AccountId: 011433970860
ContactId: 674fe64c-57ac-4501-a293-3b0db61a164f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 248949 ms
Total Talk Time (AGENT): 110034 ms
Total Talk Time (CUSTOMER): 55756 ms
Interruptions: 0
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/674fe64c-57ac-4501-a293-3b0db61a164f_20250124T15:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] I I'm calling to check on the status of a claim.
[AGENT][NEUTRAL] I can help you. What is your name and the policy number?
[CUSTOMER][NEUTRAL] It's [PII] and I'm the provider and the policy number is 0202512405.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Can you spell your name [PII]?
[CUSTOMER][NEUTRAL] Uh, [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's a good phone number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]. Give me the last four again.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] [PII]. Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what's the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you for that information.
[AGENT][NEUTRAL] And what is the date of service you said you're checking a claim, right?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the amount.
[CUSTOMER][NEUTRAL] Um, 582.
[AGENT][NEUTRAL] 582.
[AGENT][NEUTRAL] And are you a dental provider?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Are you with Sherman Westton Dental?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so it's the calendar your maximum for dental benefits have been met. We did receive your claim on [PII] and processed on the [PII], and it denied us the maximum, uh, calendar maximum is exhausted.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. Is it possible to fax me that?
[AGENT][NEUTRAL] It's actually mailed to the address that's on your claim, um, and I can show you how to download it on our online service center if you would like.
[CUSTOMER][NEUTRAL] OK, what, what is that app or that portal?
[AGENT][NEUTRAL] Um, it's
[AGENT][POSITIVE] It's secured [PII]
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] The word [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] OK. I'll go uh register for it. Thank you.
[AGENT][NEUTRAL] OK, and I'll give you the claim number you can search by the claim number.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And that number is 354-497-2. When you get to logged into the site, [PII], um, it's gonna ask you for it's two security questions. It's gonna ask you for the provider tax identification number and the patient account number that's on the claim that you submitted to APL.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK and the account number?
[CUSTOMER][NEUTRAL] Which should be the patient's member ID?
[AGENT][NEUTRAL] No, it's on your claim there's a patient account number that's assigned by the office.
[AGENT][NEUTRAL] It's that number that it's looking for.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] So I would need an EOB to be able to register.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] No, it's your claim it's the ADA form.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Oh, on the ADA form, OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] That, that patient account number.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK. All righty. Thank you.
[AGENT][POSITIVE] Alrighty. Any other questions, [PII] I can help with today?
[CUSTOMER][NEUTRAL] Nope, that's it.
[AGENT][POSITIVE] OK, thank you for calling APL. Have a good day.
[CUSTOMER][POSITIVE] Thank you, bye bye.