AccountId: 011433970860
ContactId: 6006abf6-df9b-4886-a6cb-06f008d39add
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 493410 ms
Total Talk Time (AGENT): 117223 ms
Total Talk Time (CUSTOMER): 216986 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/11/6006abf6-df9b-4886-a6cb-06f008d39add_20250611T17:17_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi, uh, good afternoon, [PII]. This is [PII] calling from Pacific Dental Services to check on a claim sheet. Is the KKK.
[AGENT][NEUTRAL] OK, I can verify claim status for you and [PII], what is the policy number, please?
[CUSTOMER][NEUTRAL] That is 603-996.
[AGENT][NEUTRAL] OK, and do you have a callback number?
[CUSTOMER][NEUTRAL] Yeah, that would be [PII].
[AGENT][NEUTRAL] And the patient's name, date of birth?
[CUSTOMER][NEUTRAL] The name of the patient is [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge?
[CUSTOMER][NEUTRAL] The date of service is on [PII] with the amount of $437 and even.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And this is for dental?
[CUSTOMER][NEUTRAL] Yeah, dental plan.
[AGENT][NEUTRAL] OK. I do not show that claim has been received. Can you verify the address it was submitted to?
[CUSTOMER][NEUTRAL] Um, yeah, uh, the address the claim was submitted to is [PII]. Is that the correct address?
[AGENT][NEUTRAL] That is correct. Uh, if you like, I can give you a fax number, you can uh fax the claim.
[CUSTOMER][NEUTRAL] One more moment.
[CUSTOMER][NEUTRAL] Sorry for the delay, just give me a moment.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So this.
[CUSTOMER][NEUTRAL] So, before resubmitting this name, can you please help me to verify the spelling of the patient's name?
[AGENT][NEUTRAL] OK, spell the patient's name.
[CUSTOMER][NEUTRAL] Yeah, that will be spelled as [PII] the last name [PII], is that right?
[AGENT][NEUTRAL] That's why I show in our system, OK?
[CUSTOMER][NEUTRAL] And uh the date of birth of the patient is [PII], is that right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And uh
[CUSTOMER][NEUTRAL] Um, she will be the subscriber as well, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK. One more moment.
[CUSTOMER][NEUTRAL] And the address of the patient, what I have here is [PII].
[CUSTOMER][NEUTRAL] Uh, a new Camp Road.
[CUSTOMER][NEUTRAL] [PII]. Is that the correct address for the patient?
[AGENT][NEUTRAL] You can contact the patient to verify their mailing address. I'm not going to verify that information with you. I can verify their name and their date of birth. Is there anything else I can assist you with today, [PII]?
[CUSTOMER][NEUTRAL] Yeah, uh, can I have the electronic payer ID to reach some of this claim. Um, is there any?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. And what is the correct group number for this patient?
[AGENT][NEUTRAL] Uh, sure. It's LA 0225.
[CUSTOMER][NEUTRAL] And uh what will be the effective date of this policy?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And uh what is the timely filing when you file the claim?
[AGENT][NEUTRAL] There isn't one.
[CUSTOMER][NEUTRAL] There is no time calling on, right?
[AGENT][NEUTRAL] Correct, there isn't one.
[CUSTOMER][NEUTRAL] OK. And uh
[CUSTOMER][NEUTRAL] Can I have the free schedule? Do you have any?
[AGENT][NEUTRAL] Are you asking for a fax back of the patient's benefits?
[CUSTOMER][NEUTRAL] Um, no, I just need to verify those information before we submitting it.
[AGENT][NEUTRAL] I don't understand why, but the fee schedule is their policy fee schedule, that's how we pay. I'm not sure if you have a fee schedule with.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Carrington, but that's something you have to contact Carrington about.
[CUSTOMER][NEUTRAL] OK, so I do have one more patient before that, can I have the reference number for this patient?
[AGENT][NEUTRAL] You may use my name in today's date.
[CUSTOMER][NEUTRAL] OK, thank you. uh, can you move to the next question?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] I would be under a different number, right, yeah sure.
[CUSTOMER][NEUTRAL] Those
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, what is the next policy number?
[CUSTOMER][NEUTRAL] That would be 02558868.
[AGENT][NEUTRAL] Patient's name, date of birth?
[CUSTOMER][NEUTRAL] The name of the patient will be [PII], whose date of birth is on [PII].
[AGENT][NEUTRAL] OK, data service amount of the charge.
[CUSTOMER][NEUTRAL] Um, the date of service is [PII] with the build amount of $1,409 and even.
[AGENT][NEUTRAL] Uh, we have not received that claim. Can you verify that address the claim was submitted to?
[CUSTOMER][NEUTRAL] Um, this was submitted to the same address which is [PII].
[AGENT][NEUTRAL] OK, you can resubmit the claim via the email or not email, sorry, mailing address or the payer ID.
[AGENT][NEUTRAL] Or fax number.
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][NEUTRAL] Sure, I'll do that. Um, before we submitting this, can you please help me to verify the spelling of this patient as well?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] That would be [PII], and last name [PII]. Is that right?
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And she will be the subscriber as well, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, can you please uh help me with the current group number for this patient?
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 70055
[CUSTOMER][NEUTRAL] OK, what will be the effective date of this policy?
[AGENT][NEUTRAL] And I show this policy termed [PII], so they were not active at the time of service. The effective date was [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And terminated on [PII], right?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So they are active because uh the date of service is February saving and uh.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So there's no time frame. There is no time frame for the family falling moment and uh that's it. OK, so the reference number will be your name but state. Thank you so much for wonderful assistance, [PII], and hope you'll have a great day and take care.
[AGENT][NEUTRAL] You're welcome. Mhm, bye.