AccountId: 011433970860
ContactId: a9b1830d-0591-48be-a864-13538a1b32f8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 326799 ms
Total Talk Time (AGENT): 128368 ms
Total Talk Time (CUSTOMER): 88187 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/01/a9b1830d-0591-48be-a864-13538a1b32f8_20250401T14:18_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] Hi [PII], this is [PII] calling from private office, and I'm looking for status.
[AGENT][POSITIVE] OK, I'll be more than happy to assist you with the um claim status and for my notes, can you spell your first name for me please and provide a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and last name initial is [PII]. And callback number is [PII].
[AGENT][NEUTRAL] Thank you for that. And um may I have the member's
[AGENT][NEUTRAL] Policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 02006183.
[AGENT][NEUTRAL] Thank you. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I have only one member.
[AGENT][NEUTRAL] All right. And may I have the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, my name is [PII] and date of birth is [PII].
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim and the total bill?
[CUSTOMER][NEUTRAL] D of service is [PII] of [PII].
[CUSTOMER][NEUTRAL] And total charge amount is $6200 even.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And that was [PII] $6200?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yeah, it's SSM Health endoscopy Center.
[AGENT][NEUTRAL] OK, the reason I'm asking is because, so we've received two claims for that data service. One of the claims is from your provider, but it's a different total bill. Could it be anything other than the 6200?
[CUSTOMER][NEUTRAL] No, there's only one claim only for 200 actually we have built the two claims.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, well, we have not received the claim in the total bill of $6200.
[CUSTOMER][NEUTRAL] So how much is the bill amount for you to see that claim?
[AGENT][NEUTRAL] The claim that I see is $1,318.
[CUSTOMER][NEUTRAL] And this is for SSM Health Endoscopy Center.
[AGENT][NEUTRAL] Yes, we can confirm the um tax ID if you like, but it is SSM Health Medical Center.
[CUSTOMER][NEUTRAL] Oh, it's different.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] No, the SSM medical center is different.
[AGENT][NEUTRAL] So it's not SSM?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] What's your tax ID?
[CUSTOMER][NEUTRAL] You didn't see yeah tax ID is [PII].
[AGENT][NEUTRAL] OK, so no, we have not received your claim. The claim that we have here is SSM Health, but it's a different tax ID. So you can file the claim if you'd like. There's no timely filing.
[CUSTOMER][NEUTRAL] But actually for this one.
[CUSTOMER][NEUTRAL] We have billed the claim through your fax number.
[CUSTOMER][NEUTRAL] Because it was initially not on file then we again billed the claim on your fax number on [PII].
[AGENT][NEUTRAL] Um, 384.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] I mean, we have, this is not your claim, we have not received your claim.
[AGENT][NEUTRAL] There's only 2 claims on file for your data service.
[AGENT][NEUTRAL] And the one that has your same name is a different tax ID. So you can resubmit it, um.
[AGENT][NEUTRAL] You have mail or electronically?
[CUSTOMER][NEUTRAL] Mm, can you please provide me the fax number? I just need to verify that.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Sure, it's [PII].
[AGENT][NEUTRAL] 365.
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK, so we have sent the claim to different.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] OK, can you provide me the call fax number I'm done.
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. First initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you, [PII].
[AGENT][POSITIVE] You're welcome. Was there anything else I can help you with today?
[CUSTOMER][POSITIVE] No, I'm done thank you so much.
[AGENT][POSITIVE] All right, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.