AccountId: 011433970860
ContactId: 726d672a-8ab2-4fe4-a7dd-9e79b103acd5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 420390 ms
Total Talk Time (AGENT): 103463 ms
Total Talk Time (CUSTOMER): 196273 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/16/726d672a-8ab2-4fe4-a7dd-9e79b103acd5_20250616T22:13_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. How are you?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][NEUTRAL] Fine, I, let me give you my policy number 450719.
[AGENT][NEUTRAL] You said 719?
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] And how can I help you today?
[CUSTOMER][NEUTRAL] I'm calling in reference to a reference letter I got from you guys over the weekend or or Friday or something like that. I have a question for you. I, I submitted a new claim on the back at the beginning of June for dental cleaning. Why you write that this submitted claim is a duplicate of a previous submitted claim? Please check your records for the date. I mean, it was dated for [PII] back of the date beginning of June.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, let me look into that and you said your name was um.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And can I get you to verify your date of birth for me please?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the address that we have on file?
[CUSTOMER][NEUTRAL] The address I have on file is [PII].
[CUSTOMER][NEUTRAL] And the data service that I did it was on [PII].
[AGENT][NEUTRAL] Of this year correct?
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] OK, let me look that up.
[CUSTOMER][NEUTRAL] When you look, I gotta ask my coworker for something, OK, hold on.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Who was supposed to come in today for film?
[CUSTOMER][NEUTRAL] Alright, I'll call him up and find out what's going on.
[CUSTOMER][NEUTRAL] Well, they'll find out which coming tomorrow.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And this is for your dental policy, correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] How much
[CUSTOMER][NEUTRAL] I'm just confused. Why would that be a duplicate file when I just that was a different I I get 4 cleanings a year so.
[AGENT][NEUTRAL] Let me look here. Give me just one second.
[CUSTOMER][POSITIVE] Alright, thanks.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] And you're saying it was denied?
[CUSTOMER][NEUTRAL] They, yeah, it said it was, yeah, well, it says in the back of it was denied because it said.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh,
[AGENT][NEUTRAL] Yeah, I am
[CUSTOMER][NEUTRAL] Tomorrow, see you tomorrow, yeah, that this, this submit submit a claim is a duplicate of a previous submitted claim. How can it be submitted to be.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I am showing that it was paid. It looks like you had a cleaning and an oral examination that was paid um on that claim and then it looks like it was just uh a claim got resubmitted for the exact same thing, um.
[CUSTOMER][NEUTRAL] Well, I have, I, I.
[AGENT][NEUTRAL] A cleaning and an, and an oral examination, but the first one was paid. Let me look here just real quick.
[CUSTOMER][NEUTRAL] And what was that?
[AGENT][NEUTRAL] They were all on the same data service. It looks like it was just filed twice. um let me see here though.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] No, because I didn't have it. I, I, I submit the other claim back earlier.
[AGENT][NEUTRAL] All right, let me look.
[CUSTOMER][NEUTRAL] One was 62 and then I had one then 4 done on [PII] and I I 410.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Yeah, it looks like.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] I wouldn't submit the same thing twice, madam.
[AGENT][NEUTRAL] Yeah, it looks like it showed like the first claim, the one that got paid, it shows that it was uh we received it on.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] And then the second time it was.
[CUSTOMER][NEUTRAL] Alright, well that's the that's the way.
[AGENT][NEUTRAL] Oh, go ahead.
[CUSTOMER][NEUTRAL] Go on. What was the last, the other one?
[AGENT][NEUTRAL] The second one, the one that got denied, it was submitted the next day on [PII]. So that's why it got denied, but the, but the original did get paid.
[CUSTOMER][NEUTRAL] Right, what
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Alright, well, I submitted two different claims. Alright, whatever. I, I just wanted to verify it. Alright, um.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] My next cleaning is on [PII]. I won't be able to do it over the four month period because do because, uh, in August I'm going for knee I'm going for hip replacement surgery.
[CUSTOMER][NEUTRAL] I'm getting my cleaning a little earlier than expected because the next time I supposed to have my cleaning would have, would have been in September and I would not be able to do it in September, so they better just do it before I have the surgery because I don't know how long I'm gonna be lamed up after the surgery. That's why.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright, so I'm just letting you know that on record that I'm getting, I'm getting a head start just because I wanna make sure my gums don't have bleeding and all that headaches.
[AGENT][NEUTRAL] Oh.
[AGENT][NEUTRAL] Sure, sure.
[CUSTOMER][POSITIVE] After and especially when I'm being in a lot of pain from the surgery, I just wanna make sure that I'm doing it. I wanna, I wanna be, have one less thing to worry about, you know what I'm saying?
[AGENT][NEGATIVE] Right, yeah, and I, and I am showing that it was the exact, it was just it was one was submitted the next day and that's the one that got denied, but the other one was paid.
[CUSTOMER][POSITIVE] That's right. I never, I never submit, uh, it's weird. I never do that. I would never do something like that. So alright, well, listen, have a nice day. Have a nice evening and thank you very much for your, uh, straighten that out for me.
[AGENT][NEUTRAL] All right, any time is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, like I won the lottery. That's all I got to help me with that.
[AGENT][NEUTRAL] I can't help you with that. I'm sorry.
[CUSTOMER][NEUTRAL] Alright bye.
[AGENT][POSITIVE] Alright, have a great day, bye.
[CUSTOMER][NEUTRAL] With that