AccountId: 011433970860
ContactId: 79dca764-1b8e-4208-89b6-6fd1d2a052c2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 835469 ms
Total Talk Time (AGENT): 183179 ms
Total Talk Time (CUSTOMER): 166519 ms
Interruptions: 2
Overall Sentiment: AGENT=1.1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/79dca764-1b8e-4208-89b6-6fd1d2a052c2_20250106T17:04_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling regarding a claim.
[AGENT][POSITIVE] Oh, it would be my pleasure to assist you, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] Um, it is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number?
[CUSTOMER][NEUTRAL] Um, it is.
[CUSTOMER][NEUTRAL] 023 44903
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is [PII]. Uh, the date of birth is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Alright, thank you, and this is for claim status for [PII] and I will be happy to assist you. That's for dental, correct?
[CUSTOMER][NEUTRAL] Yes ma'am, um, actually it, it is for a claim status we requested, um.
[CUSTOMER][NEUTRAL] A correct data service claim to be reprocessed. Um, we received a call from a rep, uh, like, uh, [PII] telling us that we needed that the claim was gonna be reprocessed with the correct date of service to allow 5 to 10 business days, um, but we haven't received anything yet.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Bear with me just one second.
[AGENT][NEUTRAL] I'm checking on that for you, so bear with me.
[CUSTOMER][POSITIVE] OK, no worries.
[AGENT][NEUTRAL] And this was for data service 1523?
[CUSTOMER][NEUTRAL] Uh, let me see, the data service is, yes, it is.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 153.
[CUSTOMER][NEUTRAL] 15 of 24, so I think, I don't know if you said 23, 24.
[AGENT][POSITIVE] I, I did say 23. I'm so sorry.
[CUSTOMER][NEUTRAL] behind.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] I'm just checking so bear with me.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm sorry, it's just taking a minute to research this and just bear with me just a minute.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] No worries, thank you.
[AGENT][NEUTRAL] And y'all received a payment on that claim?
[CUSTOMER][NEUTRAL] Um, we did, um, let me see, let me confirm.
[CUSTOMER][NEUTRAL] We did, um, we were just told that we were gonna get the correct COB that way we could process with the payment.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] In this case it would, it would just be like the the correct the EOB itself right? with no check attached.
[AGENT][NEUTRAL] Yeah, it should be. I was checking to see if that has been reprocessed. I do see the.
[AGENT][NEUTRAL] That's the service for 13 were not processed on that claim.
[AGENT][NEUTRAL] So I'm just checking to make sure.
[AGENT][POSITIVE] And I do apologize.
[AGENT][NEUTRAL] Give me just another minute, so.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] What I'm gonna do is I'm going to put in a new request for them to reprocess the claim for dates of service [PII], 0.
[AGENT][NEUTRAL] So it was for [PII] and [PII], correct?
[CUSTOMER][NEUTRAL] Yes, ma'am, um, the only services that were rendered on [PII] were the preventative services.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And on [PII], it was the fillings, 2392.
[AGENT][NEUTRAL] And you only received an EOB with the date of service of [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] I appreciate your patience.
[CUSTOMER][POSITIVE] Mhm, no worries.
[AGENT][NEUTRAL] If, do you mind holding just one moment, let me get that request put in for you that way you know.
[AGENT][NEUTRAL] That has been
[AGENT][NEUTRAL] Done if you don't mind holding just one moment.
[CUSTOMER][POSITIVE] Yes ma'am, that's fine. Thank you.
[AGENT][POSITIVE] Thank you, [PII]. I'll be right back with you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK and uh I have put in a request that they reprocess that claim for you to include the dates of service of 13 for the um preventative services.
[AGENT][NEUTRAL] And I did send that as an urgent request.
[CUSTOMER][NEUTRAL] OK, so the, the previous rep that spoke to us, um, the, the claim was the process?
[AGENT][NEGATIVE] I don't see that it has been doesn't mean that they have not sent that information, but I don't see that it's been reprocessed and I have issued a new request.
[CUSTOMER][NEUTRAL] OK. Alrighty. Alrighty, [PII], could I get a reference number please?
[AGENT][NEUTRAL] The reference number is my name and today's date, and I spelled my name [PII]
[AGENT][NEUTRAL] First initial last name [PII].
[CUSTOMER][NEUTRAL] And you said today's day, right?
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] OK, and um,
[CUSTOMER][NEUTRAL] Uh, what, uh, would it be sent to the PO box address?
[AGENT][NEUTRAL] Uh, whatever, let me.
[CUSTOMER][NEUTRAL] It would, uh, it would be the [PII].
[AGENT][NEUTRAL] Let me see if I still have that claim pulled up. What's on the claim, let's see if I can pull it back up and give that to you.
[AGENT][NEUTRAL] Or when wherever that last EOB was sent to with the check is the same address it would be sent to.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I think it was.
[CUSTOMER][NEUTRAL] The [PII]. Let me just confirm before I let you go.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] It doesn't have an address.
[AGENT][NEUTRAL] I can check something else. Hang on just a second.
[CUSTOMER][NEUTRAL] Let me see.
[CUSTOMER][NEUTRAL] Try to
[AGENT][NEUTRAL] And that actually went to.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Uh yes, ma'am. OK. Alrighty, sounds good. That is all I needed.
[AGENT][NEUTRAL] And I do apologize for any inconvenience, but they'll get that reprocessed. I've, I've I sent that request right now and I'm putting it in the notes, the request number that was sent, OK.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Alrighty.
[AGENT][NEUTRAL] [PII]ng else I can help you with today?
[CUSTOMER][POSITIVE] OK, thank you so much.
[CUSTOMER][NEUTRAL] Uh, no, ma'am, that is it.
[AGENT][POSITIVE] OK [PII], thank you for calling APL, and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thank you, you too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye bye.