AccountId: 011433970860
ContactId: 93bcdb9b-36be-4e8c-8468-60725a3c4478
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 262209 ms
Total Talk Time (AGENT): 126820 ms
Total Talk Time (CUSTOMER): 78256 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/16/93bcdb9b-36be-4e8c-8468-60725a3c4478_20250116T16:23_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] and I'm calling from Mortenson Family Dental. I am calling to check on the status of a claim for a patient, please.
[AGENT][POSITIVE] It would be a pleasure to assist you with that claim status, [PII]. What is a good callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 02445399
[AGENT][NEUTRAL] To
[AGENT][NEUTRAL] And what is the patient's name and date of birth, please, ma'am?
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Alright, thank you, and I can certainly help you with that claim status. What is the data service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Data service was [PII].
[AGENT][NEUTRAL] And what is the dental provider name?
[CUSTOMER][NEUTRAL] Doctor [PII].
[AGENT][POSITIVE] All right, thank you.
[CUSTOMER][NEUTRAL] Mm
[AGENT][NEUTRAL] I am checking on that for you. Bear with me just one second.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] I did, I do see that we've received that claim on [PII].
[AGENT][NEUTRAL] And it was processed on [PII].
[AGENT][NEUTRAL] For the CPT 70,210.
[CUSTOMER][NEUTRAL] OK, was it
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] That is not a covered benefit under this plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And for the 01440.
[AGENT][NEUTRAL] Uh, the benefits have been applied to the $50 deductible for the uh plan.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And for the 02220.
[AGENT][NEUTRAL] Um, the calendar year benefit has been exhausted.
[CUSTOMER][NEGATIVE] OK, is there, can I possibly get a copy of the EOB sent to us? We never received anything.
[AGENT][NEUTRAL] You certainly can. Now also we also have a provider portal if you're ever interested, you can even submit claims and
[CUSTOMER][POSITIVE] Great
[AGENT][NEUTRAL] Um, the claim status?
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] That is at
[CUSTOMER][NEUTRAL] Uh, I did, I did try that this morning, but I have to get one of our, we're a corporate dental office, so I have to get one of our payer relations people to help me with that part so I figured this would just be quicker.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] Well, I can help you with that, so bear with me just one second. I'm getting that ELB pulled up. Can I put it to your attention, [PII]?
[CUSTOMER][NEUTRAL] You sure can.
[AGENT][NEGATIVE] And just bear with me cause my system's running a little slow today.
[CUSTOMER][NEUTRAL] That's OK.
[AGENT][NEUTRAL] Come on.
[AGENT][POSITIVE] Sorry about that. I didn't mean to say that out loud.
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] That's all right. It's a story of my life too.
[AGENT][NEUTRAL] Oh.
[AGENT][NEGATIVE] Like, come on.
[AGENT][POSITIVE] Let me get this prepared for you and then I'll get that fax and we'll just go ahead and send it right now for you.
[CUSTOMER][POSITIVE] OK, sounds good.
[AGENT][NEUTRAL] And I can give you that claim number also while I'm completing this.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] Claim number is 353.
[AGENT][NEUTRAL] 1563
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] And believe it or not, [PII], I'm ready for your fax number.
[CUSTOMER][NEUTRAL] OK, it's gonna be 812.
[CUSTOMER][NEUTRAL] 284.
[CUSTOMER][NEUTRAL] 2721.
[AGENT][NEUTRAL] All right and just to verify that fax number, I'm sending this to [PII], correct?
[CUSTOMER][POSITIVE] Yes ma'am, that's correct mhm.
[AGENT][POSITIVE] That is on the way for you. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No ma'am, that'll take care of it thank you so much for your help.
[AGENT][POSITIVE] It's been such a pleasure to help you with that claim status, [PII]. Thank you for calling APL and I hope you have a wonderful day.
[CUSTOMER][POSITIVE] Thanks you too.
[AGENT][POSITIVE] Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Uh huh bye bye.