AccountId: 011433970860
ContactId: 78a2d5b3-1626-4971-af25-c71ef5538827
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 193000 ms
Total Talk Time (AGENT): 88075 ms
Total Talk Time (CUSTOMER): 85360 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/24/78a2d5b3-1626-4971-af25-c71ef5538827_20250224T21:28_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. That's [PII]. Um, do you need my policy number?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] 00608061
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you for that. And I have your policy here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] It's [PII], [PII].
[CUSTOMER][NEUTRAL] And birthday of [PII]. I already said that. What else was oh [PII].
[AGENT][NEUTRAL] Your email address.
[AGENT][POSITIVE] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And how may I help you today?
[CUSTOMER][NEGATIVE] Um, I got a, a statement that says this is not a bill, but it says that there was nothing paid on my, uh, February, uh, cleaning.
[CUSTOMER][NEUTRAL] And on the back it it said that they're waiting on information from employer or association to confirm the eligibility.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, what, you know, I've been retired for 12 years, so, and it, uh, the payment just comes up from my, uh, checking account direct deposit or direct draft.
[AGENT][NEUTRAL] OK, I'm gonna go ahead and send this back to be reprocessed because I do see that um denial reason here too that it's waiting for eligibility, but
[AGENT][NEUTRAL] It's not
[AGENT][NEUTRAL] Yeah, I, I don't know if this was an error. I mean, I'm, I see it as an error, but I'm gonna send it back to reprocessing so claims can um take a look at it and see if this is correct, an explanation, and if not, we can go ahead and reprocess it and get the correct decision.
[CUSTOMER][NEUTRAL] OK, is, is, would there be a reason that it could possibly need something from a past employer?
[AGENT][NEUTRAL] I don't see one, but I'm also not an examiner, so I don't want to say no and then it is really a yes. I, to me, I don't know why we would ask for, uh, have to wait for the employer, there is no employer, you know, well, you know, you're not, you're retired.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] So, right, will they uh contact me and let me know or will they directly just contact the dental office?
[AGENT][NEUTRAL] Um, I'm gonna put in there to give, if it is correct to give you a call with an update. If not, to go ahead and process it and then you'll get the new explanation of benefits with the um new decision.
[CUSTOMER][NEUTRAL] OK, I, I'll call the, the dental office back and just let them know that I'll reprocessing.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] Oh, OK. Thank you.
[AGENT][POSITIVE] You're very welcome. Was there anything else I can help you with today?
[CUSTOMER][NEUTRAL] Um, no, ma'am.
[AGENT][POSITIVE] Alright, well, thank you so much for calling APL. I hope you have a great evening.
[CUSTOMER][POSITIVE] You too. Thank you.
[AGENT][POSITIVE] Thank you. Bye-bye.