AccountId: 011433970860
ContactId: 11c30d74-8597-4a16-a2c8-033e34cfc7da
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1183810 ms
Total Talk Time (AGENT): 388262 ms
Total Talk Time (CUSTOMER): 590267 ms
Interruptions: 7
Overall Sentiment: AGENT=1.1, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/07/11c30d74-8597-4a16-a2c8-033e34cfc7da_20250207T22:16_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] and I'm calling from a dental provider office. I just would like to follow up with uh uh payment of a claim. Can you please help me with that?
[AGENT][POSITIVE] It would be my pleasure to assist you fine. What is a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes. My contact number is [PII].
[AGENT][POSITIVE] Thank you, finally, what is the policy number for the patient, please?
[CUSTOMER][NEUTRAL] Yes. It is 022734.
[CUSTOMER][NEUTRAL] 39.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] Yes. First name is [PII] and last name is [PII]. And the date of birth is [PII].
[AGENT][POSITIVE] Alright, thank you, and it would be my pleasure to assist you with that claim information for Mr. [PII].
[CUSTOMER][NEUTRAL] Mm.
[AGENT][POSITIVE] I'm just getting everything pulled up. It would be my pleasure.
[CUSTOMER][POSITIVE] Yes. Thank you very much for that. Yeah, sure. Thank you.
[AGENT][NEUTRAL] And what is the date of service?
[CUSTOMER][NEUTRAL] Yes, it is on [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] And what is the dental provider name?
[CUSTOMER][NEUTRAL] Oh, OK. Provider's name is [PII].
[AGENT][NEUTRAL] And what group is he with?
[CUSTOMER][NEUTRAL] Uh, it's in [PII].
[AGENT][NEUTRAL] And what is the name of the dental provider billing name?
[CUSTOMER][NEUTRAL] Oh, OK. It is New Smiles Dental Implant Center.
[AGENT][NEUTRAL] Is that Coase Dental Implant Center? OK, thank you.
[CUSTOMER][POSITIVE] Yes, yes. Yes, correct. Yes. We have two names. I'm sorry about that. Yes, thank you.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] Not a problem thank you. Alright, I'm checking on that claim, bear with me just one moment please.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yes. Sure. Thank you.
[CUSTOMER][NEUTRAL] I can give you additional information uh about this one.
[AGENT][NEUTRAL] Do you have a claim number?
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEGATIVE] Uh, no, I don't have a claim number, but I spoke to a representative two weeks ago on [PII], and he, she told me that, uh, a, a check payment of $38 was mailed out on [PII], but we never received it.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So I spoke to rep [PII], and she told me that she will help me to reissue the check and it will take about 2 weeks to arrive. So it is exactly 2 weeks from the day I spoke to her. So it's 2 weeks today. But uh I haven't received anything yet. So I would like to see if a new check has been issued or not.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, I'm checking on that for you. I see in the notes, let's see.
[CUSTOMER][NEUTRAL] Yes, please. Thank you. Would you like to get the reference number of the last conversation?
[AGENT][POSITIVE] I see the conversation. Thank you. I appreciate that assistance. I see that conversation.
[CUSTOMER][POSITIVE] Oh, OK, great. Yes, thank you.
[CUSTOMER][POSITIVE] Yeah, sure, thank you.
[AGENT][NEUTRAL] And is the correct address [PII]?
[CUSTOMER][POSITIVE] Yes. Yes, it's correct.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And the ZIP code is [PII].
[AGENT][POSITIVE] Perfect, thank you.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Do you mind holding for just a moment and let me check in further on that for you. Thank you. One moment.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][POSITIVE] Sure, please take your time. Thank you. Thank you.
[AGENT][POSITIVE] Thank you, fine one moment.
[CUSTOMER][NEUTRAL] Transferring
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][POSITIVE] Well, hey, [PII], it's [PII]. How are you doing? Happy Friday.
[CUSTOMER][POSITIVE] Happy Friday. I'm good, [PII]. How are you?
[AGENT][NEUTRAL] I'm doing good and I don't know if you can help me. I'm trying to decipher notes on a, a policy. Can you look at policy 2273439?
[CUSTOMER][NEUTRAL] Sure, one moment.
[AGENT][NEUTRAL] And some participant one.
[CUSTOMER][NEUTRAL] Participant one OK.
[CUSTOMER][NEUTRAL] Um, OK.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I went to old messages. Let me just get that to the newest, newest messages. One moment.
[CUSTOMER][NEUTRAL] OK, come on.
[CUSTOMER][NEUTRAL] OK, so then, OK, I see [PII]. OK, OK, [PII], OK, request to cancel claim.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 559129. Obviously she missed the number 2273439.
[CUSTOMER][NEUTRAL] OK, so she meant to put request to cancel claim 3559129.
[CUSTOMER][NEUTRAL] Cannot void as it is a dental claim. See notes below sent to [PII]. OK, to have claim DM2 per send the claim request, hm.
[AGENT][NEUTRAL] So I've got the provider on the line seeing if that was reissued and I can't figure out what's going on.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] Well, me either. Um, it does not seem like anything has been reissued with today. Today is the [PII], uh, something with DM2 today.
[AGENT][NEUTRAL] See, and that does have the provider name Coone's Dental Implant Center. So why, why was it DMO2?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] You said
[CUSTOMER][NEUTRAL] OK, let me see if [PII]'s, I'm, I'm, I'm, I'm sorry, [PII], um, give me one second.
[AGENT][NEUTRAL] Yeah, it, it's fine, it's making my head spin.
[AGENT][NEUTRAL] I'm like a what?
[CUSTOMER][NEUTRAL] I'm gonna see if maybe [PII]'s here, uh, since, you know, the request was sent to [PII] for send a clean request or [PII] is here.
[CUSTOMER][NEUTRAL] OK, so something was the M2 today.
[CUSTOMER][NEUTRAL] Oh Jesus, look back.
[AGENT][NEUTRAL] There's not a hub number in here.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] So I don't even know if we got the hub back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh [PII], OK.
[CUSTOMER][NEUTRAL] It is confusing, so that is a.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] What what's OK, what is the initial date of service?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What was
[AGENT][NEUTRAL] I'm looking to see if I can find it in the hub, see if there's any notes there.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] To me
[CUSTOMER][NEUTRAL] [PII], [PII]. OK, that's that one. That was that one there was.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEGATIVE] It does not appear that it has been reissued. I'm not sure why.
[CUSTOMER][NEUTRAL] The DMO 2
[CUSTOMER][NEUTRAL] Uh dear, I wonder is [PII] here.
[CUSTOMER][NEUTRAL] I, I'm sorry, [PII], just bear with me.
[AGENT][NEUTRAL] You're fine. I'm scrolling through the hubs right now to see if I can find the hub request.
[CUSTOMER][NEUTRAL] Not too much.
[AGENT][NEUTRAL] And that was on.
[CUSTOMER][NEUTRAL] OK, so [PII]'s here. OK, so let me ask her.
[CUSTOMER][NEUTRAL] Oh my gosh, OK, I wish we could call her.
[AGENT][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Fair enough, I found the herb.
[CUSTOMER][NEUTRAL] You did?
[AGENT][NEUTRAL] No, I thought I did. It was one number off I was like, oh man.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] On phone regard regarding.
[CUSTOMER][NEUTRAL] Claim
[CUSTOMER][NEUTRAL] OK, that was claim um 351-1283.
[CUSTOMER][NEUTRAL] For date of service.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Uh, has it been reprocessed? Has it been reprocessed.
[AGENT][NEUTRAL] Yeah, DMO2 has got me.
[CUSTOMER][POSITIVE] Yeah, me too. I have a I'm sorry, OK.
[AGENT][NEUTRAL] I don't see it completed either, so I don't know where that hub is.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] 2273439.
[CUSTOMER][NEUTRAL] I'm saying the same thing to [PII], OK, um.
[CUSTOMER][NEUTRAL] OK, she's, what is she doing? She is presenting oh, OK.
[CUSTOMER][NEUTRAL] OK, so I can see um.
[CUSTOMER][NEUTRAL] A message I am to [PII], but I can talk to the provider but I don't know if the check has been, it doesn't show that it has been reprocessed.
[AGENT][NEUTRAL] So she said that, that she was told to be given 2 weeks.
[CUSTOMER][NEUTRAL] And so it was like
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Oh, OK. How long was it? Has that been, uh, at least more than 2 weeks, obviously.
[AGENT][NEUTRAL] She spoke with, yeah, she spoke with [PII] on the [PII].
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] I mean, I'm sorry, on the [PII], uh, let me try that again. Heck.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, she sent a hub, it looks like on the [PII].
[CUSTOMER][NEUTRAL] OK, so new claim claim address is correct. OK, new claim number 3559129. I got it what?
[AGENT][NEUTRAL] Tren always there the hub numbers in here.
[AGENT][NEUTRAL] Which is the 1 DMO2.
[CUSTOMER][NEUTRAL] Avoid claim number 3511283.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK, OK, so I'll see below. OK, I'm, I'm so sorry. Check that receipt from claim 3511283. OK, that's one that we voided part one sent her to cancel.
[AGENT][POSITIVE] Take your time.
[AGENT][POSITIVE] Oh, I think I finally found it.
[CUSTOMER][NEUTRAL] And hope to hope to cancel so claim can be reprocessed to verify provider information is correct.
[CUSTOMER][NEUTRAL] You found it?
[AGENT][NEUTRAL] I did. I found the hub and it's hub number 30838, but there's a lot of
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 0 30838.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And that was back on you say, OK, yeah, it's been a minute. It's been a few days. OK, what is she what is she trying to request to cancel a claim?
[AGENT][NEUTRAL] 2 weeks ago.
[CUSTOMER][NEUTRAL] That boy is just a dental claims.
[CUSTOMER][NEUTRAL] Signals below sent to a [PII] to have plan BMO2er as the claim request.
[CUSTOMER][NEUTRAL] Oh my [PII], OK.
[AGENT][NEUTRAL] OK, so 2 weeks ago, yeah, no, that's fine. We've got to get all the information we can. [PII] and check has been voided, please process, reprocess that claim, once completed, close hub.
[CUSTOMER][NEUTRAL] I'm sorry,
[AGENT][NEUTRAL] Um, last week, [PII] asked [PII] if it's been completed.
[AGENT][NEUTRAL] Um, this week, do we have an update if you make notes here that we can track this.
[AGENT][NEUTRAL] Track the day since the request.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] [PII] sent a notice, the new claim number is 3559129 from voyage claim.
[AGENT][NEUTRAL] There was nothing issued.
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] Who's that? OK, um.
[CUSTOMER][NEUTRAL] So the check does not.
[AGENT][NEUTRAL] I reckon
[AGENT][NEUTRAL] I reckon what we can do is to just let her know that I don't see it's completed and I can send an email.
[AGENT][NEUTRAL] I, I don't know what to do.
[AGENT][NEUTRAL] An email or?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] An email to [PII]. I'm sending to see if she's.
[CUSTOMER][NEUTRAL] She hasn't responded yet to my, I am. I'm sorry, I'm sorry, [PII]. I'm sorry. I'm trying to, I'm trying to um.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] No, no, I get it.
[CUSTOMER][POSITIVE] I'm trying to decipher this too. I'm so sorry.
[AGENT][POSITIVE] No, you, you are absolutely fine. I'm doing the same thing, girl.
[CUSTOMER][NEUTRAL] See those close in to to try just request.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] I see the request, OK, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Some boy claim.
[CUSTOMER][POSITIVE] It's correct.
[AGENT][NEUTRAL] I don't know how to send an email to the dental queue.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] I, I think it needs to be sent to the adjuster, not the queue.
[CUSTOMER][NEUTRAL] Because um.
[AGENT][NEUTRAL] Should I copy?
[CUSTOMER][NEUTRAL] Just personally.
[CUSTOMER][NEUTRAL] Copy, um,
[AGENT][NEUTRAL] Um
[AGENT][NEGATIVE] [PII], I hate to do that.
[CUSTOMER][NEUTRAL] You can, you can cop, you can, you can copy. I know, yeah, I understand, I understand, but I, I, I am trying to decipher the notes too. Well, we are trying to decipher the notes and I'm, I'm kinda confused, but I think the money is still in, in house, but, but still the check has not been reissued, so that's the thing and it's been, it's been two weeks, it's been, it's been some time, um, and has not been done yet, so I'm not sure why it has not been done, but.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] maybe you can blind copy [PII]. I don't know, I don't know. uh, I, I'm so sorry. I was trying to see if [PII]'s gonna answer, but she hasn't responded yet.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] So we haven't.
[CUSTOMER][NEUTRAL] That was day of service and that was called on.
[CUSTOMER][NEUTRAL] Today's the [PII].
[CUSTOMER][NEUTRAL] The check no, nothing has been reissued. OK, I'm just talking to myself, OK? Nothing has been reissued.
[CUSTOMER][NEUTRAL] Because we don't have a check number.
[CUSTOMER][NEUTRAL] I'm not sure why that was demo too.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Not processed.
[AGENT][NEUTRAL] I'm gonna put the hub request in here.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Check not received the claim.
[CUSTOMER][NEUTRAL] She have request to have to cancel so claim can be reprocessed.
[CUSTOMER][NEUTRAL] To cancel so what she did to be canceled. So what happened before that? Something that happened before that.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] You know what I think?
[AGENT][NEUTRAL] And I think I'm
[CUSTOMER][POSITIVE] Princes Park. Oh, I'm sorry. I'm so sorry.
[AGENT][NEUTRAL] See what you think. See what you think. I'll put good afternoon provider call, checking the reissue payment on claim b blah blah blah blah. The hub request to void check was the e-issued was issued was issued on [PII] of request 30838. I don't see a reissued check. I think I'm gonna get the provider name.
[AGENT][NEUTRAL] And ask for a call back next week or today or next week. I think that's, I don't think you and I can decipher this.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, no.
[AGENT][NEUTRAL] I don't, I mean, you may have better deciphering abilities than I do.
[CUSTOMER][NEUTRAL] Well, I'm, I'm, I was trying to
[AGENT][NEGATIVE] I don't think there's enough information.
[AGENT][NEUTRAL] To decide for it.
[CUSTOMER][NEUTRAL] I was trying to I was trying to decipher but um I, I believe the money is still in the house it's just that we haven't the, the claim has been reprocessed.
[AGENT][NEGATIVE] I just don't know why that deal and MO2 is there. That just blows my mind.
[CUSTOMER][NEUTRAL] I'm not sure yet. I wasn't sure that either. I'm not sure of that. I am not sure of that.
[AGENT][NEUTRAL] I think I'm just gonna get the provider phone number and ask them if we can um check on it and then someone will call her back first part of next week. I think that's what we need to do. I think you and I could sit here and look and look and not find anything.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] Yes, I'm so sorry.
[CUSTOMER][POSITIVE] I'm so sorry. I am really sorry. I, I've been trying to go back.
[AGENT][NEUTRAL] No, you are fine. It's not, I understand.
[AGENT][NEUTRAL] It's, I just don't think there's enough information that we can put our hands on.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] To find the answer.
[CUSTOMER][NEUTRAL] Yeah, I
[CUSTOMER][POSITIVE] Yeah, I, I agree, I agree. I'm sorry, I agree.
[CUSTOMER][NEUTRAL] It was a bit choppy. I'm sorry. I'm sorry. I'm sorry, [PII].
[AGENT][NEUTRAL] Oh, girl, it ain't your, it ain't your issue.
[CUSTOMER][MIXED] Well, it is because I was able to assist and I was trying my best to assist um as best as best as I could, as best as I could, but I was a little confused with the uh the notes.
[AGENT][POSITIVE] Yes you were.
[AGENT][NEUTRAL] But there's
[AGENT][NEUTRAL] But we can't make an apple pie without the apples.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, we cannot.
[AGENT][NEUTRAL] How do you like that analogy.
[CUSTOMER][POSITIVE] No, I can't. I like that analogy.
[AGENT][POSITIVE] Sweet and simple.
[CUSTOMER][POSITIVE] Oh, I like that one, OK.
[AGENT][NEGATIVE] I just made that one up. That just came out of nowhere. I have no clue.
[AGENT][NEUTRAL] Oh
[CUSTOMER][POSITIVE] Oh my goodness.
[AGENT][NEUTRAL] I'll write that down. Put it on my wall. Can't make apple pie without the apples.
[CUSTOMER][NEUTRAL] Yeah, OK, fair enough.
[AGENT][POSITIVE] OK, let me get back to the provider and I'll just, I'm gonna handle it that way. You're good, girl.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you [PII]. I'm sorry. I, I'm so sorry.
[AGENT][NEUTRAL] No, you see, just that extra voice too. We figure, I figured out what to do. She done hung up.
[CUSTOMER][NEUTRAL] Oh Lord, well, we have been on the phone for a minute. [PII]. I'm so sorry. Oh my [PII], we were trying to figure it out. We were trying to figure out, oh my God.
[AGENT][NEUTRAL] Yeah, but she, she said, and she said that she did say take your time.
[AGENT][NEUTRAL] But I'll call her back.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Oh goodness, OK.
[AGENT][NEUTRAL] I'll call her back real quick and just tell her that I was researching it and um I'm going to send this to that department and have them research it further and give her a call back.
[CUSTOMER][NEUTRAL] Yes. Yes.
[AGENT][POSITIVE] I got, I got it, girl. I got it.
[CUSTOMER][POSITIVE] OK. Oh goodness.
[AGENT][POSITIVE] Now breathe and have a great weekend.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] You did the same, you did the same.
[AGENT][POSITIVE] Thanks, sweetie. Take care.
[CUSTOMER][NEUTRAL] OK, you too. All right, bye bye.
[AGENT][NEUTRAL] Bye-bye.