AccountId: 011433970860
ContactId: 085bd6c7-c0c9-480c-8a30-1c7a35fdf273
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 293010 ms
Total Talk Time (AGENT): 122861 ms
Total Talk Time (CUSTOMER): 81282 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/20/085bd6c7-c0c9-480c-8a30-1c7a35fdf273_20250220T21:38_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling from a provider's office to check on a few dental cleans.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you with the dental claims.
[AGENT][NEUTRAL] And [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] And the policy number.
[CUSTOMER][NEUTRAL] I have 021.
[CUSTOMER][NEUTRAL] 7032.
[AGENT][NEUTRAL] 0217032.
[CUSTOMER][NEUTRAL] 02177032.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII], [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 for the claim you'd like me to check on?
[CUSTOMER][NEUTRAL] Yes, the first one is [PII].
[AGENT][NEUTRAL] And are all the claims for the same member or there are multiple members?
[CUSTOMER][NEUTRAL] It's the same number.
[AGENT][NEUTRAL] OK, um, you can give all the dates of service and total bills.
[CUSTOMER][NEUTRAL] OK, uh, for the [PII] total bill amount 387 with 77 cents.
[CUSTOMER][NEUTRAL] Second date of service is [PII] build amount 167 with 75.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And the third one, this is the last 1 [PII], so the amount uh 1943 with 60 cents.
[AGENT][NEUTRAL] With 60 cents, you said?
[CUSTOMER][NEUTRAL] 60.
[AGENT][NEUTRAL] 60, OK, hold on one moment.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] So from [PII], there's no claim on file?
[AGENT][NEUTRAL] For [PII], there's no claim on file.
[AGENT][NEUTRAL] And [PII], um.
[AGENT][NEUTRAL] The claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 3467085.
[AGENT][NEUTRAL] And on [PII], the claim was denied as the calendar year or policy year maximum for dental benefits has been exhausted.
[CUSTOMER][NEUTRAL] OK, can you send me that EOB?
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And do I need to put attention, [PII]?
[CUSTOMER][NEUTRAL] Uh, yes.
[AGENT][NEUTRAL] And that was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] All right, I'll go ahead and send this over to you now. And was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, no, just one question. You guys do accept electronic, um, claims, right?
[AGENT][NEUTRAL] Yes, um, our pay.
[CUSTOMER][NEUTRAL] Or do they have to be mailed out?
[AGENT][NEUTRAL] No, it can be electronic. You can fax it as well. Our payer ID is 60801.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 60801.
[AGENT][NEUTRAL] Mhm. That's our payer ID. And did you need the fax number?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, so it's [PII]?
[AGENT][NEUTRAL] And that's attention APL claims department.
[CUSTOMER][NEUTRAL] OK, sounds good. Can I get a reference number?
[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].
[CUSTOMER][POSITIVE] OK sounds good thank you so much.
[AGENT][POSITIVE] You're welcome, [PII]. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] No, that would be all.
[AGENT][POSITIVE] All right. Well, thanks for calling APL. I hope you have a great day.
[CUSTOMER][NEUTRAL] You as well bye bye.
[AGENT][NEUTRAL] Bye bye.