AccountId: 011433970860
ContactId: 62af9f03-89b3-43be-9624-e75af68cf2c4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 371320 ms
Total Talk Time (AGENT): 126398 ms
Total Talk Time (CUSTOMER): 112090 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/21/62af9f03-89b3-43be-9624-e75af68cf2c4_20250221T19:25_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] Hello, [PII]. My name is [PII] looking for claim status.
[AGENT][POSITIVE] OK, I'll be more than happy to help you with the claim status, and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure, that is [PII].
[AGENT][NEUTRAL] Thank you for that. And how many claims do you have in total today?
[CUSTOMER][NEUTRAL] I have 2 claims.
[AGENT][NEUTRAL] OK, may I have the member's policy number?
[CUSTOMER][NEUTRAL] For the
[CUSTOMER][NEUTRAL] Yes, sir, sure. That is uh S as in Sam, [PII].
[AGENT][NEUTRAL] OK, so that's not an APL policy number. Our policy numbers usually start with a 01 or 02.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Do you have that number?
[CUSTOMER][NEUTRAL] Sure, sure. Give me a moment. Yeah, give me a moment.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, that is 41355.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] 421-355.
[AGENT][NEUTRAL] OK, I'll try that. Is that the group number?
[CUSTOMER][NEUTRAL] Mm, I have the social number. Can you uh find with that?
[AGENT][NEUTRAL] What's the member's name?
[CUSTOMER][NEUTRAL] That is [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And what's the date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so that was the policy number and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total bills?
[CUSTOMER][NEUTRAL] $344.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] All right, and may I have the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Yes, sure.
[CUSTOMER][NEUTRAL] The name of the providers so, that is PR Family Dentistry.
[AGENT][NEUTRAL] And the provider?
[CUSTOMER][NEUTRAL] Provider is uh
[CUSTOMER][NEUTRAL] Aaron beer
[AGENT][NEUTRAL] Thank you for that, and I'm showing you received the claim on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The claim number is 3555981.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] And on [PII], the claim was denied?
[AGENT][NEUTRAL] Because the policy does not
[CUSTOMER][NEUTRAL] Reason
[AGENT][NEUTRAL] The policy does not provide benefits?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[CUSTOMER][NEUTRAL] OK, it is not for the non-covered service, correct.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK, uh
[CUSTOMER][NEUTRAL] And, uh, I have uh one more thing to check with you.
[CUSTOMER][NEUTRAL] Can you help me with that also?
[AGENT][NEUTRAL] OK, is it the same number?
[CUSTOMER][NEUTRAL] Oh yeah, same number.
[AGENT][NEUTRAL] OK, what's the date of service?
[CUSTOMER][NEUTRAL] Uh, data service [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII] and [PII].
[AGENT][NEUTRAL] And the total bill amount?
[CUSTOMER][NEUTRAL] $2,79.
[AGENT][NEUTRAL] OK, [PII] $2,179.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Same provider?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] So I'm showing we received this claim on [PII].
[AGENT][NEUTRAL] The claim number is 355.
[AGENT][NEUTRAL] 55.
[AGENT][NEUTRAL] 52
[AGENT][NEUTRAL] And on January
[CUSTOMER][NEUTRAL] The claim number is 3, OK. Can you please uh check? The claim number is 3555552.
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] OK. Let's go ahead.
[AGENT][NEUTRAL] On [PII], the claim was denied for non-covered charges.
[CUSTOMER][NEUTRAL] OK, OK. Can you ask me the both the UB?
[AGENT][NEUTRAL] Sure, what's a good fax number for you?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And what's the call reference number?
[AGENT][NEUTRAL] Um, hold on one moment. Does it need to be attention to your name?
[CUSTOMER][NEUTRAL] Yes, please.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, that's [PII]?
[CUSTOMER][NEUTRAL] Oh yes.
[AGENT][POSITIVE] All right, so I'll go ahead and fax the explanation of benefits over to you now. Was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Oh, no. Call reference number, please.
[AGENT][NEUTRAL] So there's no call reference number, but you can use my name in today's date, and that's [PII], first initial to my last name is [PII].
[CUSTOMER][POSITIVE] OK. Thank you so much. That is all.
[AGENT][POSITIVE] You're very welcome and thanks for calling APL. I hope you have a great weekend.
[CUSTOMER][NEUTRAL] It
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye