AccountId: 011433970860
ContactId: 1f5445a7-77d4-4f15-963a-456c23a6409c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 450070 ms
Total Talk Time (AGENT): 161234 ms
Total Talk Time (CUSTOMER): 138656 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/1f5445a7-77d4-4f15-963a-456c23a6409c_20250611T21:55_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling for Rocks Dental Partners. I just need to check on the status of claims.
[AGENT][NEUTRAL] OK, I can verify claim status for you and Ms. [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] Are you wanting like their ID number or group number?
[AGENT][NEUTRAL] ID
[CUSTOMER][NEUTRAL] OK it is 02609900.
[AGENT][NEUTRAL] OK, thank you and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, ma'am. Give me a moment and verifying the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII]
[AGENT][NEUTRAL] OK, thank you. And what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] [PII] for $299.
[AGENT][NEUTRAL] OK, and give me one moment please.
[AGENT][NEUTRAL] Uh, don't show that claim has been received. Uh, can you verify the address it was submitted to?
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I have.
[CUSTOMER][NEUTRAL] [PII] and payer ID 60801.
[AGENT][NEUTRAL] Uh, yes ma'am. Uh, and if you like I can give you a fax number if you like to fax the claim.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's [PII].
[CUSTOMER][NEUTRAL] Do you have any claims for Albertina at all?
[AGENT][NEUTRAL] Uh, we do. Do you have another date you need to check for her?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII] and the amount of that charge?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] Uh, I do show that claim was received. Uh, looks like for 4346 procedure.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, give me one moment.
[AGENT][NEUTRAL] Um, what was the name of the provider?
[CUSTOMER][NEUTRAL] Uh, let me go back because I just changed patience.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I show that claim process as the policies do not provide benefits for any procedure not listed in the.
[AGENT][NEUTRAL] Dental services and procedures. It looks like it's for major services and I know the patient's policy, Lord words. I know the patient's policy, major services are not covered.
[CUSTOMER][NEUTRAL] OK, could I get a copy of that EOB?
[AGENT][NEUTRAL] Sure, um, give me a moment, and what is your fax number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and it's [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I will send this out to you in a few moments, Ms. [PII], and is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] Uh, yes, I do need to check on one other claim for another patient under the same policy.
[AGENT][NEUTRAL] OK, and what's that patient's name, date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII].
[AGENT][NEUTRAL] Uh, what was that
[AGENT][NEUTRAL] Date of birth again?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. I don't show that patient under this plan.
[CUSTOMER][NEUTRAL] I see, I have something else.
[AGENT][NEUTRAL] OK, is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Uh, yeah, give me just a second. I wanna see if I have an eligibility or anything that I can double check and see if I have something wrong.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It shows family policy.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Do you have dependents listed on this policy or just [PII]?
[AGENT][NEUTRAL] No we have dependents listed, but I don't show that, uh, dependent on the plan.
[CUSTOMER][NEUTRAL] Let me see if I have somebody typed in her date of birth, possibly wrong.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK. [PII], yeah, yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I see that person's.
[AGENT][NEUTRAL] I see the name but not the date of birth, well, the date of birth is showing different in our system.
[CUSTOMER][NEUTRAL] OK, well.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Trying to see if I have anything that shows me for sure. That's what they wrote on the paper. Of course we know that sometimes parents get in here and get the kids' stuff messed up.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so you show her on there you just show a different date of birth?
[AGENT][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Are you able to tell me if you have any claims on file for her?
[AGENT][NEUTRAL] CRE.
[AGENT][NEUTRAL] Uh, yes, give me one moment.
[AGENT][NEUTRAL] OK. I just sent that EOB for Ms. [PII] and let me see for.
[AGENT][NEUTRAL] I cannot pronounce this child's name sorry see and no I don't show any claims being received.
[CUSTOMER][NEUTRAL] OK, that was for the same date of service that you didn't have [PII], so I don't know if there was a glitch that day or what. I will get those resubmitted then.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] All right, if I could get a reference for the call, please?
[AGENT][NEUTRAL] Uh, you can use my name in today's date if you like.
[CUSTOMER][NEUTRAL] And I'm sorry, what was your name again?
[AGENT][NEUTRAL] It's [PII], last initial [PII].
[CUSTOMER][POSITIVE] All right, thank you so much.
[AGENT][POSITIVE] Yes ma'am, thank you for calling APL have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.