AccountId: 011433970860
ContactId: 6db8565f-f41c-4763-b24e-789000592f35
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 748200 ms
Total Talk Time (AGENT): 154178 ms
Total Talk Time (CUSTOMER): 94138 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/29/6db8565f-f41c-4763-b24e-789000592f35_20250429T15:33_UTC.wav
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[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII] from me calling for claim. So your name is [PII].
[AGENT][NEUTRAL] Yeah, my name is so I'm, I'm sorry, you said your name is [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And you said you're calling from where? I'm sorry, I didn't get that.
[CUSTOMER][NEUTRAL] You're fine. I'm calling from Mint dentistry.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK and may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 1972551.
[AGENT][NEUTRAL] All right. What's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] I have [PII] for 5-12-1962.
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] All right, and you need um benefits or you're looking for a back tax pack or verbal?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Claims.
[AGENT][NEUTRAL] Plains, OK. Got it. OK. And what is the date of service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I have [PII] for $730.
[AGENT][NEUTRAL] OK, let me see if I can find that claim.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] 2020, 24.
[AGENT][NEUTRAL] OK, let me pull this ELB. Let me check on this one.
[AGENT][NEUTRAL] I'm waiting on the EOB to pull up, OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, here it is and let me see why it's denied.
[AGENT][NEGATIVE] Looks like we processed on [PII] and it was denied. I'm waiting for it now.
[AGENT][NEUTRAL] OK, it looks like the calendar year maximum um maximum benefit has been exhausted.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] They maxed out the benefits.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] What's that claim number?
[AGENT][NEUTRAL] It is 357-433-9.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I'm just making a notation.
[AGENT][POSITIVE] Sure, yes, take your time. It's fine.
[CUSTOMER][NEGATIVE] Is there any way that you could um maybe fax me over the EOB? I tried to get off your portal and it's not pulling up even with the claim number.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It's OK, sure, yes, what is the fax number?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. [PII] to your attention.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out to you right now? Oh.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, ma'am. Go ahead, that's fine.
[AGENT][NEUTRAL] OK, thank you, one moment.
[CUSTOMER][NEUTRAL] Yes. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being information for you, Miss [PII]. OK, I'll send that over to you. It should be there in a few minutes. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes ma'am, I just have one other patient I need assistance with.
[AGENT][NEUTRAL] OK, sure. What is the next policy?
[CUSTOMER][NEUTRAL] It is.
[CUSTOMER][NEUTRAL] I have 02598213.
[AGENT][NEUTRAL] All right, what's the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] I have [PII] for [PII].
[AGENT][NEUTRAL] OK, what's the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] 325 2025 for $781.
[AGENT][NEUTRAL] 32525. OK, let me pull this.
[CUSTOMER][NEUTRAL] 000.
[AGENT][NEUTRAL] OK, and you said the total charge was 781, correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so we processed this one on [PII] and we send a benefit amount of $562.80.
[CUSTOMER][NEUTRAL] Um, how was that payment made?
[AGENT][NEUTRAL] It was a check, single check, paper check.
[CUSTOMER][NEUTRAL] OK at the moment.
[CUSTOMER][NEUTRAL] Mm and the check number?
[AGENT][NEUTRAL] That is 203-7850.
[CUSTOMER][NEUTRAL] Thank you that claim number?
[AGENT][NEUTRAL] It is 358-685-9.
[CUSTOMER][POSITIVE] Thank you and can I have the ELB as well?
[AGENT][NEUTRAL] Um, yes, mhm, let me go ahead and send that out.
[AGENT][NEUTRAL] OK, I'm waiting on the system.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, it should be there in a few minutes.
[CUSTOMER][POSITIVE] Alright, thank you so much for your help. Is there a reference number for the call?
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will.
[CUSTOMER][POSITIVE] OK, thank you so much have a good day.
[AGENT][POSITIVE] You as well, Miss [PII] and thank you for calling APO. Bye bye.
[CUSTOMER][POSITIVE] Thank you bye bye.
[AGENT][POSITIVE] You're welcome.