AccountId: 011433970860
ContactId: 728f9da9-4f03-4684-9389-4af39d5029b1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 501700 ms
Total Talk Time (AGENT): 196227 ms
Total Talk Time (CUSTOMER): 186920 ms
Interruptions: 1
Overall Sentiment: AGENT=0.8, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/728f9da9-4f03-4684-9389-4af39d5029b1_20250124T21:29_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] I was just thinking about you today girl how you doing? This is [PII].
[AGENT][POSITIVE] I'm good. I'm good. How are you?
[CUSTOMER][POSITIVE] I'm doing good thank you. You in the dental cue?
[AGENT][NEUTRAL] I am, yes.
[CUSTOMER][POSITIVE] Good deal. So I have uh an insured on the line that she was calling regarding a claim that we processed stating that the um facility has not received.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] The check yet
[CUSTOMER][NEUTRAL] And can you pull that up? She thinks it might have gone to the wrong place.
[AGENT][NEUTRAL] OK, what is the policy number?
[CUSTOMER][NEUTRAL] Policy number 613908.
[CUSTOMER][NEUTRAL] For Ms. [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it is the claim number 3,546,770.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] OK, thank you. One moment.
[AGENT][NEUTRAL] OK, and that was 202-0967.
[AGENT][NEUTRAL] And it shows that it was mailed to
[AGENT][NEUTRAL] $70 mailed to SR Mansville LLC.
[CUSTOMER][NEUTRAL] Yeah, when I gave her that address, she said that's her other dentist.
[CUSTOMER][NEUTRAL] But it should have gone to the ortho orthodontic dentist or.
[AGENT][NEUTRAL] Orthodontics then. OK, let me just see if I can get this claim to pull up one moment please.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEGATIVE] She just said it wasn't good.
[AGENT][POSITIVE] Outstanding.
[CUSTOMER][POSITIVE] Went to the right place.
[AGENT][NEUTRAL] OK, and but is the you said you, you have the insured on the line, is that right, [PII]? OK.
[CUSTOMER][NEUTRAL] I do, I do and her callback number is the number on file and I can give it to you if you'd rather.
[AGENT][NEUTRAL] OK, yes, if you give it to me please.
[CUSTOMER][NEUTRAL] Sure. That is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, thank you, Miss. [PII]. OK.
[CUSTOMER][NEUTRAL] You ready?
[AGENT][POSITIVE] I am, thank you.
[CUSTOMER][POSITIVE] You're very welcome. Good to talk to you if you'll hang on just a second, let me get her on the line.
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][POSITIVE] Thank you one moment.
[CUSTOMER][POSITIVE] Ms. [PII], thank you for your patience I have [PII] on the line and she is going to assist you further with that claim information. I hope you have a great weekend. All right thank you you too. Thank you bye bye. Bye.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Hello Miss. [PII].
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Yes, hi, um, I was just on the phone with [PII] and I'm going to check to see where that that check was mailed to, OK, give me one moment please. I'm trying to pull that information up. Thank you.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEGATIVE] It's just a little slow right now.
[AGENT][POSITIVE] I'm almost there, I promise.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well
[AGENT][NEUTRAL] [PII].
[AGENT][POSITIVE] I apologize. I really do apologize. It's just a little slow for me this afternoon, Miss. [PII]. I'm almost there, I promise.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, thank you for your patience. OK, so let me look at the claim as it was sent in.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, and it shows that the check was mailed to the location.
[AGENT][NEUTRAL] Uh.
[AGENT][NEUTRAL] As far as the claim that was submitted into us, it shows SR Mansfield LLC, which is where the check was mailed to.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, it was mailed to um Doctor [PII].
[AGENT][NEUTRAL] It just showed, so I'm sorry, [PII] was a treating dentist.
[CUSTOMER][NEUTRAL] Oh well, well, the other lady told me, uh, she thought it went to um [PII], uh.
[AGENT][NEUTRAL] And this will
[CUSTOMER][NEUTRAL] On [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEGATIVE] I do go to, uh, I do go to the Arredonists, but this one should have gone to [PII] because that's when I had my cleaning done.
[AGENT][NEUTRAL] Now, the location that you had the treating dentist, it was in [PII]. However, as far as their billing purposes, the billing was sent to where they wanted it to be sent to, and that was SR Mansfield LLC in [PII].
[CUSTOMER][NEUTRAL] Oh well, it that was sent wrong, but I'll check with my Donnis in [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Uh, that should have went to um
[CUSTOMER][NEUTRAL] [PII] cause that's where I had that work done.
[AGENT][NEUTRAL] Yes, ma'am, that's what it shows that you had it done and the dentist there was [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the billing
[CUSTOMER][NEUTRAL] Beg your pardon?
[AGENT][NEUTRAL] The dentist it showed was [PII].
[CUSTOMER][NEUTRAL] OK, well, that was a new dentist, so, um, but just the address was wrong.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] The well, the check was sent to the address where they wanted us to send the check to the billing department. Now, even though you may have had your work done, your dental treatment done in [PII], um, that particular dentist wanted her payment to be sent to [PII].
[CUSTOMER][NEGATIVE] Oh yeah, well, let me check, I, I, I'll check with them because I had already paid the bill and that's what the, the $70 is what the insurance was paying so I'm paying I'm overpaying.
[AGENT][NEUTRAL] OK, yes, ma'am.
[CUSTOMER][NEGATIVE] That's why I was trying to get my refund $70 back.
[AGENT][NEUTRAL] Oh, OK. OK.
[CUSTOMER][NEUTRAL] Yeah, cause see, I've already paid that $324 in [PII].
[AGENT][NEUTRAL] OK, OK.
[AGENT][NEUTRAL] OK, yes, ma'am.
[CUSTOMER][NEUTRAL] Is there any way when I have uh when they send a claim um in for me uh that the uh whatever you are gonna send for the uh the premium could it be sent to me because it looks like it's a confusion here.
[AGENT][NEUTRAL] Well, it, it
[CUSTOMER][NEUTRAL] Cause they require they require me to pay the whole amount at the uh at the beginning when I, after my service.
[AGENT][NEUTRAL] According to how the the claim was submitted into us, we had to pay the dentist. Now what you can do, you have to speak with the dentist's office. Um, sometimes the dentist will allow a patient to file a claim on their behalf, but more than likely the dentist files a claim on the insurer's behalf and we pay the dentist. So that's why we mail the check to the dentist's office.
[CUSTOMER][NEUTRAL] Yeah, yeah, yeah, y'all mail it to my [PII].
[CUSTOMER][NEUTRAL] And so with my dentist.
[CUSTOMER][NEUTRAL] He is my Ar Donald in [PII].
[AGENT][NEUTRAL] OK, we mailed it to.
[AGENT][NEUTRAL] The billing address that shows on the claim, and that was in [PII].
[CUSTOMER][NEUTRAL] OK, well, I, I, I'll check with them.
[AGENT][NEUTRAL] OK, yes, ma'am.
[CUSTOMER][POSITIVE] All right, thank you very much.
[AGENT][NEUTRAL] You're welcome, Miss [PII]. Anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, that's it today.
[AGENT][POSITIVE] OK. Well, thank you so much and you have a great weekend.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] Yes ma'am, thanks for calling APL mm bye.