AccountId: 011433970860
ContactId: 6defdb0e-4039-436f-a252-ba063a787076
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 214639 ms
Total Talk Time (AGENT): 111877 ms
Total Talk Time (CUSTOMER): 58854 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/19/6defdb0e-4039-436f-a252-ba063a787076_20250519T19:01_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling from a dental office checking claim status please.
[AGENT][NEUTRAL] Yeah, I to check on a claim for you. Uh, what was your name please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, [PII], can I get a good call back number from you first in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure [PII].
[AGENT][NEUTRAL] Thank you. And do you have that policy number?
[CUSTOMER][NEUTRAL] I do it's 251-845-9.
[AGENT][NEUTRAL] Alright, and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Um, [PII] and [PII]'s date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you for verifying that and then what was the date of service for this claim, please?
[CUSTOMER][NEUTRAL] Alright, date of service is [PII].
[AGENT][NEUTRAL] [PII]. OK, one moment.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is the provider, is it, uh, [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, alrighty, I do believe I found this claim. Give me just a moment.
[CUSTOMER][POSITIVE] OK thanks.
[AGENT][NEUTRAL] OK, so yes, we did receive this claim uh looks like currently at the moment we are awaiting information regarding eligibility from [PII]'s employer so once we have that information we'll be able to continue processing this claim uh that was last on.
[AGENT][NEUTRAL] That was [PII].
[AGENT][NEUTRAL] And if you'd like I can send you this EOB or do you I'm sorry.
[CUSTOMER][NEUTRAL] OK, because you
[CUSTOMER][NEUTRAL] I was gonna say um we sent another claim on [PII] and y'all paid that claim.
[CUSTOMER][NEUTRAL] You have to check his eligibility every single claim?
[AGENT][NEUTRAL] Um, for [PII] or for a different member under the policy?
[CUSTOMER][NEUTRAL] Yes, so for [PII].
[AGENT][NEGATIVE] I'm not sure we received anything.
[CUSTOMER][NEUTRAL] The data service on that one is [PII], but y'all paid it on [PII].
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Yes, yes, OK, sorry, I thought you meant that was the date of service. OK, um, it looks like that one was actually paid [PII], um, sometimes, no, we don't have to check eligibility for every claim. It really does depend sometimes on, uh, the group or the employer, uh, could be undergoing some renewal changes and we just have to verify that uh that information.
[CUSTOMER][NEUTRAL] OK, so how long should I give before calling back?
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] It's kind of hard to say. I maybe about a week or two, but there's really we're just waiting for that information so just as soon as they can get that information to us then we can continue processing.
[AGENT][NEUTRAL] Did you need that claim number in the meantime?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, that is 35.
[AGENT][NEUTRAL] 94091.
[CUSTOMER][NEUTRAL] OK, and if you don't hear from the employer, do you reach back out to them?
[AGENT][POSITIVE] I do believe we do um I mean if you wanted to kind of push it along you could always kind of tell me that's what we're waiting for.
[CUSTOMER][NEUTRAL] OK, I will let him know.
[AGENT][NEUTRAL] Alright, was there anything else I could help you with?
[CUSTOMER][POSITIVE] Alright thank you for your help.
[CUSTOMER][NEUTRAL] Nope, that'll do it.
[AGENT][POSITIVE] Alright well thanks for giving us a call have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Thanks bye bye.