AccountId: 011433970860
ContactId: a96f5538-ceae-4b44-b8f9-7575ebc7bd07
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 261160 ms
Total Talk Time (AGENT): 112387 ms
Total Talk Time (CUSTOMER): 47513 ms
Interruptions: 0
Overall Sentiment: AGENT=2.5, CUSTOMER=2.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/17/a96f5538-ceae-4b44-b8f9-7575ebc7bd07_20250117T21:14_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] Hi [PII], my name is [PII] and I'm just calling for a dental claim status.
[AGENT][NEUTRAL] OK, [PII], you're calling to check claim status on a dental claim, is that correct?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] Yes, I can help you with that and [PII], what is your callback number, please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And the member's policy number, please.
[CUSTOMER][NEUTRAL] 02049615.
[AGENT][POSITIVE] Thank you. One moment, please, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and you know, any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] It is for [PII], [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what is the date of service and total bill amount for him, please?
[CUSTOMER][NEUTRAL] It was [PII] with the billed amount of 263.
[AGENT][NEUTRAL] One moment, please.
[AGENT][NEUTRAL] OK, [PII], uh, let's see.
[AGENT][NEUTRAL] OK. So this claim was received.
[AGENT][NEUTRAL] And give me just one moment and I'll give you that receipt information.
[AGENT][NEUTRAL] OK, so this claim was received on [PII].
[AGENT][NEUTRAL] It was processed and denied on [PII].
[AGENT][NEUTRAL] The claim number is 3,542,340.
[AGENT][NEUTRAL] And the reason for the denial states that these services were rendered following termination of coverage.
[CUSTOMER][NEUTRAL] OK, so the policy had already terminated. Can you provide me the termination date of the policy?
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I can, yes ma'am, one moment.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Give me just a moment. I'm having trouble with one of my screens. OK, so it it was active from [PII] to its term date of [PII].
[CUSTOMER][NEUTRAL] No, you're OK.
[CUSTOMER][POSITIVE] OK, perfect. I will make note of that in their chart. Thank you so much for your help today.
[AGENT][NEUTRAL] Yes ma'am, you're very welcome and if you need a copy of that EOB you can actually go to our portal at [PII] and you should be able to um register and print that explanation of benefits.
[CUSTOMER][NEUTRAL] I'm gonna repeat that back to you because I didn't know you guys have that portal [PII]. [PII].
[AGENT][POSITIVE] Yes ma'am, that is correct.
[CUSTOMER][POSITIVE] OK. Wonderful, thank you.
[AGENT][POSITIVE] Well, you're certainly welcome. So is there anything else you know that I can help you with today?
[CUSTOMER][POSITIVE] No, that was everything. I appreciate your time.
[AGENT][POSITIVE] Well, you're certainly very welcome and I hope you have a wonderful weekend and thank you again for calling APL.
[CUSTOMER][POSITIVE] Thank you you as well. Bye bye.
[AGENT][POSITIVE] Ah, thank you, bye bye.