AccountId: 011433970860
ContactId: 3317b57c-84ba-460b-856a-ea4a204be74f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 209279 ms
Total Talk Time (AGENT): 98938 ms
Total Talk Time (CUSTOMER): 55380 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/3317b57c-84ba-460b-856a-ea4a204be74f_20250515T14:07_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], my name is [PII], and I'm calling to check on the status of a dental claim.
[AGENT][NEUTRAL] OK, well, I'll be more than happy to help you with the dental claim, and [PII], may I have a good contact number in case we're disconnected and the policy number?
[CUSTOMER][NEUTRAL] Sure, so I'm gonna give you my direct, my cell phone number. It's [PII].
[CUSTOMER][NEUTRAL] And then you need the member's policy number, correct?
[AGENT][NEUTRAL] Well, are you the insured or you're calling with the provider's office?
[CUSTOMER][NEUTRAL] Provider's office.
[AGENT][NEUTRAL] Yes, the member's policy number.
[CUSTOMER][NEUTRAL] 02612730
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service and the total bills?
[CUSTOMER][NEUTRAL] [PII] billed amount is $300.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And do you mind if I place you on just a brief hold while I locate the claim?
[AGENT][NEUTRAL] Actually, it just popped up. Hold on one moment. I don't need to.
[CUSTOMER][POSITIVE] Sure, thank you.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] And can you verify the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Southeastern Dental Center of Hamilton.
[AGENT][NEUTRAL] Alright, so I'm sure we received the claim on [PII].
[AGENT][NEUTRAL] Claim number is 35, I'm sorry, 359-6700.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And on [PII], the claim was denied, well, it's not denied, it's placed on hold. Um we're waiting for eligibility from their insured, their employer.
[AGENT][NEUTRAL] So with their type of policy and their employer, um, we just have to make sure that they were eligible for benefits at that time and then we can go ahead and continue processing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so that was 2 weeks ago. How long does that take?
[AGENT][NEUTRAL] Um, there's no turnaround on it. They, they're familiar with the process, we have to do it on all these policies. Um, we sent it out to them on the [PII], so yeah, that's about 2 weeks. I mean, there's no turnaround just once we receive it, we, we continue processing.
[CUSTOMER][NEUTRAL] I'm just writing it down.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, um, do you have a reference number for the call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] [PII], thank you so much. I hope you have a good rest of your day.
[AGENT][POSITIVE] You're very welcome. Well, thanks for calling APL. I hope you have a great day as well. Bye-bye.
[CUSTOMER][POSITIVE] You will thank you.