AccountId: 011433970860
ContactId: 2298d3f4-62cf-49dd-a2f8-1c24ae847418
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 533539 ms
Total Talk Time (AGENT): 174464 ms
Total Talk Time (CUSTOMER): 183823 ms
Interruptions: 2
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/2298d3f4-62cf-49dd-a2f8-1c24ae847418_20250528T20:32_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. I need to try and get a fax of a patient's dental benefits, please, ma'am.
[AGENT][NEUTRAL] OK, you're needing to get a fax back on a dental policy, is that correct?
[CUSTOMER][NEUTRAL] Mhm. Yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am, I can help you with that. And who am I speaking with, please?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] Thank you and [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII].
[CUSTOMER][NEUTRAL] 608-572
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Genesis gave a shot it's starting to come up like all through my nose and.
[CUSTOMER][NEUTRAL] Is it and smell it.
[AGENT][NEUTRAL] OK, and any information, [PII] that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] [PII] [PII]. I just did a
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] I was sending it on my door, but
[CUSTOMER][NEUTRAL] Usually from the time I walk from in there to this year.
[CUSTOMER][NEUTRAL] Start taking it I want it to my nephew.
[CUSTOMER][NEUTRAL] A lot of
[AGENT][NEUTRAL] OK, so [PII], on this policy, I see that he had been the subscriber. This policy was active from [PII].
[AGENT][NEUTRAL] And it turned as of [PII].
[AGENT][NEUTRAL] And there is not another policy that is active beyond that point with us.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] So his spouse.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] on this plan.
[CUSTOMER][NEUTRAL] Um, we verified she had active coverage. She came in in last week.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] And she came in in February and we were paid in February from you guys on her.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Let me look at the notes.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Give me just a sec because I need to, I'm just looking at some information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] I know coming in a little bit.
[AGENT][NEUTRAL] OK, so I can see about the claim for her. I, but I still see, but this policy I'm gonna have to send a ticket to have this researched because the policy is showing from all indication on my end that it termed as of [PII].
[CUSTOMER][NEUTRAL] that
[CUSTOMER][NEUTRAL] Do you change number 28 to 3.
[AGENT][NEGATIVE] And the entire policy is lapsed.
[CUSTOMER][NEUTRAL] Just so we can have accurate.
[AGENT][NEUTRAL] Let's see
[CUSTOMER][NEUTRAL] Just to remove it.
[AGENT][NEUTRAL] And that's the only claim that's recently been processed was for the spouse.
[CUSTOMER][NEUTRAL] For 227, so, so 5-19 has not been processed.
[AGENT][NEUTRAL] In March.
[CUSTOMER][NEUTRAL] Or anything.
[AGENT][NEUTRAL] Oh, I haven't checked any of her claims. I just looked at what you were saying.
[CUSTOMER][NEUTRAL] OK, OK, and what was your name?
[AGENT][NEUTRAL] Um, I, my name is [PII]. Now I can.
[AGENT][NEUTRAL] What is the spouse's date of birth?
[CUSTOMER][NEUTRAL] [PII]'s, um, the one the claim was on that was paid, um her date of birth is [PII].
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And what is the data service for her?
[AGENT][NEUTRAL] It was processed.
[CUSTOMER][NEUTRAL] Well, the, the process claim was 22705.
[AGENT][NEUTRAL] That's the date of service.
[CUSTOMER][NEUTRAL] And then I have a pending claim, yeah, I have a pending claim.
[AGENT][NEUTRAL] 3 27 2.
[AGENT][NEUTRAL] All right, wait just a second. We're gonna, we have to do them one at a time. So 227, what was the total on that claim?
[CUSTOMER][NEUTRAL] $227 on 22725.
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] All right, let's
[CUSTOMER][NEUTRAL] I paid $55.
[AGENT][NEUTRAL] OK, but what was the, OK. Hm.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The data service and the claim amount are the same amount 227.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so it's for some, I don't know what's going on with the policy. Hold on just a moment. Uh.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Mhm OK.
[CUSTOMER][NEUTRAL] 578
[CUSTOMER][NEUTRAL] Tylenol, OK, and ibuprofen, you wanna take it on the way home, please.
[CUSTOMER][POSITIVE] Yeah, oh, I'm sorry.
[CUSTOMER][NEUTRAL] 2 weeks of suture removal. So just to check all the site.
[CUSTOMER][NEUTRAL] To bleeding infection.
[AGENT][NEUTRAL] And that was on plain Melanie, 357-470-5. Is that correct?
[CUSTOMER][NEUTRAL] I don't know what claim number it is. OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I have a 9:20.
[CUSTOMER][NEUTRAL] Or 11:30.5 is [PII]
[CUSTOMER][POSITIVE] I'm sorry, it's 10:30. I'm so sorry.
[AGENT][NEUTRAL] OK, so it looks like the policy had been reinstated, but then it was.
[AGENT][NEUTRAL] After your claims were processed.
[CUSTOMER][NEUTRAL] So
[AGENT][NEGATIVE] The policy was lapsed.
[CUSTOMER][POSITIVE] So we wanna ask to have you come back.
[CUSTOMER][NEUTRAL] So after the [PII], it was reinstated, but then it lapsed.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That's what it's from what I can see. But again, I just need to send this.
[AGENT][NEUTRAL] And have it looked at because that's all I can see. I can see it was restated early February, but then it is since termed.
[CUSTOMER][NEUTRAL] Um, I could do, uh, Thursday. And you're not so.
[AGENT][NEUTRAL] With a term date of [PII].
[CUSTOMER][POSITIVE] [PII] OK all right [PII] thank you and you have a good day.
[AGENT][POSITIVE] Mhm. Yes. Well, yes, ma'am. You're welcome. So is there anything else I can help you with, [PII], or try to help you with?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] No, ma'am. [PII], thank you.
[AGENT][POSITIVE] OK. All right. Well, you're very welcome and thank you for calling APL. I hope you have a very nice evening.
[CUSTOMER][NEUTRAL] You too mhm bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you