AccountId: 011433970860
ContactId: 07a4a48c-4192-4f5b-a8e9-978b7d4f2df3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 578830 ms
Total Talk Time (AGENT): 202111 ms
Total Talk Time (CUSTOMER): 179695 ms
Interruptions: 2
Overall Sentiment: AGENT=0.9, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/06/07a4a48c-4192-4f5b-a8e9-978b7d4f2df3_20250306T18:40_UTC.wav
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[AGENT][POSITIVE] Thanks for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yup. Hi [PII]. This is [PII] calling from Masment Dental. Need to check on clients.
[AGENT][POSITIVE] Oh yeah, I can check on a claim for you. [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you and then do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I have the policy number here, it is 02453967.
[AGENT][NEUTRAL] OK, and then what was the name and date of birth for the insured please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] They so.
[CUSTOMER][NEUTRAL] Don't devious slowly.
[CUSTOMER][NEUTRAL] And the date of birth, [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII]. What was the date of service for this claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and then uh that bill amount please?
[CUSTOMER][NEUTRAL] [PII] and then I.
[CUSTOMER][NEUTRAL] $2,677 even.
[AGENT][NEUTRAL] That was $2,637.
[CUSTOMER][NEUTRAL] That was $2,637.
[CUSTOMER][NEUTRAL] $77
[AGENT][NEUTRAL] OK, 2,677.
[CUSTOMER][POSITIVE] Yeah, that's right.
[AGENT][POSITIVE] OK, thank you one moment please.
[CUSTOMER][NEUTRAL] One moment
[AGENT][NEUTRAL] I'm sorry, [PII], what did you say the name of the provider's office is?
[CUSTOMER][NEUTRAL] As for dental
[AGENT][NEUTRAL] Do you happen to have that tax ID?
[CUSTOMER][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Yeah, the tax ID is [PII].
[AGENT][NEUTRAL] OK, got it. Thank you so much for verifying that, [PII]. Uh, so we did receive this claim. It looks like we paid a benefit of $84. The only ones we were unable to pay are not covered procedures. If you'd like, I can send you a copy of this fax back or I'm sorry, the, uh, a copy of the EOB.
[CUSTOMER][NEGATIVE] The only ones we were unable to pay are.
[CUSTOMER][NEUTRAL] Just
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah, before that, uh, can I have the claim re date?
[AGENT][NEUTRAL] Oh yes, one moment.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] So this claim was received [PII], and it was processed [PII].
[CUSTOMER][NEUTRAL] 234
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Can I have the claim number?
[AGENT][NEUTRAL] Claim number is 3479566.
[CUSTOMER][NEUTRAL] Thank you. You stated that the claim was paid $84 right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, could you please tell me which purchase credit was paid?
[AGENT][NEUTRAL] I'm sorry, could you repeat that?
[CUSTOMER][NEUTRAL] Uh, which project code it was paid $84. So the claim contains a lot of.
[AGENT][NEUTRAL] Oh, which, which procedure code? Um, that was 0140 was what that code paid towards.
[AGENT][NEUTRAL] Or would that benefit paid towards
[CUSTOMER][NEUTRAL] 01.
[CUSTOMER][NEGATIVE] OK, remaining codes are no account service.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] It's an onco service under the patient's plan, right?
[AGENT][NEGATIVE] It's not covered for this uh policy, correct.
[CUSTOMER][NEUTRAL] Uh, could you please send an UV through fax?
[AGENT][NEUTRAL] Yes, what was that fax number for you?
[CUSTOMER][NEUTRAL] Yeah, it's a
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna read that back to make sure I heard that correctly. That was [PII]?
[CUSTOMER][POSITIVE] You got it.
[AGENT][NEUTRAL] OK, I will go ahead and send that now. You should get it within 10 to 15 minutes. Um, was there anything else I could help you with, [PII]?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah, I have one more patient. Uh, before moving to the next patient, can I have the call reference number?
[AGENT][NEUTRAL] Sure, um, so the reference number would be the same, uh, for any claims that we check that would be my first name, last initial, and today's date. So my name is spelled [PII] Last initial is [PII]
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And if you'll give me one moment, I'm gonna go ahead and send this EOB. I'll let you know when I'm ready for that next policy number.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you one moment.
[AGENT][POSITIVE] OK, I appreciate your patience, [PII]. Um, I'm ready for that next policy number when you are.
[CUSTOMER][POSITIVE] Yeah, I'm ready for that uh.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] ID is 02.
[CUSTOMER][NEUTRAL] 246-460
[AGENT][NEUTRAL] OK, and then uh what was the name and date of birth for this number?
[CUSTOMER][NEUTRAL] Patient's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] OK, thank you for verifying that and then uh what was the date of service for this claim?
[CUSTOMER][POSITIVE] OK, thank you for verifying
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], OK, and then uh that bill amount please.
[CUSTOMER][NEUTRAL] Yup. The bill amount is $1,948 even.
[AGENT][NEUTRAL] OK thank you one moment please.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Was this what they the same provider [PII] or is this a different provider?
[CUSTOMER][NEUTRAL] It was a different provider.
[AGENT][NEUTRAL] OK, do you have that tax ID please?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] The tax ID is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, thank you for verifying that, [PII], but we did receive this claim. Give me just a moment.
[AGENT][NEGATIVE] OK, so we were unable to pay a benefit at all for this policy as none of the procedures are covered.
[CUSTOMER][NEUTRAL] The all the post code is not covered?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Uh, may I know the reason?
[AGENT][NEUTRAL] They're just not covered procedures under this policy?
[CUSTOMER][NEUTRAL] Yeah, [PII] and [PII] is also not covered.
[AGENT][NEGATIVE] None of them are covered under this policy.
[CUSTOMER][NEUTRAL] Can I have the client receive it?
[AGENT][NEUTRAL] Yes, one moment.
[AGENT][NEUTRAL] Uh, one actually give me just a moment. It looks like we had a couple for this state of service.
[AGENT][NEUTRAL] OK, yeah, so that's the only one, you asked for the received date I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, so that's the only one.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[AGENT][NEUTRAL] That was uh [PII].
[AGENT][NEUTRAL] And then it was processed um [PII].
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Ma
[CUSTOMER][NEUTRAL] Claim number
[AGENT][NEUTRAL] That is 329-427-5.
[CUSTOMER][NEUTRAL] For
[CUSTOMER][NEUTRAL] That's it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, may I know the patient's responsibility?
[AGENT][NEUTRAL] We don't say what is patient responsibility that would be up to the provider.
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] Yeah, OK, no problem. So all the.
[CUSTOMER][NEUTRAL] She's not covered under occupations.
[CUSTOMER][NEUTRAL] Thank you. Uh, could you please send a UP through fax?
[AGENT][NEUTRAL] Sure. Yes, sir.
[AGENT][NEUTRAL] I will get that sent to you. Was there anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] I get that sent to you.
[CUSTOMER][NEUTRAL] Uh, that's it because the calls are the same, right?
[AGENT][NEUTRAL] Right, yes.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][POSITIVE] Yeah, thank you so much, uh, [PII].
[AGENT][POSITIVE] Alright, of course, thanks for calling [PII]. Have a great rest of your day.
[CUSTOMER][POSITIVE] Yeah, you too. Have a great day. Bye for now.
[AGENT][POSITIVE] Thank you bye bye.