AccountId: 011433970860
ContactId: 9163fafb-ba53-4e33-99cc-e04f81d9e2f4
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 413579 ms
Total Talk Time (AGENT): 147755 ms
Total Talk Time (CUSTOMER): 120237 ms
Interruptions: 3
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/24/9163fafb-ba53-4e33-99cc-e04f81d9e2f4_20250424T17:09_UTC.wav
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[AGENT][POSITIVE] Good afternoon thank you for
[CUSTOMER][NEUTRAL] Hello? sorry you broke up there.
[AGENT][NEUTRAL] Calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, um, my name is [PII].
[AGENT][POSITIVE] Good afternoon. Thank you for calling APR.
[CUSTOMER][NEUTRAL] Yeah, I just broke up there and then it I think we're on the same page now whatever like there was.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, I'm [PII] with the Northwest Dentistry or dental, and I'm calling on a claim. It looks like [PII], the previous financial coordinator, spoke to [PII] about this claim, and looks like last month. I'm just calling for um status.
[AGENT][NEUTRAL] OK, so you're needing to check claim status, [PII] on a dental claim, is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes ma'am, I can help you with that and what is your callback number please?
[CUSTOMER][NEUTRAL] Um, it is [PII].
[AGENT][NEUTRAL] Thank you and the member's policy number please, [PII]?
[CUSTOMER][NEUTRAL] Uh, the policy number is, give me just a moment to pull that up.
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Is
[CUSTOMER][NEUTRAL] 0251.
[CUSTOMER][NEUTRAL] 0118 that's a subscriber ID.
[AGENT][POSITIVE] Thank you. One moment.
[AGENT][NEUTRAL] OK, and any information that I do provide for you would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII] sorry, [PII] birthday [PII].
[AGENT][NEUTRAL] I
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Uh, the date of service would be, uh, [PII] and what was your second question? My apologies.
[AGENT][NEUTRAL] The total, that's OK, total bill amount.
[CUSTOMER][NEUTRAL] Uh, $303.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][POSITIVE] No worries, take your time.
[AGENT][NEUTRAL] OK, so this works receive.
[CUSTOMER][NEGATIVE] I'm sorry, you broke you're breaking off again.
[AGENT][NEUTRAL] On 3:17 and it was processed this, yes, ma'am, and I can't help that. I'm so sorry. Um.
[AGENT][NEGATIVE] It was received 3-17 and denied on 317.
[AGENT][NEUTRAL] The claim number is 357, yes, 357.
[CUSTOMER][NEGATIVE] It was denied.
[AGENT][NEUTRAL] 6425
[CUSTOMER][NEUTRAL] 3576425
[AGENT][NEUTRAL] And the reason for the denial.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The reason for denial states our records indicate that.
[AGENT][NEGATIVE] Premium for this service state was not.
[AGENT][NEUTRAL] Therefore, benefits are not payable.
[CUSTOMER][NEUTRAL] I'm sorry you broke off again. Our like premium was met for the year or was?
[AGENT][NEUTRAL] Not
[AGENT][NEUTRAL] No, ma'am. Our records indicate that premium for this service date.
[AGENT][NEGATIVE] Was not received.
[AGENT][NEUTRAL] Therefore benefits are not payable.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEGATIVE] Premium for this service was not received like evidence or?
[AGENT][NEUTRAL] The service date.
[CUSTOMER][NEUTRAL] for the service date.
[AGENT][NEUTRAL] We've not received premium from lawyer to cover for this data service, so therefore it doesn't, according to our records.
[AGENT][NEGATIVE] Because premium was not received for the service date.
[AGENT][NEGATIVE] Benefits are not payable.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Not payable, OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Now if you need a copy of that as the benefits, [PII] with that remark on it, you should be able to print that by using that claim.
[AGENT][NEUTRAL] Number from our portal and our portalite is located at [PII].
[CUSTOMER][NEUTRAL] OK, I will download it from there and we'll go from there.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][POSITIVE] And that this is the only thing I needed thank you so much for.
[AGENT][NEUTRAL] OK. Well, is there anything else that I could help you with?
[AGENT][POSITIVE] Well, you're welcome and I'm sorry about the phone delays. I'm so sorry. I, I, I'm so sorry, but unfortunately, there's, I have no control over it. I wish that I did, but I'm sorry.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] It's OK. I'm
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] It's OK. It's OK.
[CUSTOMER][POSITIVE] Uh, it just, it just makes me laugh, so it's all good. I will take care of it and go from here. You have a lovely day, OK?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] Yes, ma'am. You too. And thank you again, [PII], for calling APL if that's all I can help you with.
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][POSITIVE] No, that is it. You have a good day.
[AGENT][NEUTRAL] You too. Bye-bye.