AccountId: 011433970860
ContactId: 05a40439-a89e-4fa5-a8a3-ad3bc08ba88c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 793000 ms
Total Talk Time (AGENT): 266799 ms
Total Talk Time (CUSTOMER): 287158 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/05a40439-a89e-4fa5-a8a3-ad3bc08ba88c_20250417T13:00_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 the provider's office to check on claim status.
[AGENT][NEUTRAL] OK, you said your name is [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][POSITIVE] Thank you for that, and I'll be more than happy to help you with the claim status. And how many claims do you have today in total?
[CUSTOMER][NEUTRAL] Uh, 2 claims.
[AGENT][NEUTRAL] OK, may I have the member's policy number?
[CUSTOMER][NEUTRAL] Uh, sure. That is 025.
[CUSTOMER][NEUTRAL] 646-52
[AGENT][NEUTRAL] Thank you, hold on one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes. Uh, the patient would be, uh, [PII] with the date of birth of [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills for the claim?
[CUSTOMER][NEUTRAL] Yes, this is for [PII] for $95 even.
[AGENT][NEUTRAL] OK, here it is. Hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Can you verify the name of the provider on the provider's office on the claim?
[CUSTOMER][NEUTRAL] Oh yeah, sure. The facility that would be Mission Valley Dentist.
[AGENT][NEUTRAL] Uh, what's the tax ID?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, this is it
[CUSTOMER][NEUTRAL] And we are also having another name as uh AH Dental Corporation.
[AGENT][NEUTRAL] Yes, thank you for that. So I'm showing that we received the claim on [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] The claim number is 354-7135.
[AGENT][NEUTRAL] And also on [PII], we paid out on the claim to the provider, a total of $88.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Did you need that check information?
[CUSTOMER][NEUTRAL] Hm, yes, please.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] So it's a single check?
[CUSTOMER][NEUTRAL] Mm, sure.
[AGENT][NEUTRAL] Um, it was issued on [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And it was mailed to [PII].
[AGENT][NEUTRAL] Is that the correct address?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, yeah, that would be the rendering address of ours.
[AGENT][NEUTRAL] OK, I'm just asking because I see that the check is still outstanding and it's been over 30 days. So if you like, I can go ahead and send this over to our representative to check on the check. If it has in fact been cleared, we can provide you with a copy of the cleared check. If not, we can um void this out and reissue it to you.
[CUSTOMER][NEUTRAL] Mm, yes.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. OK. Before that, can I get that check number so I can also check at my end whether it has been received or not?
[AGENT][NEUTRAL] Um, it's check number 202.
[AGENT][NEUTRAL] 357 1.
[CUSTOMER][NEUTRAL] OK, got it. Uh, give me a moment. Let me check on that.
[CUSTOMER][NEUTRAL] OK. So I'm not seeing as the check receipt at the end. So, uh, I'm also confirming your information. So this claim has been processed under the tax ID which I provided, right? [PII]. And also with the facility information that, that I just provided, correct?
[AGENT][POSITIVE] Correct.
[AGENT][POSITIVE] Correct. Mhm.
[CUSTOMER][NEUTRAL] OK. So, yeah, for this one, I'm also seeing this check not clear at our end or received. Uh, so before uh requesting to be reissued or placing a check traer on this 1 may I know that, do you have any other address other than the [PII] for this provider like any [PII] box address has been available?
[AGENT][NEUTRAL] I mean, I can look and see what, what if there's other addresses on the documents that were received, but this is the only address for billing that we sent it to.
[CUSTOMER][NEUTRAL] Uh-huh. OK. Why I am asking because the [PII] would be our rendering address. Uh, we are having a, uh, financial address or a billing address which is [PII]. So if this address has been available at your end, we are requesting to uh like reissue a check to this address. If it is not available, it's fine. We can go with the [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, um, hold on one moment. If you don't mind, I'm gonna place you on a brief hold and look at the documents that have been received and what addresses are on there.
[CUSTOMER][NEUTRAL] Um, yeah, sure, sure, yes.
[AGENT][NEUTRAL] All right, hold on one moment.
[CUSTOMER][NEUTRAL] Mm mm, sure, sure.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, where is our base?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, it's coming up.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Oh, what, how does that do that? I hate when that happens.
[AGENT][NEUTRAL] What is it that makes that happen?
[AGENT][NEUTRAL] Got to figure that out.
[AGENT][NEUTRAL] This is all the you be.
[AGENT][NEUTRAL] OK, so I'm have to do it like this and go to.
[AGENT][NEUTRAL] Click out of that the claims look up.
[AGENT][NEGATIVE] Oh no, I don't want that. I want the middle number.
[AGENT][POSITIVE] Bom bom bom bom.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] I know.
[AGENT][NEUTRAL] Hello, [PII].
[CUSTOMER][NEUTRAL] Yes, yes, I'm still here.
[AGENT][POSITIVE] Thank you, thank you so much for holding. I apologize for that wait. So on the claim form that was received, it's only the 563 8 address on there. It's for, it's listed under billing and the treating location.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh-huh. OK. So, yeah. And also, let me confirm that, so to be reissue the check, first you need to place a check traer on this one, right? After getting the update only, you are able to be reissue the check on this claim, right?
[AGENT][NEUTRAL] Um, I don't know of the process on the back end. I'm gonna send the, uh, um, send the information over to the representative that handles the check. She's gonna do her part, I don't know what all this entails, and then once she checks and sees if the check has cleared or not, if it has cleared, we'll provide you with a copy of the cleared check. If it hasn't, she's gonna let us know to void this and reissue. I don't.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Uh-huh. OK. So in order to get an update on this one, whether the check cleared or not, how will be the turnaround time to get an update from the, from your back end?
[AGENT][NEUTRAL] 7 to 10 business days.
[CUSTOMER][NEUTRAL] 7 to 10 business days. OK. And also, may I know one thing for the future payments uh to be issued uh the future payments to the address that I provided to the PO box address, uh, how we can update the address.
[AGENT][NEUTRAL] When you send the claim form, make sure where it lists billing dentist or dental entity. You put the correct address there in [PII].
[CUSTOMER][NEUTRAL] OK. So I'm also confirming in the receipt claim at your end the [PII], it has been listed as the [PII] only, right? You are not seeing the PO box address at your end, correct?
[AGENT][NEUTRAL] Correct, it says Aaron Jed Dental Corporation and then it says [PII], that address.
[CUSTOMER][NEUTRAL] OK. Uh-huh. OK. So why I'm asking, uh, I'm seeing the claim form that we submitted and I'm seeing the PO box address in that, but, uh, I'm not sure why it is not reflecting, reflecting at your end in the receipt claim form. So nobody, so in the future claims, we can uh make sure that uh we are submitting the correct claim form for this one. So, yeah, could you please request to that uh representative in the back and to check on this check, please?
[AGENT][NEUTRAL] Sure, and the next claim, is it for the same member or is it a different member?
[CUSTOMER][NEUTRAL] Yes. Uh, no, no, same patient only, uh, like different bill amount, same data service.
[AGENT][NEUTRAL] OK, and what's the next bill amount?
[CUSTOMER][NEUTRAL] Uh, $227 even.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] You yes.
[AGENT][NEUTRAL] Alright, so that claim was received also on [PII]?
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, the claim number is 354.
[AGENT][NEUTRAL] 7120.
[AGENT][NEUTRAL] And also on [PII], we paid out on this claim $139.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Can I get that check number as well?
[AGENT][NEUTRAL] Sure, hold on one moment.
[AGENT][NEUTRAL] So let's check number 2023572.
[CUSTOMER][NEUTRAL] The
[CUSTOMER][NEUTRAL] OK. Single check for the $39139 even, right?
[AGENT][POSITIVE] Yes, and this one is also outstanding, so I'll include this on the request to the representative.
[CUSTOMER][NEUTRAL] Uh-huh. OK. Thank you so much for that, [PII]. So, uh, yes, uh, that's for this patient. So for this check as well to get an update, it will take up to 7 to 10 business days, right?
[AGENT][POSITIVE] Correct. Mhm.
[CUSTOMER][POSITIVE] OK, got it. Thank you so much. And can I get that reference on this call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date and again that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] Uh-huh. OK. Thank you so much, [PII]. So, yeah, that's for this patient, but I just need to know one thing as well. So tomorrow it will be a holy day, right?
[AGENT][POSITIVE] Tomorrow is a holy day? Oh, because it's Good Friday. We're still open.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Mm, yes.
[CUSTOMER][POSITIVE] Open. Uh-huh. OK. Yeah. Thank you so much for this information, and uh, so that's for today. So anyway, thank you so much for your time and assistance with me. You can reach us at [PII] between [PII] Eastern time for any further queries. So thanks again. Have a great day. Take care. Have a great weekend ahead. Bye-bye.
[AGENT][NEUTRAL] Is there anything else I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] Uh, no, no, that's for today, [PII]. Have a great day. Bye-bye.
[AGENT][POSITIVE] Alright, thanks for calling APO bye bye.