AccountId: 011433970860
ContactId: 89fb01b5-7f2c-4429-b925-a37dfdb4af34
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 473989 ms
Total Talk Time (AGENT): 170369 ms
Total Talk Time (CUSTOMER): 194591 ms
Interruptions: 2
Overall Sentiment: AGENT=0.8, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/30/89fb01b5-7f2c-4429-b925-a37dfdb4af34_20250530T17:50_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] Uh, yeah, this is [PII] and
[CUSTOMER][NEUTRAL] My dentist is saying that y'all won't take a claim.
[CUSTOMER][NEUTRAL] For my cleaning visit.
[AGENT][NEUTRAL] Um, OK, I can look into the claim for you and see what's going on. I'm definitely sorry to hear that. Uh, Mr. [PII], may I have a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Sure it's [PII].
[AGENT][NEUTRAL] Thank you. And may I have your policy number?
[CUSTOMER][NEUTRAL] 024726667
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] And I have you here. I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And I, you want my home address?
[AGENT][NEUTRAL] Yes, the home address and your email address.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the email is [PII].
[AGENT][NEUTRAL] Thank you for that and all the information provided is a verification of benefits, not a guarantee of payment. And the claim is, is it for you or your spouse or one of your dependents?
[CUSTOMER][NEUTRAL] Just me.
[AGENT][NEUTRAL] OK. The reason I was asking is because we
[CUSTOMER][NEUTRAL] Just uh
[CUSTOMER][NEUTRAL] Regular cleaning.
[AGENT][NEUTRAL] The reason I was asking is because there's no claims here. We haven't like literally the page is blank. We haven't we haven't processed any claims for you yet. So I'm wondering where they're sending it to.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] That that's what I'm telling you they called, they called and said that they can't submit a claim that they were told that y'all are just a discount.
[CUSTOMER][NEUTRAL] Which didn't make sense because even on the card I have it says to submit a claim, so I'm trying to figure out what's going on.
[AGENT][NEUTRAL] OK, I understand what you're saying. I'm just letting you know they haven't submitted anything to us. Do you have a phone number? I can try to give them a call to see what's going on, but I, I, I don't know if they're sending it to the wrong place or.
[CUSTOMER][NEUTRAL] Yeah, sure.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Well they didn't send anything because they were when they called they told them they don't take claims whoever it was that they talked to. I don't know if they talked to the wrong person or what, but it's uh I don't.
[AGENT][NEUTRAL] Yeah, I don't know who they called either, but I'll give them a call.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, hold on one moment, OK?
[CUSTOMER][NEUTRAL] And [PII] is the one.
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] You were giving a name?
[CUSTOMER][NEUTRAL] Oh, I said [PII] is who I was talking to, but whoever answers should be able to help.
[AGENT][NEUTRAL] OK, hold on one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Thank you for calling Summit Dental. This is [PII]. How may I help you?
[AGENT][NEUTRAL] Hey [PII], my name is [PII]. I'm calling from American Public Life. Um, we have a mutual patient, [PII], and he gave us a call today. He's on the line as well. He gave us a call, um, saying that he was told that we're rejecting a claim. I'm just trying to see if if there's something I can provide to help because we don't have anything on file and don't have a record of anyone calling.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, let me look.
[CUSTOMER][NEUTRAL] So, um.
[CUSTOMER][NEUTRAL] Can you verify that date of birth for me please?
[AGENT][NEUTRAL] Sure. It is [PII] of
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Go ahead.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK and then the um.
[CUSTOMER][NEUTRAL] Claim in question because we know a date what that was for.
[AGENT][NEUTRAL] Mr. [PII], did they give you a date?
[CUSTOMER][NEUTRAL] It's the most recent one was uh about a month ago and he just emailed me the um.
[CUSTOMER][NEUTRAL] The invoice or bill or whatever statement yesterday [PII].
[CUSTOMER][POSITIVE] Yeah, that sounds right.
[CUSTOMER][NEUTRAL] OK, so it's for 172, uh, for cleaning and exam that was done on [PII], um, what insurance company did you say this is?
[AGENT][NEUTRAL] The insurance company is American Public Life. Let me see what type of dental policy he has. Hold on one moment.
[CUSTOMER][NEUTRAL] Mhm because we don't have an insurance policy in here now.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] Hold on one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And are you needing just the policy number and I can fax you over a fax back as well if you need it.
[AGENT][NEUTRAL] But it's on the Carrington PPO network?
[CUSTOMER][POSITIVE] Uh, yeah, I mean that'd be great for.
[CUSTOMER][NEUTRAL] OK, yeah, I need, I need that information.
[AGENT][NEUTRAL] Alright. The policy number is 2.
[CUSTOMER][NEUTRAL] I sent them the card.
[CUSTOMER][NEUTRAL] Do what?
[CUSTOMER][NEUTRAL] I sent [PII] the insurance card.
[CUSTOMER][NEUTRAL] OK, she's off today so she she won't get that until Monday.
[CUSTOMER][NEUTRAL] Yeah. And it is
[CUSTOMER][NEUTRAL] It was that
[CUSTOMER][NEGATIVE] They wouldn't take the claim and then I call them and the the claim hasn't even been submitted.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK, so obviously needed to go to a different company than than what we had in the um.
[CUSTOMER][NEUTRAL] In the computer so if you could send me that fax, uh, ma'am, that would be great and I'll enter that and then resend the claim.
[AGENT][NEUTRAL] OK, did you need the policy number?
[CUSTOMER][NEUTRAL] Would that not be on the claim that you're gonna send me?
[AGENT][NEUTRAL] On the fax back, it's not going to be on there, but
[CUSTOMER][NEUTRAL] OK, sure, I'll take it.
[AGENT][NEUTRAL] OK, it's 247.
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] 2667. It's been effective since [PII].
[CUSTOMER][POSITIVE] OK perfect that sounds great and you've got my fax number?
[AGENT][NEUTRAL] No, what is your fax number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, that's attention, [PII].
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Alright, so I'll go ahead and send the fax back over to you now. Thank you, [PII].
[CUSTOMER][POSITIVE] Awesome, uh huh thank you bye bye.
[AGENT][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] All right, Mr. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] All right, so they didn't file the claim because they didn't have the insurance on file. So I just gave them the policy number and I'm getting ready to fax over your policy breakdown so that they know how to file a claim, so that they can get it to us so we can make payment or give the decision.
[CUSTOMER][NEGATIVE] Yeah, that's, that's a bogus answer on their end because they had the insurance cards like I said I sent them to [PII].
[CUSTOMER][POSITIVE] So, but anyway, thank you for your help and hopefully getting this resolved.
[AGENT][POSITIVE] You're very welcome. Well, was there anything else I could assist you with today?
[CUSTOMER][NEUTRAL] Uh, I don't think so.
[AGENT][POSITIVE] All right, well, thank you so much for calling [PII]. I hope you have a great weekend.
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][POSITIVE] Thank you. You're welcome. Bye-bye.
[CUSTOMER][NEUTRAL] OK.