AccountId: 011433970860
ContactId: 6e6a986c-3771-403d-98ea-d0eecfaf875a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 356920 ms
Total Talk Time (AGENT): 118813 ms
Total Talk Time (CUSTOMER): 159280 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/07/6e6a986c-3771-403d-98ea-d0eecfaf875a_20250307T21:16_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][POSITIVE] Hey [PII], my name is [PII] and I'm calling from a provider's office. Happy Friday.
[AGENT][POSITIVE] Happy Friday, yes, ma'am.
[CUSTOMER][NEUTRAL] So I wanted to check on the status of some claims for a patient please.
[AGENT][NEUTRAL] OK, uh, what is that policy number, please?
[CUSTOMER][NEUTRAL] Uh, we've got 02293914.
[AGENT][NEUTRAL] OK, one moment. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, uh, direct line is [PII].
[AGENT][NEUTRAL] OK, and verify that patient's name, date of birth, please.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, let's see, and you say you're calling for claim status, correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, and this is for dental?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, what was that date of service and amount of the charge or dates of service?
[CUSTOMER][NEUTRAL] Yeah, I've got, yeah, I've got the first date is [PII] for a build amount of 3-11.
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] 626 to 24?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] I do not show a claim for that data service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm wondering if it's gonna be this way for all of these, but let's find out um the next one is um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 71 of 24 for a billing amount of 650.
[AGENT][NEUTRAL] Uh, for periodontal scaling.
[CUSTOMER][NEUTRAL] Uh, yeah, let me just verify that real quick.
[AGENT][NEUTRAL] Oh, this looks like it was sent twice. Oh, give me one moment.
[CUSTOMER][NEUTRAL] Uh, yeah.
[CUSTOMER][NEUTRAL] It is scaling and route planning.
[AGENT][NEUTRAL] OK, uh, show that claim process as not covered, uh, with this insurance policy, it doesn't cover any major services and periodontics is considered major.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, and then the last one is 7-Eleven, which is probably gonna be the same reason.
[CUSTOMER][NEUTRAL] 7 1124 for billed amount of 685.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] Uh, yes, ma'am. It looks like that one was also processed. It's not covered.
[CUSTOMER][NEUTRAL] OK, are you able, we don't have uh any EOBs to confirm this information. Are you able to fax that to me?
[AGENT][NEUTRAL] Sure. What's your fax number?
[CUSTOMER][NEUTRAL] It's 719.
[CUSTOMER][NEUTRAL] 455.
[CUSTOMER][NEUTRAL] 0566.
[AGENT][NEUTRAL] OK, that's [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][POSITIVE] OK, I will send this off to you in a few moments. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Yeah, can we circle back on, I just wanna make sure that we've got, I mean, obviously we have the right information to submit the claims, but um we've got [PII] for the address.
[AGENT][NEUTRAL] Uh, the address did change [PII], and I give you that current address and or fax number if you like.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] OK, uh, the mailing address is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] So let me just read that back to you real quick, um, [PII].
[AGENT][POSITIVE] Correct, yes, ma'am.
[CUSTOMER][NEUTRAL] And then uh payer ID?
[AGENT][NEUTRAL] 60801.
[CUSTOMER][NEUTRAL] OK, so that is correct it's just the mailing address that has changed.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK and then um yeah if you can give me a fax number we'll go ahead and fax over that remaining.
[CUSTOMER][NEUTRAL] Claim which probably will deny as well but at least we'll have it on on file.
[AGENT][NEUTRAL] OK, let me know when you're ready.
[CUSTOMER][NEUTRAL] Yes, go ahead.
[AGENT][NEUTRAL] OK, it's 877.
[AGENT][NEUTRAL] 3659423.
[CUSTOMER][NEUTRAL] So you said [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] OK, perfect.
[CUSTOMER][NEUTRAL] Alright, and then typically how long does it take before um does do the faxes have to go through a queue or something before they're sent?
[AGENT][NEUTRAL] No, it just, um, I'll send it right after I get off the phone with you.
[CUSTOMER][NEUTRAL] OK, alright, very good, and then [PII], can I get a reference number please?
[AGENT][NEUTRAL] Sure, um, well, we don't give reference numbers, but if you like, you may use my name at today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So 37 OK very good thank you so much for your time today.
[AGENT][POSITIVE] Alright, you're welcome and thank you for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Uh-huh.