AccountId: 011433970860
ContactId: 9e58af9a-001c-4401-8114-c726441c020c
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 264459 ms
Total Talk Time (AGENT): 95227 ms
Total Talk Time (CUSTOMER): 117008 ms
Interruptions: 0
Overall Sentiment: AGENT=2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/27/9e58af9a-001c-4401-8114-c726441c020c_20250527T18:11_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] Hey, [PII]. Hey, so I got a
[CUSTOMER][NEUTRAL] A bill or claim or something like that from.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Oh, when I got two teeth pulled, but.
[CUSTOMER][NEUTRAL] I, I paid for all that myself, you know what I mean? so.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I'm trying to figure out what like I even got I got it.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I don't, maybe you can walk me through this, uh, if I give you a claim number or something.
[AGENT][NEUTRAL] What, what are you, so you just want to go over, I don't understand the, are you needing help with the claim or?
[CUSTOMER][NEUTRAL] Uh, OK, so.
[CUSTOMER][NEUTRAL] Well, I'm wondering who put in a claim since I paid for it.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I can search it for you. May I have your name and a good contact number in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah it's it's [PII] and.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you for that and um [PII], may I have either the policy number or your claim number?
[CUSTOMER][NEUTRAL] Yeah, it's the claim number is 3604619.
[AGENT][NEUTRAL] OK, hold on one moment.
[AGENT][NEUTRAL] Alright, now I have your policy here, um, [PII], I just need you to verify your date of birth, your mailing and email address on file.
[CUSTOMER][NEUTRAL] Um, it's [PII].
[CUSTOMER][NEUTRAL] And uh what else do you need?
[AGENT][NEUTRAL] Your mailing address and email address?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Um, and my email is [PII].
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. So the dentist um submitted this claim, South Lakeland Dental.
[AGENT][NEUTRAL] They submitted the claim.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK, so the, what, what did they submit the claim for, like,
[AGENT][NEGATIVE] Well, anytime you have services, anytime you, you have services and there's an insurance company on file, they're going to bill for, they're going to bill for it. Um, but it was also denied because the major, the major part of your policy was not eligible.
[CUSTOMER][NEUTRAL] Like how, how
[CUSTOMER][NEUTRAL] Right, right. So,
[CUSTOMER][NEUTRAL] Uh, so they asked me if I had insurance. I said, yeah, well I just got it though, and they're like, alright, well, we'll run it, and they're like, no, it, it won't go through. You haven't been on there long enough. I said, OK, I'll just pay for it and I have a receipt right here like on my banking statement that shows, you know, I paid $500 for two extractions.
[CUSTOMER][NEUTRAL] So I just wanna make sure that.
[CUSTOMER][NEUTRAL] They're not
[CUSTOMER][NEUTRAL] You know what I mean? I don't wanna be stuck.
[CUSTOMER][NEGATIVE] With a bill from you guys paying them when I already paid them, you know what I mean?
[AGENT][NEUTRAL] Right, well, it was denied because your policy hasn't been active long enough, but they're most likely already from what it sounds like they already knew that they probably just needed the explanation of benefits for the record, but that's the only way you can get one is if you file the claim.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] Oh well.
[CUSTOMER][NEUTRAL] OK, so this ain't a bill that you sent me.
[AGENT][NEUTRAL] Right, no, there's no bill here. That's just your copy of the explanation of benefits.
[CUSTOMER][POSITIVE] Oh good.
[CUSTOMER][NEUTRAL] OK, I, I was just making sure because I know how some of these places are.
[AGENT][POSITIVE] Yes, and they'll try to get the double payment. Yes, I, I completely understand.
[CUSTOMER][NEUTRAL] So yeah.
[AGENT][POSITIVE] Well, there's no worry at all.
[CUSTOMER][POSITIVE] OK, well I thank you very much.
[AGENT][POSITIVE] You're welcome, Mr. [PII]. Was there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um, no, ma'am, that's it.
[AGENT][POSITIVE] Alright, well, thanks for calling APL and I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye bye.