AccountId: 011433970860
ContactId: a5980ee1-0adb-4c7d-be96-4a37741a2697
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 563900 ms
Total Talk Time (AGENT): 161494 ms
Total Talk Time (CUSTOMER): 171685 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/a5980ee1-0adb-4c7d-be96-4a37741a2697_20250509T16:41_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Um, yes ma'am. What was your name again? I'm sorry.
[AGENT][NEUTRAL] I'm sorry, it's [PII]
[CUSTOMER][POSITIVE] Thank you so much, [PII]. My name is [PII]
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, and Ms. [PII], how may I assist you today?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Uh yes ma'am. I was calling for one of our patients, [PII]. Um, date of birth is [PII] to follow up on two claims.
[AGENT][NEUTRAL] Uh, do you happen to
[AGENT][NEUTRAL] OK, um, I'll verify claim status for you. Do you have the policy number?
[CUSTOMER][NEUTRAL] Yes ma'am, it's uh 021-31659.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call uh call drops?
[CUSTOMER][NEUTRAL] Yes ma'am, [PII].
[AGENT][NEUTRAL] OK thank you one moment.
[AGENT][NEUTRAL] And the patient's name again? I'm sorry.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK. And the date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] OK, and this is for dental?
[CUSTOMER][NEUTRAL] Yes ma'am it is.
[AGENT][NEUTRAL] OK, and what was the data service and amount of the charge?
[CUSTOMER][NEUTRAL] Uh, one of them was [PII]. The total fee was 12731.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I'm glad to see you he's great. He plays all and he made me he read me a story this morning.
[AGENT][NEUTRAL] OK, and it looks like this is for periodontal maintenance?
[CUSTOMER][POSITIVE] Correct, yes ma'am.
[AGENT][NEUTRAL] OK, let's see.
[CUSTOMER][NEUTRAL] Right now.
[CUSTOMER][NEUTRAL] Like other granny up there and
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Uh, dental care at the fountain.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Um, let's see.
[CUSTOMER][NEUTRAL] they'll eventually take them down, but
[CUSTOMER][NEUTRAL] Any
[CUSTOMER][NEUTRAL] I started to bring him today but I was telling Mar.
[CUSTOMER][NEUTRAL] The
[AGENT][NEUTRAL] OK. It looks like the claim is processed as um no benefits payable, other insurance carrier pay benefit in full.
[CUSTOMER][NEUTRAL] Um, so we did submit the EOB, um.
[CUSTOMER][NEGATIVE] The primary didn't pay anything.
[CUSTOMER][NEUTRAL] You know, get that, you know.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][POSITIVE] But I'll be in touch with you alright bye.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Because I had called um.
[CUSTOMER][NEGATIVE] A couple months ago I called in February and I spoke with a lady named [PII] and she said that um that they were gonna mail us a check for $69.20 and she also gave me a check number and a claim number but we never got anything.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Um, she said that the, the check was never cashed and since it has been over 30 days that it's no longer good and that she would get the check voided and have um APL reissue as a new check.
[AGENT][NEUTRAL] OK, let me see what's going on.
[CUSTOMER][NEGATIVE] But we haven't, we haven't gotten anything.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Well um.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'll send a request for them to review this one because.
[AGENT][NEUTRAL] What I couldn't pull up the claim. I'm sorry, but give me one moment because I do show it looks like a check was issued initially the amount of 6920 and then it was she sent a request to have a check verification.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] But I will have to send them a request to see what's going on. Give me one moment, OK?
[CUSTOMER][NEGATIVE] Mhm, yes ma'am, because I, I told the representative that I spoke with that we never got the check and then she said that since it was no longer good she would get it voided and send us a new one.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um OK.
[CUSTOMER][NEUTRAL] right
[CUSTOMER][NEUTRAL] And
[AGENT][NEUTRAL] this is [PII].
[AGENT][NEUTRAL] Yeah, let me send a request for them to review this claim because.
[AGENT][NEUTRAL] I'm not showing where it was reissued.
[AGENT][NEUTRAL] This looks like they just denied it as primary paid, but yeah, I'll send a request for this to be reviewed and reprocessed.
[AGENT][NEUTRAL] 44466.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Yes ma'am, let me put a quick note.
[CUSTOMER][NEUTRAL] get
[AGENT][NEUTRAL] OK, and you say you had another claim you wanted to check?
[CUSTOMER][NEUTRAL] Uh yes ma'am, data service is.
[AGENT][NEUTRAL] For the same patient? Oh, God, I'm sorry.
[CUSTOMER][NEUTRAL] Yes ma'am, it's the same patient.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, for [PII].
[AGENT][NEUTRAL] The [PII].
[AGENT][NEUTRAL] And the amount of the charge?
[CUSTOMER][NEUTRAL] 16575.
[AGENT][NEUTRAL] 575 OK.
[CUSTOMER][POSITIVE] Thank
[AGENT][NEUTRAL] And you said [PII] of this year, correct?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Great
[AGENT][NEUTRAL] And what was the procedure for?
[CUSTOMER][NEUTRAL] It was
[CUSTOMER][NEUTRAL] 01 surface composite filling on tooth number 19. The code is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, I show that claim, uh, that one looks like it processed on.
[AGENT][NEUTRAL] [PII] and a check was mailed in the amount of 15,680.
[CUSTOMER][NEUTRAL] OK, you said 15,680?
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][POSITIVE] OK. All right. Well, thank you so much and then we should get that shortly. Can I get a reference number, Miss [PII]?
[AGENT][NEUTRAL] Uh, you may use my name and today's date if you like.
[AGENT][NEUTRAL] OK. And is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, no, that's all.
[AGENT][POSITIVE] Alright, well thank you for calling APL. Have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye.
[AGENT][NEUTRAL] Bye.