AccountId: 011433970860
ContactId: 93bc70c6-39a0-4cc1-b25a-b40891fbba1f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 616929 ms
Total Talk Time (AGENT): 222386 ms
Total Talk Time (CUSTOMER): 195778 ms
Interruptions: 5
Overall Sentiment: AGENT=0.6, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/02/93bc70c6-39a0-4cc1-b25a-b40891fbba1f_20250102T21:59_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, is [PII] still at the office, [PII]? Is she still on? I guess I should ask.
[AGENT][NEUTRAL] Um, she is here today. Um, uh, let me see if she, uh, I can see if she's available. Were you needing to speak with her?
[CUSTOMER][NEGATIVE] Yeah, I was returning her call.
[AGENT][NEUTRAL] OK, uh, what was your name?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and really quick, [PII], can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, thank you and then uh may I get your policy number?
[CUSTOMER][NEUTRAL] 677-217, I believe is it.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] OK, yes, I'm just gonna verify some information really quick [PII], can I get your date of birth please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you and then can I get your mailing address?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Perfect. The last thing I need is the email address that we've got on file for you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much for verifying that information um give me just a moment let me see if she is available for you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] a donation to the university's general scholarship fund. Thank you Allstate.
[CUSTOMER][NEUTRAL] 3
[AGENT][NEUTRAL] Alright, just a moment, Miss [PII]. I'm just gonna put you on a brief hold, OK?
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Alright, thank you.
[CUSTOMER][NEGATIVE] There ain't nothing. You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] So
[AGENT][NEUTRAL] OK, [PII], sorry about that wait are you still with me?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, so she is not available at the moment she did say she would call you back though.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, was there anything else I could do to help?
[CUSTOMER][NEUTRAL] Well, I just need to check on the EOB for dental claim.
[AGENT][NEUTRAL] Oh, I could check I could check on a claim for you, hang on.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh, was this claim for you?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And data service was 10-1724.
[CUSTOMER][NEUTRAL] But.
[AGENT][NEUTRAL] OK. I believe I found it. Um, Grant's Ferry Family Dentistry.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] There's a line item on there for $299 that was excluded and I was just gonna see what the issue was with that line item.
[AGENT][NEUTRAL] Oh, I see. OK, um, well, I see one that it was 293, um.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Let me see if I was sure.
[AGENT][NEUTRAL] It's stating it's not a covered procedure under your policy. I can double check that though.
[CUSTOMER][NEUTRAL] Yeah, because it's, it was just filling a tooth.
[AGENT][NEUTRAL] Let's see.
[CUSTOMER][NEUTRAL] In the country as far as
[AGENT][NEUTRAL] So I can just not understand which plan you have here.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. Yeah, um, that procedure is not
[AGENT][NEUTRAL] Pulling up on your policy.
[CUSTOMER][NEUTRAL] What procedure are you showing that it actually is?
[CUSTOMER][NEGATIVE] They like they twisted in my face.
[AGENT][NEUTRAL] The code is 23931.
[AGENT][NEUTRAL] That's what it's saying to me.
[CUSTOMER][NEUTRAL] What's that in English?
[AGENT][NEUTRAL] 5 pole. Well, uh, give me just a moment. Hang on, I'm actually, if you don't mind, I mean you can wait for [PII] if you'd like or um I can reach out to our claims specialist um that actually go through they do the filing and such, um, so they might be able to shed a bit more light on this.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that'd be fine.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] That way you're not having to wait.
[AGENT][NEUTRAL] Alright, give me just a moment I'm gonna put you back on that hold, OK? I'll get right back with you.
[CUSTOMER][POSITIVE] OK, thanks.
[AGENT][POSITIVE] Alright thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you?
[CUSTOMER][POSITIVE] I'm good how are you?
[AGENT][NEUTRAL] You all right, thank you. I've got a member on the line, um, and she's calling regarding a claim. Uh, one of the procedure codes is just stating that it's not covered under her policy, um, and she's asking me what procedure it is and frankly it doesn't look like a dental procedure code that I've ever seen, so just wondering if you could help shed some light on that.
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] OK, what's that policy number?
[AGENT][NEUTRAL] It is 677217.
[AGENT][NEUTRAL] And this claim was for part one.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Part one OK for [PII] alright and what is that claim number please?
[AGENT][NEUTRAL] Uh, it's 354-431-8.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Thank you for calling APL. This is [PII]. How can I help you? Oh, I'm sorry. Oh.
[AGENT][NEUTRAL] Oh sorry. Oh, that's me. No, I didn't know you wanted to talk to her. I'm sorry. Um, I don't know if you could just tell me what procedure was sorry.
[CUSTOMER][NEUTRAL] Oh, OK
[CUSTOMER][POSITIVE] Oh, OK. What procedure is it? I'm so sorry. I'm so sorry. Sorry.
[AGENT][NEUTRAL] No, you're perfectly fine. No, I appreciate it, but um, honestly I wouldn't mind learning if this is something, uh, screening lion or something that shows what each procedure is.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes, it is, it's um the screen is CLCOD.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] So can you tell me right off that one, the 23931?
[CUSTOMER][NEUTRAL] Yes, 239-31. That should be, OK, 12.
[CUSTOMER][NEUTRAL] Oh, OK, I think I see what she did. OK, give me one moment please. I'm so sorry. That's normally a filling, um, I do know that, but I think it may have been keyed and wrong, but.
[AGENT][NEUTRAL] Oh yeah, yeah.
[CUSTOMER][NEGATIVE] The preceding number is supposed to be 0.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That's what I thought. OK. That's why I wanted to talk to you because I was like that doesn't even look like a dental procedure.
[CUSTOMER][NEUTRAL] No, let me, let me just pull the claim up real quick. I'm so sorry. I'm so sorry. Uh, do you have it up real quick? Do you have it up the claim up?
[AGENT][NEUTRAL] No, you're fine.
[AGENT][NEUTRAL] I do have to climb up, yes.
[CUSTOMER][NEUTRAL] Oh, you do. OK, so for that procedure code, the 23931, is it 0239?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It just says 23931. That's all it's uh for this procedure. There are two others on there, but for this one it's the one that's saying it's not a covered procedure.
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'm thinking, OK, so do you have the actual claim up though, the actual claim?
[AGENT][NEUTRAL] Um, I do on my end. Do you mean in on-base?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Oh, that would be smarter, huh?
[CUSTOMER][NEGATIVE] No, no, no, no. I did.
[AGENT][NEUTRAL] I'm still recovering.
[AGENT][NEUTRAL] I still, I sold a holiday dragon.
[CUSTOMER][NEUTRAL] OK, OK, 2019 24 555555.
[AGENT][NEUTRAL] OK, hang on, let's see.
[CUSTOMER][NEUTRAL] 555. OK, it's it's finally oh no it's not coming up. OK, what is this?
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] 155? I'm talking to myself now, OK.
[AGENT][NEUTRAL] No, you're fine.
[CUSTOMER][NEUTRAL] 667217.
[CUSTOMER][NEUTRAL] OK, that's 121924555.
[AGENT][NEUTRAL] OK, I don't see what was actually sent to us um I see ours and that code.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is showing on our EOB but I don't see what was submitted to us.
[CUSTOMER][POSITIVE] OK, that's because it was a, uh, this is an employee or past employee um claim. OK, so what's gonna, I can talk to Miss [PII]. Miss [PII] used to work here, so I can talk to Miss [PII]. Thank you so much for your patience.
[AGENT][POSITIVE] OK, OK, well I appreciate you let me know either way. No thank you. Alright, I'll hand it over. bye bye.
[CUSTOMER][POSITIVE] OK, thank you, bye.