AccountId: 011433970860
ContactId: cbba0396-73f0-4cba-8a1a-99981d81e952
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238550 ms
Total Talk Time (AGENT): 103886 ms
Total Talk Time (CUSTOMER): 79453 ms
Interruptions: 0
Overall Sentiment: AGENT=1.8, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/cbba0396-73f0-4cba-8a1a-99981d81e952_20250326T13:01_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 office, and I'm looking for claim status.
[AGENT][POSITIVE] [PII], it would be my pleasure to assist you with claim status today. What is a good callback number?
[CUSTOMER][NEUTRAL] Yeah, callback number is [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, policy number is 02144068.
[AGENT][NEUTRAL] Thank you, [PII]. And the patient's name and date of birth, please?
[CUSTOMER][NEUTRAL] Yeah, patient name is [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you and it would be my pleasure to assist you with that claim status for [PII]. Do you have a claim number or date of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I have date of service. It is [PII].
[AGENT][NEUTRAL] And the bill amount, please.
[CUSTOMER][NEUTRAL] Yeah, bill amount is $3100 even.
[AGENT][NEUTRAL] And do you have that procedure code associated with the claim?
[CUSTOMER][NEUTRAL] Yeah, it's 43239.
[AGENT][POSITIVE] Alright thank you I appreciate that.
[AGENT][NEUTRAL] And then what is the name of the facility, please?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] SSM Health Endoscopy Center.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I'm getting that claim information for you. [PII], we received that claim on [PII].
[AGENT][NEUTRAL] The claim was processed on [PII].
[AGENT][NEUTRAL] With a payment of $258.74 sent to SSM Health Medical Group.
[CUSTOMER][NEUTRAL] No, this is not medical work. It's HSM Health Endoscopy Center.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when did you receive the claim?
[AGENT][NEUTRAL] I'm sorry, what was that bill amount?
[CUSTOMER][NEUTRAL] Bill amount is $3100 even.
[AGENT][NEUTRAL] OK. I do apologize. We do not have the facility claim on file.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] I apologize. That was for professional team.
[CUSTOMER][NEUTRAL] But actually, I have.
[CUSTOMER][NEUTRAL] I have last called on [PII].
[CUSTOMER][NEUTRAL] And the previous step was stating that claim was not on file, so we again will the claim on [PII].
[CUSTOMER][NEUTRAL] As the paper
[CUSTOMER][NEUTRAL] On your mailing address.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] I do not have a claim. We did not receive it. Can you fax it directly to us?
[CUSTOMER][NEUTRAL] No, yeah, sure. Can you please provide me the fax number?
[AGENT][NEUTRAL] Fax number to our claims department is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK. And ma'am, was active on data of service?
[AGENT][NEUTRAL] Yes, the effective date is [PII] and the policy is active.
[CUSTOMER][POSITIVE] OK, thank you so much. I'm done. Can you please provide me the call reference number?
[AGENT][NEUTRAL] Call reference number is my name and today's date, and I spell my name [PII].
[AGENT][POSITIVE] And [PII], it was a pleasure to assist you with that claim status. Anything else I can help you with today?
[CUSTOMER][POSITIVE] No, I'm done. Thank you so much, [PII].
[AGENT][POSITIVE] And thank you for calling APL. Hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.