AccountId: 011433970860
ContactId: 5d7dd286-73e5-4e12-aaa0-e570ae3a268c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 569429 ms
Total Talk Time (AGENT): 160243 ms
Total Talk Time (CUSTOMER): 237614 ms
Interruptions: 4
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/05/5d7dd286-73e5-4e12-aaa0-e570ae3a268c_20250305T18:06_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling to get some information um about a claim for one of my patients.
[AGENT][NEUTRAL] OK, I can help you, [PII]. um, what's the policy number?
[CUSTOMER][NEUTRAL] Um, the number I have.
[CUSTOMER][NEUTRAL] 02365851.
[AGENT][NEUTRAL] And what's the phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] Um, it's gonna be [PII], excuse me, [PII].
[AGENT][NEUTRAL] OK, and you're just basically calling about claim status or clarification of a claim?
[CUSTOMER][NEUTRAL] Um, claim status. I have 2 claims.
[CUSTOMER][NEUTRAL] Um, well, one, I need to see what, what your timely filing is, and then the other one, it was filed to you all. I just don't don't have any payment information for it.
[AGENT][NEUTRAL] OK, if you can verify the patient's name and date of birth, [PII].
[CUSTOMER][NEUTRAL] Um, the patient is [PII]. [PII].
[AGENT][NEUTRAL] And what's the date of service?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] The latest one is [PII].
[AGENT][NEUTRAL] And the amount?
[CUSTOMER][NEUTRAL] For 218.
[AGENT][NEUTRAL] OK, and what was the other day of service?
[CUSTOMER][NEUTRAL] The other data service is for February. Give me one second. Excuse me.
[CUSTOMER][NEUTRAL] [PII], um, the amount would be the same 220.
[AGENT][NEUTRAL] What's the 1st 1 218 or 220?
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] Oh,
[CUSTOMER][NEUTRAL] The [PII], let me get back sorry.
[CUSTOMER][NEUTRAL] 218. I'm sorry. 218.
[AGENT][NEUTRAL] OK, all right, no worries, one moment.
[AGENT][NEUTRAL] And are you a medical or dental provider's office?
[CUSTOMER][NEUTRAL] Dental.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so for [PII], I'm only showing the [PII].
[AGENT][NEUTRAL] [PII] data service.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And let me see.
[AGENT][NEUTRAL] Since these services were rendered following the termination.
[AGENT][NEUTRAL] Of the coverage, so let me see, so this policy was no longer active as of [PII].
[AGENT][NEUTRAL] [PII] and let me see if there's any.
[AGENT][NEUTRAL] Yeah, the policy termed [PII].
[AGENT][NEUTRAL] And I don't show the um February date of service.
[CUSTOMER][POSITIVE] Got you.
[CUSTOMER][NEUTRAL] OK, and what's your timely filing?
[AGENT][NEUTRAL] There's no timely limit, uh, filing limit in which to submit a claim.
[CUSTOMER][NEUTRAL] OK, so for the February, um, would I be able, I would be able to um go ahead and send that one?
[AGENT][NEUTRAL] Mhm, because there's no timely filing limit.
[CUSTOMER][NEUTRAL] OK. And then let me just make sure I have the correct um.
[CUSTOMER][NEUTRAL] Payer ID and a PO box. Give me one second, let me get there.
[CUSTOMER][NEUTRAL] So the payer ID I have is 60801.
[CUSTOMER][NEUTRAL] Is that correct?
[AGENT][POSITIVE] Mhm. That's correct.
[CUSTOMER][NEUTRAL] And then the PO box 24895 excuse me 950 Oklahoma City, Oklahoma 73124.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, alrighty, I'll get that sent back over then.
[AGENT][NEUTRAL] And you can also check your status online at secure.m.
[CUSTOMER][NEGATIVE] Well, I tried and it, it gave me an error message.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] What did it say?
[CUSTOMER][NEUTRAL] It says that no user was found with the information that was entered, please try again.
[AGENT][NEUTRAL] And so, uh, what criteria did it ask you for?
[CUSTOMER][NEUTRAL] So it's asking for the um our tax ID and then the patient account number.
[AGENT][NEUTRAL] And did you enter the patient account number that's on your claim?
[CUSTOMER][NEUTRAL] And then
[CUSTOMER][NEUTRAL] Yes, the 02365851.
[AGENT][NEUTRAL] OK, give me 1 2nd.
[AGENT][NEUTRAL] Um, and what tax identification number did you enter?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Mhm and can you give me the patient account number again please?
[CUSTOMER][NEUTRAL] 02365851
[AGENT][NEUTRAL] OK, so that's the policy number.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, so we're, I, so I don't have the patient account number. How do I get that?
[AGENT][NEUTRAL] I'm gonna, I'm gonna pull up your claim. It's on the, it's on the ADA form, the dental claim form. Give me a second. I'm gonna pull it up and see what I can find.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, so would it be our patient, um, account number? Oh, OK.
[AGENT][NEUTRAL] Yes. Yes.
[AGENT][NEUTRAL] And not the policy number. Yeah.
[CUSTOMER][NEUTRAL] OK, and not the got you. Let me make sure. Let me see if this 90,068,160.
[CUSTOMER][NEUTRAL] Nope, it
[AGENT][NEUTRAL] Box number 23.
[CUSTOMER][NEUTRAL] It does that same thing.
[CUSTOMER][NEUTRAL] Yeah. So do you have 90068?
[CUSTOMER][NEUTRAL] 160.
[AGENT][NEUTRAL] Are you looking in box number 23 on the claim form?
[CUSTOMER][NEUTRAL] Let me look, let me, let me make sure I'm looking in the right way.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEGATIVE] Yes, that's, that's what I have, but it's, it's still giving me that same error message.
[CUSTOMER][NEUTRAL] Let me make sure I have the right tax ID number that's on here.
[AGENT][NEUTRAL] So did you go to the claim form?
[CUSTOMER][NEUTRAL] Yes, I'm looking at it, um, box 23, it has 9,068,160.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] On the claim that we received, it says 601-266-862, so that's why you're not able to retrieve it. What you enter mhm and those two categories have to match what we have in our system that we have based on the claim information.
[CUSTOMER][NEUTRAL] Oh, what?
[AGENT][NEUTRAL] And then this is what we're showing.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And then you, I just wanna see where if that.
[CUSTOMER][NEUTRAL] I don't see that number anywhere on here.
[CUSTOMER][NEGATIVE] What you just wrote off.
[CUSTOMER][NEUTRAL] Read off to me.
[CUSTOMER][NEUTRAL] OK, can you give that to me again?
[AGENT][NEUTRAL] 601.
[AGENT][NEUTRAL] 266862.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] 266-862.
[CUSTOMER][NEUTRAL] That's crazy.
[CUSTOMER][POSITIVE] OK, that helps me get in.
[CUSTOMER][NEUTRAL] So I wonder why the claims number. I wonder why.
[CUSTOMER][NEUTRAL] Anyway, I'll figure that out later. OK. Uh, can I get a call reference number?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] So, so if you enter that.
[AGENT][NEUTRAL] If you enter that patient account number you should be able to pull it up um you'll use uh my name in today's date as reference for today's call.
[CUSTOMER][POSITIVE] OK, and tell me your name again I'm sorry.
[AGENT][NEUTRAL] It's [PII] and then first initial last name is [PII].
[CUSTOMER][POSITIVE] OK, thank you [PII]. I really appreciate you.
[AGENT][POSITIVE] You're welcome. OK. Well, thanks for calling APR [PII]. Have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Mhm.