AccountId: 011433970860
ContactId: 0a931d53-65f0-4c12-89b5-cf148e046e75
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172809 ms
Total Talk Time (AGENT): 69852 ms
Total Talk Time (CUSTOMER): 59958 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/02/0a931d53-65f0-4c12-89b5-cf148e046e75_20250502T16:24_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] from Cleveland Dental Institute, and I'm calling you regarding a dental claim.
[AGENT][NEUTRAL] OK, I can verify claim status for you and you say your name is [PII]?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK. And what is that policy number, please?
[CUSTOMER][NEUTRAL] 023-304-33.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, thank you. And Mr. [PII], you say you're calling for claim status, correct?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, and what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Uh, [PII], and the bill amount is $75.
[AGENT][POSITIVE] OK, thank you so much. Give me one moment please.
[CUSTOMER][POSITIVE] Take your time.
[AGENT][NEUTRAL] Is this for oral evaluation?
[CUSTOMER][POSITIVE] Yes, correct.
[AGENT][NEUTRAL] OK, and you're calling from?
[CUSTOMER][NEUTRAL] I'm calling from Cleveland Dental Institute.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK. I'm showing on this claim, it looks like we paid $20 and the other benefit was applied towards your deductible.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. But I, I have one question. Um, is it processed in or out of network?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh, we don't have a network. Uh, the claim process is UCR.
[CUSTOMER][NEGATIVE] Because there is no adjustment.
[CUSTOMER][NEUTRAL] OK. So that's a correct processing and the member uh responsibility is $55.
[AGENT][NEUTRAL] Uh, isn't, uh, if that's on the explanation benefits, we can't real, uh, really say what is patient responsibility. We can only verify how the claim was processed.
[CUSTOMER][NEUTRAL] OK. I didn't know that, sir, for that.
[AGENT][NEUTRAL] Oh no you're fine.
[CUSTOMER][NEUTRAL] All right. Um,
[CUSTOMER][POSITIVE] All right. Thank you so much for that. I just wanted to confirm that.
[AGENT][NEUTRAL] OK, and [PII], is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] No, that's all.
[AGENT][POSITIVE] OK, well I thank you for calling APL and you have a great rest of your day.
[CUSTOMER][NEUTRAL] Like one. How much?
[AGENT][NEUTRAL] Mm bye.