AccountId: 011433970860
ContactId: 0ec76fac-0597-4d5f-9837-8cb9ea284b87
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 334399 ms
Total Talk Time (AGENT): 116605 ms
Total Talk Time (CUSTOMER): 111474 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/07/0ec76fac-0597-4d5f-9837-8cb9ea284b87_20250107T13:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm [PII] calling from provider's office. I would like to check on a claim status.
[AGENT][NEUTRAL] Hey I'm sorry, I can't hear you at all.
[CUSTOMER][NEUTRAL] Hi, I'm [PII] calling from provider's office. I would like to check on a claim status, [PII].
[AGENT][NEUTRAL] OK, I can help you. [PII], what's the policy number?
[CUSTOMER][NEUTRAL] It's 022.
[AGENT][NEUTRAL] OK, I can't hear you.
[CUSTOMER][NEUTRAL] 95.
[AGENT][NEUTRAL] Do you have me on speaker?
[CUSTOMER][NEUTRAL] It is.
[AGENT][NEUTRAL] Do you have me on speaker?
[CUSTOMER][NEUTRAL] What about now?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, could you remove me from speaker because I can't hear you.
[CUSTOMER][NEUTRAL] Hello?
[CUSTOMER][NEUTRAL] All right. So the member ID is 022.
[CUSTOMER][NEUTRAL] 952-86.
[AGENT][NEUTRAL] OK, and what's a good phone number [PII] in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII]. Thank you. And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Uh, it does [PII].
[AGENT][NEUTRAL] The patient's date of birth?
[CUSTOMER][NEUTRAL] Uh, it is [PII], which is [PII].
[AGENT][NEUTRAL] OK, thank you for that information, [PII], and you're checking a claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, I am.
[AGENT][NEUTRAL] And the date of service and total charge?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] You said [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And the total charge?
[CUSTOMER][NEUTRAL] Uh, it is.
[CUSTOMER][NEUTRAL] $50 which is $50 even.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Are you a dental or medical provider?
[CUSTOMER][NEUTRAL] Dental.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the procedure code on the claim?
[CUSTOMER][NEUTRAL] Uh, which is D 1206.
[CUSTOMER][NEUTRAL] It's 1206.
[AGENT][POSITIVE] Uh, thank you.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, that code is not covered under the schedule of benefits, so there was no payment made on that, uh, procedure code.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Well that's so it does not a covered benefits, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Alright, uh, when the, I mean when the claim was received.
[AGENT][NEUTRAL] OK, I can't hear you.
[CUSTOMER][NEUTRAL] The claim received a date.
[AGENT][NEUTRAL] I received on [PII], processed [PII]. Did you need the claim number?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] It's 353.
[AGENT][NEUTRAL] 3
[AGENT][NEUTRAL] 804.
[CUSTOMER][NEUTRAL] Could you please repeat that? 353.
[AGENT][NEUTRAL] 353-3804.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Any other questions I can help out with today?
[CUSTOMER][NEUTRAL] Mm, yeah, uh, could you please fax the UP?
[AGENT][NEUTRAL] OK, so the explanation of benefits was mailed on [PII], and it's now available to download on our online service center. Let me know when you're ready and I'll give you that address and help you create the account if you would like.
[CUSTOMER][NEGATIVE] I'm sorry, I didn't get you.
[AGENT][NEUTRAL] The ELB has already been mailed and it's now available to download on our online service center. I can give you the web address and help you create the account to download the ELB if you would like.
[CUSTOMER][NEUTRAL] Alright, so you're not able to fax the UB right because it has already been faxed, right?
[AGENT][NEUTRAL] Well, it's actually already been mailed.
[CUSTOMER][NEUTRAL] Alright, and may I know the call reference? Is there any other plan available for this patient?
[AGENT][NEUTRAL] I'm sorry, I didn't hear you.
[CUSTOMER][NEUTRAL] Is there any other plan available? I mean other policy?
[AGENT][NEUTRAL] A dental another dental policy?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] This is the only one that they have with American Public Live.
[CUSTOMER][NEUTRAL] Alright then I need to call reference.
[AGENT][NEUTRAL] My name in today's date, [PII] and any other questions?
[CUSTOMER][NEUTRAL] Your name is [PII], right?
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] Yeah, and today [PII], all right, and today's date which is um [PII] is that.
[AGENT][NEUTRAL] My name in today's date is your reference for today's call. Any other questions?
[CUSTOMER][POSITIVE] All right. So thank you. No, [PII]. Thank you so much.
[AGENT][POSITIVE] You're welcome thank you for calling APL. Have a good day.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Yeah.