know.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] We don't have a claim yet essentially it's why you would get that more than likely mhm.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Alrighty well I appreciate your help. I hope you enjoy the rest of your Monday.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Yes, ma'am. I hope you do too. I hope you do too, and I hope you have a very nice week, [PII]. And is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No, ma'am. That was it.
[AGENT][POSITIVE] OK, well then, thank you again for calling APL. Have a great day.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][NEUTRAL] Yes, ma'am. Bye-bye.
[CUSTOMER][NEUTRAL] Bye-bye.