AccountId: 011433970860
ContactId: 676dbd73-439d-4416-bf02-4edefcff64d8
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 345980 ms
Total Talk Time (AGENT): 150678 ms
Total Talk Time (CUSTOMER): 67757 ms
Interruptions: 0
Overall Sentiment: AGENT=0.9, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/18/676dbd73-439d-4416-bf02-4edefcff64d8_20250218T20:41_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] Hey [PII], my name is [PII]. I'm calling about a claim please.
[AGENT][NEUTRAL] OK, I can help you with the claim status and [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] Thank you for that and the member's policy number?
[CUSTOMER][NEUTRAL] 126.
[CUSTOMER][NEUTRAL] 6556.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service or the, um, I'm sorry, the date of service and the total bill for the claim?
[CUSTOMER][NEUTRAL] [PII] for $781.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] OK, this looks like it's all one claim. hold on one moment.
[AGENT][NEUTRAL] And what is the name of the provider's office on the claim?
[CUSTOMER][NEUTRAL] Mint dentistry or De Soto mint dentistry?
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] So I'm showing the claim was received on [PII].
[AGENT][NEUTRAL] The claim number is 355.
[AGENT][NEUTRAL] 256 8.
[AGENT][NEUTRAL] And on [PII], I'm sorry, [PII], the claim was denied and I'm getting that reason for you now.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, looks like it's been submitted, uh, the submitted claim is a duplicate of a previously submitted claim. Please check your records for the data service and charges submitted. Hold on one moment. Let me see what the original claim was.
[AGENT][NEUTRAL] And that was [PII], right?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] 568. OK, here goes the the first one.
[AGENT][NEUTRAL] OK, so the original was received on [PII].
[AGENT][NEUTRAL] Claim number is 3552197.
[AGENT][NEUTRAL] And on [PII], the claim was paid out on to the provider, a total of $559.40.
[CUSTOMER][NEUTRAL] How was that paid?
[AGENT][NEUTRAL] Um, this was a single check.
[CUSTOMER][NEUTRAL] May I have the check number?
[AGENT][NEUTRAL] Hold on one moment.
[AGENT][NEUTRAL] OK, so the check number is 22022913.
[CUSTOMER][NEUTRAL] And and you said it was a single check, right? No bulk amount?
[AGENT][NEUTRAL] Hey
[AGENT][NEUTRAL] Right, it was just a single check for 55,940.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can you tell me what address that was mailed to?
[AGENT][NEUTRAL] Mhm. [PII].
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] And um are you the check is still outstanding at this time?
[CUSTOMER][NEUTRAL] Are you able to see that?
[AGENT][POSITIVE] Yes, it is still outstanding at this time.
[CUSTOMER][POSITIVE] OK perfect and and uh.
[AGENT][NEUTRAL] So if you like.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, go ahead.
[AGENT][NEUTRAL] Since it's been over 30 days, if you'd like, I can have for the check to be um checked on, and uh we can either send you a copy of the clear check if it is cleared or reprocess this so that it can be resent out.
[CUSTOMER][NEUTRAL] Oh no, that's OK. Um, we give our checks 75 days um because it goes to the treating location instead of our billing office, so it takes us a little bit longer.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] Yes, OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, before you go, can I just have a reference number for our call?
[AGENT][NEUTRAL] Sure, so there's no call reference number, but you can use my name, which is [PII] name is [PII], and then today's date.
[CUSTOMER][POSITIVE] OK, thank you again. I hope you have a great rest of your day, [PII].
[AGENT][POSITIVE] You also, thanks for calling [PII], I hope you have a great week.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] You're welcome. Bye bye.