AccountId: 011433970860
ContactId: 3004f95a-ccd6-49ae-9d0b-af9c7bd4fc77
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270899 ms
Total Talk Time (AGENT): 101936 ms
Total Talk Time (CUSTOMER): 125503 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/3004f95a-ccd6-49ae-9d0b-af9c7bd4fc77_20250116T18:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Hi [PII]. My name is [PII]. It's spells like [PII] Last initial is [PII]. Could you spell your name for me once?
[AGENT][NEUTRAL] That's [PII]
[CUSTOMER][NEUTRAL] Thank you, [PII]. Uh, OK, actually I'm looking for uh dental claim status.
[AGENT][NEUTRAL] OK, yeah, I could check on a claim for you. [PII]. Can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah, it's [PII]. It's the declined.
[AGENT][NEUTRAL] OK, thank you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yeah, uh, in my system I can see the policy number is 02137723.
[AGENT][NEUTRAL] OK, thank you. And what was the name and date of birth for the insured?
[CUSTOMER][NEUTRAL] Uh, my first name is [PII] and the last name is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, I'm sorry, you did say this was a dental claim?
[CUSTOMER][NEUTRAL] Uh, it's a medical claim actually.
[AGENT][NEUTRAL] It is medical. OK, OK, just wanted to make sure. I appreciate you verifying that information. Uh, what was the date of service for this claim, [PII]?
[CUSTOMER][NEUTRAL] Uh, actually, the data service is, uh, [PII]. It's [PII].
[AGENT][NEUTRAL] OK, and what was the uh bill amount?
[CUSTOMER][NEUTRAL] Belt amount is, uh, let me provide you with amount. It's $11.66.
[AGENT][NEUTRAL] I'm sorry, that was $11.66?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, all right one moment please.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Was this for um Maco Medical Laboratories?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, OK, so we did receive this claim, uh, however we were needing a copy of the primary EOB in order to complete processing.
[CUSTOMER][NEUTRAL] OK, uh, it means you're saying the status of this claim is still pending due to, uh, primary you will be needed, right?
[AGENT][NEUTRAL] It is denied um but it's just missing that information so if we can get that then we can process it.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, uh, could you provide me the denial date when it it was got denied because we didn't receive any OK. Yeah, please go ahead.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Of course that was uh [PII].
[AGENT][NEUTRAL] If you'd like I can send you a copy of the EOB.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh, sure, please. Uh, before that, could you please also provide me the claim number?
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Yes, that was 339-721-7.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK. And uh you are able to send me this copy through fax, right?
[AGENT][NEUTRAL] Correct. What was that fax number for you?
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] It's uh [PII]. Mark attention to my name. It's [PII]
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, and I'm going to repeat that number back to you, make sure I heard that correctly, that was [PII]?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, I will go ahead and get that sent to you. You should get it here in maybe 10-15 minutes depending on how busy your machine is. Was there anything else I could help you with?
[CUSTOMER][POSITIVE] That's all I needed for today, [PII]. Thanks so much for your assistance. May I also have a call reference before I call?
[AGENT][NEUTRAL] Of course.
[AGENT][NEUTRAL] Yeah, reference number would just be my first name, last initial, and today's date, uh, so my last initial is A.
[CUSTOMER][POSITIVE] OK, thank you so much. Have a wonderful rest of your day.
[AGENT][POSITIVE] Of course, thanks for calling APL you too bye bye.
[CUSTOMER][NEUTRAL] With the right.