AccountId: 011433970860
ContactId: 43144656-52d4-4142-8493-0fd8968f5dd0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 712739 ms
Total Talk Time (AGENT): 264099 ms
Total Talk Time (CUSTOMER): 224487 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/25/43144656-52d4-4142-8493-0fd8968f5dd0_20250225T20:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi [PII]. I've got two questions for you. Um, do you want my, uh, policy number first before we start?
[AGENT][NEUTRAL] Yeah, go ahead.
[CUSTOMER][NEUTRAL] It is um 682-548.
[AGENT][NEUTRAL] OK, let me pull this up here one second.
[AGENT][NEUTRAL] And then if I could just get your first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yeah, [PII] [PII].
[AGENT][POSITIVE] Alright [PII], I've got this pulled up. How can I help today?
[CUSTOMER][NEGATIVE] Oh, another thing actually, this card is like so worn out. It's, it's paper. Um, can I get a new one possibly?
[AGENT][NEUTRAL] Oh
[AGENT][POSITIVE] Yeah absolutely do you want sent in the um.
[CUSTOMER][NEUTRAL] That was it.
[AGENT][NEUTRAL] US postal mail. I can email one too, but I can send one in the mail.
[CUSTOMER][POSITIVE] This email is better. Yes, thank you. [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I know.
[CUSTOMER][NEUTRAL] You have the address, right?
[AGENT][NEUTRAL] Yeah, let me just verify that is accurate and up to date. We have you at [PII]. Is that correct in [PII]? OK.
[CUSTOMER][NEUTRAL] Yes, yes, it is, uh huh.
[AGENT][POSITIVE] All right, so we will send one out to you, uh, just give it a little time to come. Is there anything else I can help with?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEGATIVE] Yeah, I've got two questions that I called about. So one thing is I went to my, my regular dentist a few weeks ago because I had an accident and I kind of screwed up my speech, um, and I wanted to get an X-ray and maybe cleaning too, and she's sending me to a periodontist. She didn't do anything. They just called me a couple of hours ago and said, you guys send a check for $89 which I would have loved to have, um.
[CUSTOMER][NEUTRAL] I'm not sure why because she didn't do anything, so they were just concerned they actually sent it back, she said.
[CUSTOMER][NEGATIVE] But I'm not sure why that's what was sent out.
[AGENT][NEUTRAL] Hm, OK, let's see.
[AGENT][NEUTRAL] Let me look at recent claims.
[CUSTOMER][NEUTRAL] You know, talking to [PII], my do my dentist.
[AGENT][NEUTRAL] So it was for $89 correct, [PII]?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] And it was for [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me see here.
[CUSTOMER][NEUTRAL] Is this an old visit perhaps that you're finally catching up on or something like that?
[AGENT][NEUTRAL] So it's for a date of service of [PII], um,
[CUSTOMER][NEUTRAL] Right, and I was there, yeah.
[AGENT][NEUTRAL] Yeah, so the codes that come through, it looks like it was for leave a cleaning and stuff like that and so that's why it was sent.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Right, but well, how would, you know, how did she get it when she didn't file anything with you guys? That's that's our mystery.
[AGENT][NEUTRAL] Yeah, I mean, I don't, I don't know how.
[AGENT][NEUTRAL] She didn't file it?
[CUSTOMER][NEUTRAL] No.
[AGENT][NEGATIVE] Weird.
[CUSTOMER][NEUTRAL] She basically looked at me and said, you know, I can't do anything if I see a pair of doctors, so that was it.
[CUSTOMER][NEGATIVE] Do nothing.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Yeah, I mean, I'm looking at the claim form that they like that was sent over, so.
[CUSTOMER][NEUTRAL] Oh, they said, OK, and somebody that somebody did send one. That's weird.
[AGENT][NEUTRAL] Yeah I mean so it has the procedure codes on it and all of that and so yeah I mean that's why that's why it was sent sent to them so.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] Yeah, they're puzzled why you send it because they said we didn't nothing we didn't file anything, didn't know why you send it, you know, the check.
[AGENT][NEUTRAL] Well they should get a copy of the explanation of benefits and they should be able to see exactly what was billed and why we paid them um the only the only other thing you can do [PII] is just tell them that you called us and this is what it was for if they have questions or concerns they can call us. I can we can fax them the explanation of benefits and and all that.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEGATIVE] But nothing was done. I mean, that's the point. I mean, they didn't, they didn't, they said they didn't, they didn't follow anything with you, and she didn't do anything. I mean, there's like no charge for the visit. She's nothing.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So they, she said to send the check back, she said.
[AGENT][NEUTRAL] OK, yeah, I mean if they send the check back then we'll just discard it obviously um I mean there was a claim that I see that was sent in, so.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That's so weird. Do you know who was from? Does it say like a name of the person?
[AGENT][NEUTRAL] No, it doesn't say who it was from. There's no cover letter or anything like that.
[CUSTOMER][NEUTRAL] OK. All right.
[CUSTOMER][NEUTRAL] OK. All right. Yeah, they're puzzled because they said they didn't send anything in so.
[CUSTOMER][NEUTRAL] Huh, um.
[AGENT][NEUTRAL] Not sure.
[AGENT][NEUTRAL] Did you have any other questions or concerns?
[CUSTOMER][NEGATIVE] Alright, I just don't want.
[CUSTOMER][NEUTRAL] I do, yes, so I, I have 3 periodons I can call. I just wanna make sure that I might be covered under them. Um, can I give you, give you their names?
[AGENT][NEUTRAL] Uh, yeah, let me get to where I can search for providers here. Give me one second.
[AGENT][NEUTRAL] Are they um in your same zip code or is city and state?
[CUSTOMER][NEUTRAL] They're close by they they're in the same state but not the same zip code.
[AGENT][NEUTRAL] OK, let me do city and state then.
[AGENT][NEUTRAL] And you're looking for somebody in Periodonics, correct?
[CUSTOMER][NEUTRAL] Right, and I've got 3 names here. I just wanna make sure because the last one I called was not, I was not covered under so I can see, see him, so I just wanna make sure I can see the person before I make an appointment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right. uh, what's the first one that you have?
[CUSTOMER][NEUTRAL] Call [PII] and per periodontics and implants.
[CUSTOMER][NEUTRAL] And will their phone number help you?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] I don't see them.
[CUSTOMER][NEUTRAL] OK. Next one is Doctor [PII].
[CUSTOMER][NEUTRAL] And he's in [PII].
[CUSTOMER][NEUTRAL] And his number is [PII].
[AGENT][NEUTRAL] Don't see him.
[CUSTOMER][NEUTRAL] All right. Last one is Doctor [PII] [PII].
[AGENT][NEUTRAL] Uh, don't see him either. The list.
[CUSTOMER][NEUTRAL] Oh darn it, what do I do then?
[AGENT][NEUTRAL] I can give you 4 others or 3 others that I see listed here.
[CUSTOMER][POSITIVE] That'd be wonderful. Let me just get a fresh piece of paper.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK, all right, go ahead.
[AGENT][NEUTRAL] First one is JBSeromics.
[AGENT][NEUTRAL] It shows the uh doctor's name is [PII]. Last name is [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII],
[AGENT][NEUTRAL] First name again is [PII].
[CUSTOMER][NEUTRAL] OK, and they're, do you know where they're they're located?
[AGENT][NEUTRAL] Their address is showing at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] What town is that?
[AGENT][NEUTRAL] It's showing [PII].
[CUSTOMER][NEUTRAL] OK, all right, that's OK.
[AGENT][NEUTRAL] And they're
[CUSTOMER][NEUTRAL] Do you have an uh phone number? OK, you're.
[AGENT][NEUTRAL] Phone number is [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 814.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, the next one is Dental Health and associates.
[CUSTOMER][NEUTRAL] You know where they're, they're located also that town.
[AGENT][NEUTRAL] Uh, they're in [PII].
[CUSTOMER][NEUTRAL] OK, alright, that's fine.
[AGENT][NEUTRAL] There's another one in [PII]. There's a couple others if you want those instead.
[CUSTOMER][POSITIVE] That'd be great. Do you wanna email those to me? Is that easier? Or just text them to me?
[AGENT][POSITIVE] Yeah I can send you an email with a few that I have here absolutely.
[CUSTOMER][POSITIVE] That, that'd be perfect. That'd be wonderful. Yeah, you have my email, right?
[AGENT][NEUTRAL] Is it the MSN address?
[CUSTOMER][NEUTRAL] Yes it is.
[AGENT][NEUTRAL] OK. Yeah, I've got that here. So I'll just forward you the ones that I pulled up, um, and it will have the full address, phone number, uh, provider, the facility name, and the doctor's name as well, so.
[CUSTOMER][POSITIVE] That'd be so helpful. I really appreciate your help.
[AGENT][POSITIVE] Yeah, no problem. Is there anything else I can help with?
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] That's it. Thanks so much. Take care. I appreciate your help.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Bye bye.