AccountId: 011433970860
ContactId: 6c8a986f-2c04-4e67-afbc-329d6a00eea0
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 445089 ms
Total Talk Time (AGENT): 88033 ms
Total Talk Time (CUSTOMER): 185369 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/6c8a986f-2c04-4e67-afbc-329d6a00eea0_20250227T16:39_UTC.wav
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[AGENT][NEUTRAL] Calling ATL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII] and I'm calling from a dental provider's office. I have two claims on the same patient. I just wanted to see what the status was.
[AGENT][POSITIVE] I'd be happy to assist with going today [PII] if I can get a good callback number for you.
[CUSTOMER][NEUTRAL] Yeah, it's gonna be [PII].
[AGENT][NEUTRAL] And what is the policy
[CUSTOMER][NEUTRAL] The policy number is
[CUSTOMER][NEUTRAL] 02129245
[AGENT][NEUTRAL] Patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] and date of birth is [PII].
[AGENT][POSITIVE] Thank you for that information and the date of service.
[CUSTOMER][NEUTRAL] Um, the data service was 66 of 24 and it was for scaling and route planning. I know this claim was denied. I just need an EOB so that I can send it to the secondary.
[AGENT][NEUTRAL] Oh OK alright.
[AGENT][NEUTRAL] Yes
[AGENT][NEUTRAL] OK, so I'm showing it looks like y'all did y'all send it twice?
[CUSTOMER][NEUTRAL] The for that data service do you have two claims on file?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] I wonder if we accidentally sent it twice. Was one was one approved?
[AGENT][NEUTRAL] Um, the first one, let me get that one.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Yeah, Doctor [PII].
[AGENT][NEGATIVE] Yeah, so the first time you sent the claim in June, we processed it and paid $236. The second time we received it, we denied it as a duplicate.
[CUSTOMER][NEUTRAL] OK. When?
[CUSTOMER][NEUTRAL] OK, so, so it was $236 was paid. Let me, OK.
[CUSTOMER][NEUTRAL] Sorry, I'm, I'm walking through here, um.
[CUSTOMER][NEUTRAL] And that was for 6624.
[AGENT][NEUTRAL] 662024 for a code 49.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Uh, well, the payments 4999 was denied, but um 4341, both of those we made payment on.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let me put my notes in here.
[CUSTOMER][NEUTRAL] OK, what about, I, I think I see what, what happened here. I think that I.
[CUSTOMER][NEUTRAL] The the person who was here before me posted the payment to the wrong data service. What about 6524?
[CUSTOMER][NEUTRAL] Also for scale, scaling and root pointing just the other side of the mouth.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] So let's see, it looks like uh.
[AGENT][NEUTRAL] What was the
[AGENT][NEUTRAL] The code?
[CUSTOMER][NEUTRAL] Uh, it was D4341, D4341, 2 of those for the right side of the mouth.
[AGENT][NEUTRAL] Um,
[AGENT][NEGATIVE] Oh, now that one denied because they had maxed out their benefits for the year.
[CUSTOMER][NEUTRAL] OK, so that one was denied. OK, can I get an EOB for that data service?
[AGENT][NEUTRAL] 65
[CUSTOMER][NEUTRAL] For 65, yeah, yeah, I, I think what happened was somebody had taken the or the payment that was supposed to go to 6624 and posted it on my, in my bookkeeping to the wrong data service. I just, I need to get the other half of this SRP sent to the secondary insurance, so I think I'll need, I'll need the one that was denied the 6524.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] Sorry to confuse you. I know that was confusing.
[AGENT][NEUTRAL] Oh, no, that's fine.
[AGENT][NEUTRAL] What's that fax number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Alright, you should receive that within the next 10 minutes. Was there anything else I could assist you with today?
[CUSTOMER][POSITIVE] Wonderful.
[CUSTOMER][NEUTRAL] Yeah, I just have one more claim for the same patient, um, it's for the data service 10:15 and 24.
[CUSTOMER][NEUTRAL] Looks like we had spoken to a rep uh to see if the claim was on file and they didn't see anything for the data service so we faxed it over. I just wanna make sure it was received this time.
[AGENT][NEUTRAL] I don't see anything and I don't see anything pending.
[CUSTOMER][NEUTRAL] OK, for the, for the [PII], 24?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] All right. Um, what should I fax the claim over? Should I use my clearing house? I, I, I've tried once through my clearing house and once over fax, and it looks like it hasn't gotten to you guys.
[AGENT][NEUTRAL] Um, uh, what, uh, are you using the 877-365?
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 365. I don't think that's that must not be the one that she sent it to if you guys didn't get it. 877-365 and what was the last four?
[AGENT][NEUTRAL] 942 3.
[CUSTOMER][NEUTRAL] 942-3. OK. I'll try faxing it again.
[AGENT][NEUTRAL] All right.
[CUSTOMER][POSITIVE] And I think, I think that's all I needed. I appreciate your help.
[AGENT][POSITIVE] OK, well thank you for calling APL you have a good day.
[CUSTOMER][POSITIVE] You too. Thanks. Bye.
[AGENT][NEUTRAL] Mhm. OK.
[CUSTOMER][NEUTRAL] OK.