AccountId: 011433970860
ContactId: 591230d2-3cef-4893-a177-45c09b62e36c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 562969 ms
Total Talk Time (AGENT): 93900 ms
Total Talk Time (CUSTOMER): 100250 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/23/591230d2-3cef-4893-a177-45c09b62e36c_20250123T18:14_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Um, yes, I'm, I need to check dental claim status for two different dates of service for a patient.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status and may I have your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Miss [PII], may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Mhm [PII].
[AGENT][NEUTRAL] Thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Mhm it is.
[CUSTOMER][NEUTRAL] 02434238
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] It is let me get back to the date of birth. It is [PII].
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Um, the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you and may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Um, yes, so the first one is for 11-27-2024. Let me get you that claim amount real quick.
[CUSTOMER][NEUTRAL] Sometimes it reflects differently on this other screen than the actual claim, so let me.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Um, that one.
[AGENT][NEUTRAL] Or you can give me the coding.
[CUSTOMER][NEUTRAL] Um, I have the claim amount. It's um $1,909.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me pull this explanation of.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] OK, so it looks like we um processed the claim on [PII].
[AGENT][NEUTRAL] And the claim was denied. Um, the reason for this denial is
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] The service was rendered following the termination of coverage.
[CUSTOMER][NEUTRAL] OK, um, is there any way that you can give me that termination date?
[AGENT][NEUTRAL] Uh yes.
[AGENT][NEUTRAL] The policy got terminated on [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Alright, um, and.
[CUSTOMER][NEUTRAL] I'm assuming the 12-19 claim got denied for the same reason then?
[AGENT][NEUTRAL] Yes, let me double check, but I believe so.
[CUSTOMER][NEUTRAL] And it was for $304.
[AGENT][NEGATIVE] Yes, mhm, yeah, I see that one is the same denial. Mhm.
[CUSTOMER][NEUTRAL] OK, um, and is there any way that I can get a copy of those EOBs faxed to me?
[AGENT][NEUTRAL] Um, sure, yes. What is the fax number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] To your attention, Ms. [PII].
[CUSTOMER][POSITIVE] Yes, that would be great.
[AGENT][NEUTRAL] OK, [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[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.
[CUSTOMER][NEUTRAL] You
[AGENT][POSITIVE] Thank you for holding and being patient for me. OK, I went ahead and send um both of them. It should be there in a few minutes. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, no, just your name and a reference number please.
[AGENT][NEUTRAL] My name is [PII]. That's [PII].
[AGENT][NEUTRAL] And we don't have reference number so you can use my name into the thing.
[CUSTOMER][NEUTRAL] OK, and
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, alright, thank you so much for your help.
[AGENT][POSITIVE] You're welcome and thank you for calling ATL. Have a good day.
[CUSTOMER][NEUTRAL] You too. Bye bye.
[AGENT][POSITIVE] Thank you. Bye-bye.