AccountId: 011433970860
ContactId: a343aaa4-3191-4a77-8fbb-89ade8c05bab
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 901010 ms
Total Talk Time (AGENT): 320905 ms
Total Talk Time (CUSTOMER): 135773 ms
Interruptions: 2
Overall Sentiment: AGENT=1.3, CUSTOMER=0.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/15/a343aaa4-3191-4a77-8fbb-89ade8c05bab_20250115T16:21_UTC.wav
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[AGENT][NEUTRAL] Hi, thank you for calling APL. This is [PII]. How can I help you today?
[CUSTOMER][NEUTRAL] Hey, uh, my name is [PII]. I'm calling from the Loveland Dental Group. I was just calling to check on the status of two claims for the family.
[AGENT][POSITIVE] OK, yeah, I'd love to help you out with claim status today, Miss [PII], and do you mind if I get a good call back number from you real quick?
[CUSTOMER][NEUTRAL] Yeah, uh [PII].
[AGENT][POSITIVE] Wonderful. And the member's policy number?
[CUSTOMER][NEUTRAL] Uh, it is let me get on the screen.
[CUSTOMER][NEUTRAL] OK, it's 775405.
[AGENT][NEUTRAL] 775405
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Perfect and.
[AGENT][NEUTRAL] Sorry, give me one second. And you said you had two claims in the family to check, were they for different people or the same?
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] Two different people.
[AGENT][NEUTRAL] OK, and if you wouldn't mind, could you verify both of their names and date of birth for me, please?
[CUSTOMER][NEUTRAL] Sure, uh, so the first one is [PII]. Um, his date of birth is [PII], and the other one is also [PII], and his birthday is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Alright, so starting with [PII], um, what is the date of service we wanna look at for him?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the
[AGENT][NEUTRAL] The name of the provider?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] It wouldn't be under another provider by any chance?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] It could possibly um
[CUSTOMER][NEUTRAL] Have went out under [PII], which I think that might be the issue.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] It did.
[AGENT][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] So, I do have that claim here for you.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] It did go out under [PII].
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I have your claim was received [PII]. It was processed [PII].
[AGENT][NEUTRAL] And I have
[AGENT][NEUTRAL] I'm so sorry. Hang tight with me.
[CUSTOMER][NEUTRAL] It's OK.
[AGENT][NEUTRAL] OK, perfect. Um, when I opened the claim back up, it only had one of the line items and I thought like I like did something really awful. OK, so your claim number is 3,512,240, and I do show that the claim had benefits payable of
[AGENT][NEUTRAL] $323.12. It was made via check, a single check, and I have the check number is 2005421 and I can get check details for you if you need.
[CUSTOMER][NEUTRAL] Yeah, that'd be great. So we actually did not receive that check, um, and is there a way that you can check to see if it was like cleared and reprocess it?
[AGENT][NEUTRAL] Um, yeah, I actually showed that the check was issued [PII], but I do not show that it was cleared. Um, so if you don't mind hanging out with me a minute, I can put in a request to get that, um.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] To get that reissued.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] We've had a lot of issues with our mail over the past couple of months, so I don't.
[AGENT][NEGATIVE] That's rough.
[CUSTOMER][NEUTRAL] one of the many, yeah.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEGATIVE] We're getting like other mail, other people's mail, we're not getting our mail, it's crazy.
[AGENT][NEGATIVE] Oh yeah, I definitely would not be thrilled about that, especially like as a business, like, my only mail is bills, so I'm fine. Don't send them, but.
[CUSTOMER][NEUTRAL] Right, I'm like, hello. Mhm, mhm, mhm.
[AGENT][NEUTRAL] You need mail.
[CUSTOMER][NEGATIVE] Like sometimes we'll go a week without getting any mail at all and that's not, that's not normal for us.
[AGENT][POSITIVE] No, goodness, yeah.
[AGENT][NEUTRAL] To
[AGENT][POSITIVE] I appreciate your patience.
[CUSTOMER][POSITIVE] No problem.
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] So I just have like 2 more fields and then
[AGENT][NEUTRAL] I should be able to hit send on this request for you.
[AGENT][NEUTRAL] All right.
[AGENT][NEUTRAL] My parents.
[AGENT][POSITIVE] All right, wow, I appreciate your patience. I am ready to check on um [PII].
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] And what was
[AGENT][NEUTRAL] The data service for him?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, so the data service for this one is 9-1824.
[AGENT][NEUTRAL] OK and then what was that other provider name you had listed?
[CUSTOMER][NEUTRAL] Um, the one that I think it may have went out under, uh, [PII].
[AGENT][NEUTRAL] So this one didn't go out under [PII]. What was the the other the first name you gave me?
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][POSITIVE] Thank you. OK, yes, this one is for [PII], um.
[AGENT][NEUTRAL] Alright, hold on one second, let's just back this up. 960.
[AGENT][NEUTRAL] Alright, I have your claim. I have that we received it.
[AGENT][NEUTRAL] The first, or no, I'm so sorry, the [PII] this year, um, we processed it the [PII] this year, and the claim number is 3,549,690 and the claim denied. I have the reason stating.
[AGENT][NEUTRAL] Oh, that it's a duplicate. OK, hold on, let me double check and see if I have another claim listed for him. Hang tight.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, we're gonna try.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Oh, OK, so I do have this claim on file. It actually did go out under [PII] as well, um, but let me still give you the breakdown on status. I show that we've received it [PII]. Um, we processed it [PII]. The claim number is going to be 3,512,230.
[AGENT][NEUTRAL] And the check number is 2005396. It had benefits payable in the amount of $1,0016 and
[AGENT][NEUTRAL] 96 cents.
[AGENT][NEUTRAL] And let me pull the check details on that one for you.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] This one I also show is outstanding. It looks like it was issued on the [PII], and I can also go ahead and put in a request on this one for you as well, my friend.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Claim number 3.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] All right.
[AGENT][POSITIVE] All right, I was able to submit the request for that one as well, um, and so hopefully, um those get reprocessed and resent back out to you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And do you know, I just, I just wanna verify uh what address they were sent to.
[AGENT][POSITIVE] Oh yeah, absolutely. Let me pull that up for you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I have the address as [PII].
[CUSTOMER][POSITIVE] OK, yeah, perfect.
[AGENT][POSITIVE] Perfect. I'm gonna just double check that other check as well just to make sure it went to the same place.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And the same on that first check, yes.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Awesome. Anything else I can do for you, Ms. [PII]?
[CUSTOMER][POSITIVE] No, ma'am, I appreciate it. Do you know what the turnaround time on that typically is?
[AGENT][NEUTRAL] Typically fifteen-ish days um between it being, I mean, at most.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, if you, I'd say if I'd wait 2 weeks. If you don't see something come through by the [PII], you might give us a call back and see if we're able to get that reprocessed for you.
[CUSTOMER][POSITIVE] Perfect
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Awesome.
[CUSTOMER][POSITIVE] All right. Thank you so much.
[AGENT][POSITIVE] Hey, yeah, my pleasure. Thank you for calling us here at APL and I hope you have a fabulous day.
[CUSTOMER][POSITIVE] Thank you. You as well.
[AGENT][POSITIVE] Thanks. Bye bye.
[CUSTOMER][NEUTRAL] Bye.