AccountId: 011433970860
ContactId: 9896b688-6915-4ad0-9fcb-cafd14458a7f
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 334010 ms
Total Talk Time (AGENT): 130811 ms
Total Talk Time (CUSTOMER): 75523 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/9896b688-6915-4ad0-9fcb-cafd14458a7f_20250527T17:50_UTC.wav
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[AGENT][NEUTRAL] Good afternoon, thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. My name is [PII]. I'm calling from Doctor [PII]'s dental office. How are you?
[AGENT][POSITIVE] I'm good, [PII]. How are you today?
[CUSTOMER][NEUTRAL] Doing well, thank you for asking. Um, so the reason for my call, so it is because I received an EOB, um, stating that they're not making payment on a patient's treatment due to unable to confirm eligibility, um, but she was covered at the time of service, um, so I just wanted to see if there was more information you could provide me on that.
[AGENT][POSITIVE] Good. Well, how can I help you?
[AGENT][NEUTRAL] OK, so you're needing to check status on a claim that you all have received an explanation of benefits on. Is that correct?
[CUSTOMER][POSITIVE] Correct.
[AGENT][POSITIVE] Yes, I can help you with that, [PII]. And what is your callback number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And the member's policy number?
[CUSTOMER][NEUTRAL] Policy is gonna be 02596197 for [PII].
[AGENT][NEUTRAL] One moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Giving the information that I do provide for you, [PII] would be a verification of benefits and not a guarantee of payment. What is the patient's name again and date of birth?
[CUSTOMER][NEUTRAL] [PII], um, probably but the last name and her date of birth is gonna be [PII].
[AGENT][NEUTRAL] Uh
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And then what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Data service is [PII] in the amount of $469.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] OK, so I do see that this claim that the eligibility information has now been received, um, and this claim has been processed.
[AGENT][NEUTRAL] So there was a benefit paid in the amount of $356 and
[AGENT][NEUTRAL] Uh, well, let me look at one thing, hold on just one second.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[AGENT][NEUTRAL] OK, so yes, there has been a benefit paid in the amount of $356.60.
[AGENT][NEUTRAL] And that is on single check 2045086.
[CUSTOMER][NEUTRAL] And when was that sent out?
[AGENT][NEUTRAL] Uh, that was issued on [PII].
[CUSTOMER][NEUTRAL] Does that still show outstanding on your side?
[AGENT][NEUTRAL] I'm so sorry, what was your question again, [PII]?
[CUSTOMER][NEUTRAL] Does it still show outstanding on your side?
[AGENT][NEUTRAL] It does, yes. I'm sure that has not happened with the [PII], yes, today just being the [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] Um, I don't know if it was been issued on [PII], which is a Monday, so it would not have even been mailed out until.
[AGENT][NEUTRAL] Oh, a week ago, till the [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. I really appreciate your help in looking into this.
[AGENT][NEUTRAL] Oh, you're welcome and then one last thing, [PII], you may already have this information, but we do have a portal that you should also be able to access claim status once we've processed the claim and the website for that portal is located at [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII]. Perfect, thank you so much, [PII]. I appreciate it.
[AGENT][POSITIVE] OK, well, you're welcome. So again, if that is all I can help you with, thank you so much for calling APL and I hope you have a very nice um afternoon.
[CUSTOMER][POSITIVE] You as well thank you.
[AGENT][POSITIVE] Yes, ma'am. Thank you too.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] OK thanks bye bye.