AccountId: 011433970860
ContactId: 58285872-0f58-45c8-99d7-f2d3a6ab3f6c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 367589 ms
Total Talk Time (AGENT): 139389 ms
Total Talk Time (CUSTOMER): 124765 ms
Interruptions: 0
Overall Sentiment: AGENT=1.4, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/58285872-0f58-45c8-99d7-f2d3a6ab3f6c_20250307T18:53_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Uh, hi, [PII], this is [PII] calling from provider's office to check on any eligibility and benefits for information. This call may be recorded for training and quality purposes.
[AGENT][POSITIVE] OK, well, I'll be more than happy to assist you. Um, [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure. My callback number is [PII].
[AGENT][NEUTRAL] Thank you for that. And may I have the member's policy number?
[CUSTOMER][NEUTRAL] Sure, ma'am. ID number is 02466115.
[AGENT][POSITIVE] Thank you for that. And you said this is for eligibility, correct?
[CUSTOMER][NEUTRAL] Yeah, right.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Sure. Patient's name is [PII] and the date of birth is on [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And I am showing that the policy is no longer active. It was effective from [PII], and there were no other policies after this one.
[CUSTOMER][POSITIVE] Got it. Thank you. Could you please help me with the group name and group number under this plan?
[AGENT][NEUTRAL] Sure, the group number is 70,030.
[AGENT][NEUTRAL] The group name is Creative Circle LLC.
[CUSTOMER][NEUTRAL] Thank you. Could you please help me with the claim's mailing address and the payer ID to a clearinghouse Dental exchange?
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Alright, so the payer ID is 60801.
[AGENT][NEUTRAL] Our claims mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The zip code is [PII].
[CUSTOMER][NEUTRAL] Oh, got it, thank you. And I just need to confirm if the patient is to subscribe under this plan. [PII] is the subscriber.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Thank you. And I just need to spell the patient's name as the patient's first name it's spelled as [PII].
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And the date of birth is on [PII].
[AGENT][POSITIVE] Yes, this is correct.
[CUSTOMER][NEUTRAL] Thank you. And could you please help me with the call reference number, [PII]?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name in today's date.
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Yeah, sorry for that. Uh, before that, uh, can I get the claim status for this patient for the date of service? [PII]. Sorry for that.
[AGENT][NEUTRAL] For the policyholder?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And what's the total bill amount?
[CUSTOMER][NEUTRAL] $1,973 even.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what is the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Your office name is Chastain Park Industry.
[AGENT][NEUTRAL] And the dentist
[CUSTOMER][NEUTRAL] Yeah, the link provider's name is [PII].
[AGENT][NEUTRAL] Alright, so I'm showing we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 3,447,310.
[AGENT][NEUTRAL] And on [PII], we paid out on the claim to the provider a total of $58.
[CUSTOMER][NEUTRAL] Thank you. Actually, this is for the date of service, [PII] with the amount of $729 right?
[CUSTOMER][NEUTRAL] Sorry, $1,973. Sorry for that.
[AGENT][NEUTRAL] Correct. Hold on one moment I can double check it. Hold on one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 9:47.
[AGENT][NEUTRAL] OK, so we have two claims that came in for December, I'm sorry, for [PII]. Um, they're both from your provider. One of the total bills is $608 the other is $947. Do you need the total for each? I mean, would you like the claim status for each? These are the only two claims for the insured, but they are from your provider.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Oh, got it. So that is, uh, for this one, it's a, a different amount of $1,973. So there's no claim on file for this one?
[AGENT][NEUTRAL] So if that's only, if that's the only total bill, then yes, there's no claim on file.
[CUSTOMER][NEUTRAL] Oh, got it. Thank you then. Could you please help me with the call reference number, [PII]?
[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] OK. Thank you, thank you for assisting me. It was nice talking to you. Have a nice day. Bye-bye.
[AGENT][POSITIVE] You're very welcome. And was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Uh no, thank you.
[AGENT][POSITIVE] Alright, thanks for calling APL. Bye-bye.