AccountId: 011433970860
ContactId: a84a2726-29c4-44e6-b174-960dbea2ac1a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 328290 ms
Total Talk Time (AGENT): 140550 ms
Total Talk Time (CUSTOMER): 142827 ms
Interruptions: 5
Overall Sentiment: AGENT=1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/14/a84a2726-29c4-44e6-b174-960dbea2ac1a_20250514T20:28_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] OK.
[CUSTOMER][NEUTRAL] Hi [PII], I'm calling from Lakewood Family. Oh hi, sorry, I'm calling from Lakewood Family Dental of Indianapolis.
[AGENT][NEUTRAL] Trophy.
[AGENT][POSITIVE] Yes ma'am. How can I help you today?
[CUSTOMER][NEUTRAL] Uh hello? Yeah, hi, I'm calling because I needed information in regards to a claim that's still pending to pay.
[AGENT][NEUTRAL] OK, so you're wanting to check claim status, is that correct?
[CUSTOMER][POSITIVE] Yes, yes, please.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And who am I speaking with?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] [PII], is that correct?
[CUSTOMER][NEUTRAL] Yeah. Yeah, [PII], yeah, [PII]
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] Like [PII], like North or South Carolina?
[AGENT][NEUTRAL] OK, thank you. And [PII], what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you and the member's policy number, please.
[CUSTOMER][NEUTRAL] Member's policy number is 02606022.
[AGENT][NEUTRAL] OK, thank you. Give me a moment please to get the member's information pulled up.
[CUSTOMER][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Yeah who's there.
[CUSTOMER][NEUTRAL] yeah
[CUSTOMER][NEUTRAL] Yeah, who's said?
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] I have one on the.
[AGENT][NEUTRAL] OK, and any information [PII] that I do provide for you will be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Patient's name, it's [PII]. Date of birth [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] In the canon be on me.
[AGENT][NEUTRAL] And what is the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I'm sorry. Data service is [PII].
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] And the total amount, 5:30.
[AGENT][POSITIVE] Thank you, one moment.
[CUSTOMER][NEUTRAL] [PII] don't say that [PII]. Don't say your [PII] to say no, no, no.
[CUSTOMER][NEUTRAL] I see [PII].
[AGENT][NEUTRAL] OK [PII], so I do see that this claim was received and yes ma'am, this claim has been denied.
[CUSTOMER][POSITIVE] And you can use it.
[AGENT][NEGATIVE] The reason for the denial on here states our records indicate that premium for this service state was not received. Therefore, benefits are not payable.
[CUSTOMER][NEUTRAL] It has
[CUSTOMER][NEUTRAL] But yeah.
[CUSTOMER][NEUTRAL] What does it mean premiums? Like the patient didn't pay insurance?
[AGENT][NEUTRAL] I show that this policy.
[AGENT][NEUTRAL] We have not we have not received this policy is still showing as active, but as of now we have not received the premium to cover this data service we're still awaiting that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Premium. And that is the patient that has to pay for it, correct?
[AGENT][NEUTRAL] Yes ma'am, it goes through their employer.
[AGENT][NEUTRAL] But we have not we have not received verification that that's.
[AGENT][NEUTRAL] Has been received for this data service.
[CUSTOMER][NEUTRAL] OK, can I get a call reference number for that?
[AGENT][NEUTRAL] You can, yes, ma'am. You would use my name along with today's date. And [PII], I don't know if if
[CUSTOMER][NEUTRAL] Can you spell your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] He, he
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], or [PII]. Yeah. Mhm. [PII]. OK, [PII]. Thank you. Yes, go ahead, tell me.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes ma'am, and then, and we also have our portal that you should be able to also have access to the explanation of benefits to and the website for our portal is located at [PII].
[CUSTOMER][NEUTRAL] OK for like.
[CUSTOMER][NEUTRAL] In
[CUSTOMER][NEUTRAL] [PII]?
[AGENT][NEUTRAL] [PII] uh-huh.
[CUSTOMER][NEUTRAL] [PII], OK. [PII]. Uh-huh.
[AGENT][NEUTRAL] [PII]. Yes, ma'am. And the claim number?
[AGENT][NEUTRAL] It's 359-0167.
[CUSTOMER][POSITIVE] Okey dokey thank you so much.
[AGENT][POSITIVE] OK. Well, you're welcome. Can I help you with anything else today?
[CUSTOMER][POSITIVE] You too. No, [PII], you've been very helpful. Thank you, I appreciate it.
[AGENT][POSITIVE] Well, you're very welcome, [PII], and thank you for calling ATL and I hope you have a nice evening.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye-bye.