AccountId: 011433970860
ContactId: 9fb7b982-b997-4c3a-acf6-720f687c5f9a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 372929 ms
Total Talk Time (AGENT): 147146 ms
Total Talk Time (CUSTOMER): 181285 ms
Interruptions: 5
Overall Sentiment: AGENT=0.3, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/9fb7b982-b997-4c3a-acf6-720f687c5f9a_20250409T14:46_UTC.wav
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[CUSTOMER][NEUTRAL] OK, yes, I do see it.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] 3
[CUSTOMER][NEUTRAL] Yes, hello, um, my name's [PII]. I'm calling from a dental provider and I have a question about an EOB I received.
[AGENT][NEUTRAL] OK, Miss [PII], I can help you with your EOB um for the claim. Can I please get your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So.
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] Thank you and then what is the name of the provider's office you're calling from?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and can you please give me the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII] and then my policy number is that like the um his like member ID is that what you're wanting? I'm sorry.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK, it is 01656458. No, that was like a random.
[AGENT][NEUTRAL] OK, let me pull that up real quick.
[CUSTOMER][NEUTRAL] I had
[CUSTOMER][NEUTRAL] Uh, I can have.
[AGENT][NEUTRAL] OK and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] Uh, OK, so the data service is one of the things I have a question about. So, um, the data service was actually 10 or 3-18-2024, but when we received the EOB, the service date is listed as [PII].
[CUSTOMER][NEUTRAL] So I'm not sure how it would be listed with you with you in your system.
[AGENT][NEUTRAL] The the data service was listed as [PII] you said?
[CUSTOMER][NEUTRAL] So that was the date the patient came in, but when we received the EOB, um, it was processed as date of service [PII] so that's one of the reasons I'm calling because I need to get the date corrected.
[AGENT][NEUTRAL] Oh, OK.
[AGENT][NEUTRAL] OK and then what is the um claim number that you have for that EOB?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, I have, OK, found it 3582373.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 352-373
[CUSTOMER][NEUTRAL] 3 3582373.
[AGENT][NEUTRAL] OK, alright, so what I'm gonna do is I'm going to need to transfer you on over to the claims department so they can help with that date of service, um, that was incorrect on time. It's gonna be a brief hold while I transfer you on over.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Got you. And uh this pain like the very one again I don't know if those are.
[AGENT][NEUTRAL] Is there anything else I
[AGENT][NEUTRAL] Before we go,
[CUSTOMER][NEUTRAL] Um, I just had one other question on, um, the bite wings. It did not pay and it had a remark one, but the copy I got, I'm not sure if it just missed the reason that it denied, but it could you tell, can you tell me why?
[AGENT][NEUTRAL] OK, on the bite wings, I'm sorry, I didn't hear our phone cut out. It was on the bite wings.
[CUSTOMER][NEUTRAL] Like our other doctor.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. And, and what was the problem with the, the bite?
[CUSTOMER][NEUTRAL] Um, it, it denied, but I, on my copy, I don't see the reason that it denied, so I was just hoping you could tell me why the 130.
[AGENT][NEUTRAL] OK, so it denied the bite wings OK so that's also something that department can help with so it's going to be a brief hold while I transfer you on over OK?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, that sounds fine thank you.
[AGENT][POSITIVE] All right, thank you so much. You have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] Thank you bye.
[AGENT][NEUTRAL] Mhm bye bye.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] This is [PII]. May I help you?
[AGENT][NEUTRAL] Hi, Ms. [PII]. This is [PII]. I've got a provider on the phone. She is calling about policy number 1656458.
[AGENT][NEUTRAL] And she is calling at plan number 3.
[AGENT][NEUTRAL] 2
[CUSTOMER][NEGATIVE] The phone's cutting out. I can't hear you.
[CUSTOMER][NEUTRAL] Hello.
[AGENT][NEUTRAL] 2024 but it came back on the EOB as 318.
[CUSTOMER][NEGATIVE] I didn't get any of that. Your phone cut out. I didn't get the claim number or anything.
[AGENT][NEUTRAL] I'm sorry.
[AGENT][NEUTRAL] I'm sorry, Ms. [PII]. The claim number is 3582373.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] And she's calling because the data service on the claim is incorrect.
[AGENT][NEUTRAL] She um said the data service. Can you hear me, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yeah, I can hear you now.
[AGENT][NEUTRAL] OK, she said the data service should be 3-18 of 2024, which is what she sent in but the claim came back with data service 318 [PII].
[AGENT][NEUTRAL] And she just needs to speak to somebody about that.
[CUSTOMER][NEUTRAL] OK, I'll have to send in a hub to [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, if we can just give her some kind of answer, thank you so much for helping.
[CUSTOMER][POSITIVE] You're welcome.
[AGENT][NEUTRAL] Bye bye.