AccountId: 011433970860
ContactId: 28932a4d-6a94-47a1-a947-9d889e2d1c6d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 394600 ms
Total Talk Time (AGENT): 183189 ms
Total Talk Time (CUSTOMER): 186027 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/28932a4d-6a94-47a1-a947-9d889e2d1c6d_20250121T16:14_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII], um,
[CUSTOMER][NEUTRAL] I have a question regarding um letters that I received uh from your company. So my son, um,
[CUSTOMER][NEUTRAL] My son and I have the insurance and my son had a checkup um in December. And your insurance keep us sending letters to me and my dentist about saying that this still looking for information, looking for confirmation. Um, it says, um, you received a claim on your policy, um,
[CUSTOMER][NEUTRAL] So I'm just wondering what's going on. And my dentist.
[AGENT][NEUTRAL] OK, I can look into it.
[CUSTOMER][NEGATIVE] Pay it because it has been so long that insurance hasn't paid to them. I just want to understand the problem.
[AGENT][NEUTRAL] OK, well, I definitely can assist you um with looking into that claim. And may I have a good contact number in case we're disconnected and then your policy number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My phone number is [PII]. And the policy number, let's see, um,
[CUSTOMER][NEUTRAL] 02
[CUSTOMER][NEUTRAL] 544545.
[AGENT][POSITIVE] Thank you. Hold on one moment.
[CUSTOMER][POSITIVE] It is me and my son should be there too.
[CUSTOMER][NEUTRAL] Employee and child, so.
[AGENT][NEUTRAL] OK, I'm pulling it up now. Hold on one moment and I have the policy here. I just need you to verify, um, well, you've already given me your first and last name, your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Yes, date of birth is [PII]. Um, do you want the address?
[AGENT][NEUTRAL] Yes, your home address and email address.
[CUSTOMER][NEUTRAL] Uh, home address is [PII].
[CUSTOMER][NEUTRAL] An email is my name together all lower case [PII].
[AGENT][NEUTRAL] All right, um, and this one is a [PII]. Did you want to keep that on file?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] No, no, no. OK, just use the Gmail, save that [PII]. That's, that's fine.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You don't have to, you don't have to include hot meals. This is fine.
[AGENT][NEUTRAL] OK. Well, all the information provided is a verification of benefits, not a guarantee of payment. So let me take a look at the claim and then I can see what's going on. Um, hold on one moment, and you said this is for your son, correct?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK, so we've only, do you have the date of service because we've only processed one claim for your son from [PII] from [PII].
[CUSTOMER][NEUTRAL] That's it. That's it. Mhm.
[AGENT][NEUTRAL] So we paid out on this claim.
[CUSTOMER][NEUTRAL] That's still
[AGENT][NEUTRAL] We paid out on this claim $188.
[CUSTOMER][NEGATIVE] No, they didn't receive it.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] Because this claim was paid on.
[AGENT][NEUTRAL] Let me check the check.
[AGENT][NEUTRAL] So they haven't received the check. OK, so you can let them know that the, the claim was paid to them on, oh, wait a minute.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] OK, well, let me give you this information. They have not received the payment yet. So we received the claim, let them know we received the claim on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The claim number is 354.
[CUSTOMER][NEUTRAL] 354
[AGENT][NEUTRAL] 70
[CUSTOMER][NEUTRAL] Clean
[AGENT][NEUTRAL] 83
[CUSTOMER][NEUTRAL] Claim number is, OK.
[AGENT][NEUTRAL] So the claim number is 3547083. We received it on [PII], and on [PII], we paid out on the claim $188.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The check is coming from, go ahead.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] It's paid to the my dentist, right?
[AGENT][NEUTRAL] Right, we paid it to your dentist. So it was just sent out on the [PII], so.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] They have until [PII] to receive the payment, so it just hasn't gotten to them yet.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] They, they received a letter saying that um uh the company needs more information, but they didn't know what kind of information they needed. That's they, that's why they reach out to me.
[CUSTOMER][NEUTRAL] Um, yesterday saying that they didn't receive the payment, there's something going on, please check your account.
[AGENT][NEUTRAL] Right, they called us on [PII] um for the claim status.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] Um, and, and we told them that there was no claim on file, but they since then, they sent it in in January, so they just sent it to us last week or the week before last, yeah, week before last.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, got it.
[CUSTOMER][NEUTRAL] So the delay was delay was receiving the claim from your site. OK.
[CUSTOMER][NEUTRAL] Um, I will call my dentist saying that the check is on the way, um.
[CUSTOMER][NEUTRAL] On its way to get there. Mhm.
[AGENT][NEUTRAL] Yes, and if they have any questions, go ahead.
[CUSTOMER][NEUTRAL] And
[CUSTOMER][NEUTRAL] If they don't receive until [PII] then
[CUSTOMER][POSITIVE] They can, I can reach out to you again.
[AGENT][NEUTRAL] Well, they actually need to reach out to us. So I was gonna say you need, um they can, you can give them our contact information when you speak with them and let them know um that if they don't receive the check by [PII], then they can give us a call back and we'll check on the check and reissue it, or if they need claim status, we can give it to them.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much. I appreciate your help.
[AGENT][NEUTRAL] You're very welcome. You're welcome. Well, again, all the information provided was a verification of benefits, not a guarantee of payment. And was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] Um, that's it. Uh, I was wondering that only this. Thank you so much. I really appreciate your help.
[AGENT][POSITIVE] You're welcome. You're welcome and I hope you have a great day.
[CUSTOMER][NEUTRAL] Hello
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thanks for calling APL. Bye-bye.