AccountId: 011433970860
ContactId: 44aa1ce1-0c25-41a3-ae60-29204212c990
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 786059 ms
Total Talk Time (AGENT): 204055 ms
Total Talk Time (CUSTOMER): 208843 ms
Interruptions: 11
Overall Sentiment: AGENT=0.8, CUSTOMER=-0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/03/44aa1ce1-0c25-41a3-ae60-29204212c990_20250103T14:48_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, calling from the products office Aspen Dental to check on the claim status. Uh, may I know your name? sure, right? [PII].
[AGENT][NEUTRAL] My name is [PII]
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] [PII] so.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Yeah, got it. OK.
[AGENT][NEUTRAL] OK. And may I have your name? I didn't quite catch your name.
[CUSTOMER][NEUTRAL] Yeah, my name is [PII]
[AGENT][NEUTRAL] Yeah, OK, and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yeah. It's [PII].
[AGENT][NEUTRAL] OK. And what's the patient's policy number?
[CUSTOMER][NEUTRAL] Yeah, it's 025153993.
[AGENT][POSITIVE] Yes thank you.
[AGENT][NEUTRAL] What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Yeah, it's uh
[CUSTOMER][NEUTRAL] [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you. What is the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Yeah, yeah, it's uh [PII] and the claim amount is uh $252 even.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][POSITIVE] Thank you
[AGENT][NEUTRAL] Let me see if I can find this claim.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] OK, let me pull this EOB and see if this is your claim.
[CUSTOMER][NEUTRAL] Let me pull up.
[AGENT][NEUTRAL] And for future you can check claim status online through our website at [PII] and that's just optional and it's gonna be a minute. I'm waiting on the AOB.
[CUSTOMER][NEUTRAL] And for future you can check claim status online through our website at [PII].
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] There's a
[AGENT][NEUTRAL] OK, so it looks like we processed the claim on [PII] and we send a benefit amount of $85.80 to the provider.
[CUSTOMER][NEUTRAL] And it looks like we process the claim.
[CUSTOMER][NEUTRAL] 24
[CUSTOMER][NEUTRAL] significant amount of $85.80 to the provider.
[CUSTOMER][NEUTRAL] OK. Um, once again, may I know the claim receive date?
[AGENT][NEUTRAL] Um, let me check and see if we have that one moment.
[AGENT][NEUTRAL] 0050.
[AGENT][NEUTRAL] It was received [PII], processed [PII].
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] number
[CUSTOMER][NEUTRAL] OK. Uh, may I know the, you mean, uh, it's paid, right?
[AGENT][NEUTRAL] Yeah, we send the payment of $85.80 to the provider.
[CUSTOMER][NEUTRAL] Yeah, we send the payment of today.
[CUSTOMER][NEUTRAL] OK. $85.80. Uh, may I know the allowed amount?
[CUSTOMER][NEUTRAL] On the pay date?
[AGENT][NEUTRAL] OK, and the pay date is [PII].
[CUSTOMER][NEUTRAL] the payment on the [PII].
[AGENT][NEUTRAL] Um, it seems.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Mm, when you say the allowed amount, um, what do you mean that this is not a major medical, it's the dental.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] May I know the
[CUSTOMER][NEUTRAL] Uh, is there any patient responsibility?
[AGENT][NEUTRAL] There is $50 supplied towards the deductible.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Sorry?
[AGENT][NEUTRAL] There was $50 applied towards the deductible.
[CUSTOMER][NEUTRAL] $50.52 right?
[AGENT][NEUTRAL] $50 just $50.
[CUSTOMER][NEUTRAL] Um, OK, OK.
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Is there any dinner?
[AGENT][NEUTRAL] Is there any, what I'm sorry?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Is there any denial, denial?
[AGENT][POSITIVE] No, there's no denial. Uh, the network fee for $150 is $57 which she was paid 100%.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 8%.
[AGENT][NEUTRAL] The, um, for the code 210, the network fee is $86 which it was paid 80%, which we pay $5720 and then $50 was applied towards the deductible.
[CUSTOMER][NEUTRAL] The um for the 210.
[CUSTOMER][NEUTRAL] The network fee is 86.
[CUSTOMER][NEUTRAL] Which it was pay 80% which we pay 5720 and 50 was applied for cent deductible.
[AGENT][NEUTRAL] I mean, which would be 2880. I'm sorry.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So it looks like the patient's responsibility is 5720.
[CUSTOMER][NEUTRAL] It looks like the pictures on 5720.
[AGENT][NEUTRAL] In total.
[CUSTOMER][NEUTRAL] It's 57.20, right?
[AGENT][POSITIVE] Mhm. Correct.
[CUSTOMER][NEUTRAL] OK. And the check number?
[AGENT][NEUTRAL] And the check number for the 8580 is 25153993.
[CUSTOMER][NEUTRAL] And the 4 days.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You know the claim number?
[AGENT][NEUTRAL] Claim number is 3,520,050.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK. Um, for this 1 may I know the CTD is 150, uh, was paid $85.80 and the, uh, 210 CTD was paid, uh, mean the paid amount for the CTD 210.
[CUSTOMER][NEUTRAL] 210
[AGENT][NEUTRAL] No, you got the 150 wrong, so let me repeat it again.
[AGENT][NEUTRAL] Uh code 150 was paid at $57 because that's the network fee.
[AGENT][NEUTRAL] It was paid at $57. That's 100% of the network fee.
[CUSTOMER][NEUTRAL] Let's say that $57 of the network. OK.
[AGENT][NEUTRAL] OK, and 210.
[CUSTOMER][NEUTRAL] OK, and 210.
[AGENT][NEUTRAL] The network fee is $86.
[CUSTOMER][NEUTRAL] 86.
[AGENT][NEUTRAL] From the $86 we pay 80%.
[CUSTOMER][NEUTRAL] And the $86 we pay 80%.
[AGENT][NEUTRAL] So $50 went towards the deductible.
[CUSTOMER][NEUTRAL] So $50 went towards the deductible.
[AGENT][NEUTRAL] $57.20 went to the member's responsibility.
[CUSTOMER][NEUTRAL] 20 cents plus to the member's responsibility and we pay $28.80.
[AGENT][NEUTRAL] And we pay $28.80.
[CUSTOMER][NEUTRAL] Again, could you repeat the deductible and the patient responsibility?
[AGENT][NEUTRAL] Deductible is 50.
[AGENT][NEUTRAL] Patients responsibility is 5720.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] 720, uh, for the $210 right, uh 210 CDD, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. Um, and the conference number. Could you fax the UOB?
[AGENT][NEUTRAL] What is the fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. [PII].
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] 2
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me. Yeah, I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I'm gonna help you with today, Mr. [PII]?
[CUSTOMER][NEUTRAL] Yeah, may I know the call reference number?
[AGENT][NEUTRAL] And we don't have reference numbers you can use my name in today's date.
[CUSTOMER][POSITIVE] OK. Thank you. So it's wonderful talking to you. Have a nice day. Bye for now.
[AGENT][POSITIVE] You're welcome. You as well, and thank you for calling APL. Bye bye.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Bye-bye.
[AGENT][NEUTRAL] Bye.