AccountId: 011433970860
ContactId: 1a5ad919-ceef-4069-9e88-91eeefe12a11
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 997010 ms
Total Talk Time (AGENT): 174393 ms
Total Talk Time (CUSTOMER): 106084 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=-2.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/08/1a5ad919-ceef-4069-9e88-91eeefe12a11_20250508T16:11_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Good morning. My name is [PII]. I'm just calling to check on a claim status for a patient.
[AGENT][NEUTRAL] OK, sure. I can assist you with claim status, Ms. [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] That was [PII] or [PII]?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And may I have the name of the facility you're calling from, Mr. [PII]?
[CUSTOMER][POSITIVE] 5 star dental.
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] 02465225
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK. OK.
[AGENT][NEUTRAL] And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] It's for [PII] $315.
[AGENT][NEUTRAL] OK, let me see if I can find this claim, and that was [PII] of [PII], correct?
[CUSTOMER][NEUTRAL] Yes it was.
[AGENT][POSITIVE] Got you.
[AGENT][NEUTRAL] And you say [PII] for future you can check claim status online through our website at [PII] and that's just optional. And let me pull this email.
[CUSTOMER][NEGATIVE] So I actually have a lot of trouble pulling anything up on the website. I can't ever pull any eligibility up or any claims.
[AGENT][NEUTRAL] Well, eligibility is not gonna be there it's just for claim and status, but you can always call us. That's just an optional service, um.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] OK, so let me just go ahead and pull this ERP one moment.
[CUSTOMER][POSITIVE] And we've submitted this claim a couple of times we've never had any issues getting claims to you guys and I'm looking at this whole family they've had this plan for a while and we've gotten plenty of payments so I'm not sure what's going on with this one in particular.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yeah, and it looks like we processed twice. The last one was processed as a duplicate, so let me get the original one hold on.
[CUSTOMER][NEUTRAL] Oh, you do have it on file though I for a while, the problem was that we couldn't get it to you, so I'm glad you at least have it.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Yeah, it looks like we do, um, it, it was for prophy and X-rays.
[AGENT][NEUTRAL] An evaluation? Mhm, yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so let's see.
[AGENT][NEUTRAL] Looks like we processed this claim back in [PII] and we send a benefit amount, we send a check in the amount of $249.60.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Got you, we might need to get a tracer on that because we have not received that.
[AGENT][NEUTRAL] Let me check and see if I have a clear day if it will show me uh one moment.
[AGENT][NEUTRAL] What is the address?
[AGENT][NEUTRAL] To submit um the checks.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, that's where we send it to. Um, let me go ahead and, yeah, it doesn't look like it's been clear. Let me check one more place.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me go ahead and send the request for the check to be canceled. I mean it doesn't show like in my end it doesn't seem that it's cleared, so I'm gonna go ahead and send the request for research and review and see if they can cancel and issue. Um, do you mind holding for me while I send this, um, request over to the correct department?
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][POSITIVE] Yeah, no worries.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me, Ms. [PII]. I do apologize for that long wait. I did send out the request for to have the check counselor reissued, OK?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] OK, it's gonna be reprocessed?
[AGENT][NEUTRAL] Yes, it usually takes 24 to 48 business hours for them to um do all the process.
[CUSTOMER][POSITIVE] Got it thank you so much. Can I just get a reference number for our call?
[AGENT][NEUTRAL] Welcome.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information, Mr. [PII]?
[CUSTOMER][NEUTRAL] Uh, no, that's OK, um, and after it's reprocessed, about how long does it take? Is it just standard mailing time?
[AGENT][NEUTRAL] Yes. Mhm. Correct. So after 24 to 48 hours, we'll go ahead and send it by mail.
[CUSTOMER][NEUTRAL] To get to us, OK.
[CUSTOMER][POSITIVE] Perfect thank you so much for your help.
[AGENT][POSITIVE] You're welcome, Mr. [PII] Is there anything else I may help you with today?
[CUSTOMER][POSITIVE] No, that was it. Thank you.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thank you, bye bye.