AccountId: 011433970860
ContactId: 01a84f35-a61f-4b14-91b2-39aca4c9f149
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 427230 ms
Total Talk Time (AGENT): 166203 ms
Total Talk Time (CUSTOMER): 115471 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/01a84f35-a61f-4b14-91b2-39aca4c9f149_20250429T18:02_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, yes ma'am. I am trying to get information on a claim that was submitted, um, back in August that still has not been paid for, and I want to see if you could help me with that.
[AGENT][NEUTRAL] OK, so you're wanting to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Yes, ma'am. I can help you with that. And are you calling from a provider's office or are you the insured?
[CUSTOMER][NEUTRAL] I am I'm the provider's office.
[AGENT][NEUTRAL] OK, hold on. OK, yes, ma'am. I can help you. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][POSITIVE] Thank you and [PII], what is a good callback number for you?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] OK, so that policy number is 02260953.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] And she's no longer has an active policy.
[AGENT][NEUTRAL] Oh, that's fine.
[AGENT][NEUTRAL] I just need to get her information pulled up and I'll need to verify a couple of things with you for security and also [PII], any information that is provided would be a verification of benefits and not a guarantee of payments. So just a moment please.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is your patient's name, please, and their date of birth?
[CUSTOMER][NEUTRAL] OK, her name is [PII] and her date of birth is [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for her place?
[CUSTOMER][NEUTRAL] OK, so the date of service is [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And then the total bill is.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] 2:15.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, so I do see that this claim was received this claim was actually.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so this claim was actually received on [PII] and processed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um, what is the
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, practice name?
[CUSTOMER][NEUTRAL] Baker Family Dentistry.
[AGENT][NEUTRAL] And the tax ID number?
[CUSTOMER][NEUTRAL] Do [PII].
[AGENT][NEUTRAL] OK. And what's?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so I do show that there was a benefit paid on this plan in the amount of $149.
[AGENT][NEUTRAL] And that was on single check.
[AGENT][NEUTRAL] 2000689.
[AGENT][NEUTRAL] And I do show that this check cleared on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um, can you look up another claim for me then? Um, I do see that check number in here but it was put for a claim paid on a different date.
[AGENT][NEUTRAL] Yeah, sure. Give me just one second so.
[CUSTOMER][NEUTRAL] So we might have put the payment in for a wrong date.
[AGENT][NEUTRAL] Oh, OK, alright, so give me just a second please.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] OK, and what was the other data service?
[CUSTOMER][NEUTRAL] OK, so the other data service was 9-19-2023.
[AGENT][NEUTRAL] OK, and to build them out.
[CUSTOMER][NEUTRAL] That one is a little different, sorry, bear with me.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, 195 was the total bill amount for that one.
[AGENT][NEUTRAL] Um, let's see.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and I showed that there was a benefit paid. Yes, that claim was also received the claim number is going to be.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 336-3543
[AGENT][NEUTRAL] And there was a benefit paid in the amount of $165.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that was paid.
[AGENT][NEUTRAL] One single check, 181-9078.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, perfect.
[AGENT][NEUTRAL] And that one does show cleared as well, 1116 of 23.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK great alright well thank you so much and I can come to their account and see what we need to figure out.
[AGENT][NEUTRAL] OK, and then one last thing, [PII], and you may already have this information, but we do have a portal that if you need copies of the explanation of benefits, you should be able to print them from our portal and our website for that is secured. [PII].
[CUSTOMER][POSITIVE] Yeah, yes ma'am.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, great, thank you so much for all your help today. I appreciate it.
[AGENT][POSITIVE] Well, you, absolutely. You're welcome. And can I help you with anything else?
[CUSTOMER][POSITIVE] No ma'am, you've been a great help thank you.
[AGENT][POSITIVE] Oh, well, it was my pleasure, [PII], and thank you for calling APL. I hope you have a wonderful afternoon.
[CUSTOMER][NEUTRAL] Alright you too bye.
[AGENT][POSITIVE] Thank you, bye bye.