AccountId: 011433970860
ContactId: b04c7ea4-e5b4-42b6-a662-4a8f4a6b0ccf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 569559 ms
Total Talk Time (AGENT): 271988 ms
Total Talk Time (CUSTOMER): 186689 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/28/b04c7ea4-e5b4-42b6-a662-4a8f4a6b0ccf_20250528T14:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good morning, [PII]. Um, my name is [PII]. Uh, the last time we went to the dentist, um, they filed for, uh, which y'all, uh, it seems to be some kind of, some kind of issue or something y'all didn't pay anything. You're looking into eligibility. I, I'm not sure what was going on. I couldn't understand it. Anyway, can you check in this my account and see what's happening?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes, I can check your claim they sent in, sir. um, Mr. [PII], can I please get your callback number just in case the call's dropped I'll be able to call you right back.
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] OK, it's uh [PII].
[AGENT][NEUTRAL] OK. And then what is your policy number, sir?
[CUSTOMER][NEUTRAL] That'd be 025553.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[AGENT][NEUTRAL] All right, Mr. [PII], can you please uh verify your date of birth for me, sir?
[CUSTOMER][NEUTRAL] Uh, I can, um, uh, it's under my wife's name actually. Her, her, uh, date of birth is, is [PII].
[AGENT][NEUTRAL] Yes sir.
[AGENT][NEUTRAL] Yes, sir. And then what is your date of birth, sir?
[CUSTOMER][NEUTRAL] Mine is [PII].
[AGENT][NEUTRAL] Thank you. And then what is the address, phone number and email address that's on the policy?
[CUSTOMER][NEUTRAL] Uh, phone number, you prob you might have the whole house number [PII].
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] Or I can give you her
[CUSTOMER][NEUTRAL] Her phone number.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Is that one right or you need the other one?
[AGENT][NEUTRAL] No, that one's fine. The one that we have on the policy, I can't, I can't change anything unless.
[AGENT][NEUTRAL] You know, she gives me consent to do that um and do you know her email address?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I just want to be sure.
[AGENT][NEUTRAL] That's on the policy, sir?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] Always forget that. It's [PII].
[AGENT][NEUTRAL] That's OK.
[AGENT][POSITIVE] That, that's all right.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] Most people don't know what their spouse's, uh, email is, so it's OK, sir.
[CUSTOMER][NEUTRAL] And you
[CUSTOMER][NEUTRAL] It's, it's [PII] something, uh, and, uh, the mailing address is, uh, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes sir, thank you very much. I appreciate you verifying the policy for me alright so we're looking is the claim for yourself sir that was denied?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, let me look up real quick.
[AGENT][NEUTRAL] OK, I see.
[AGENT][NEUTRAL] A claim that was for data service of [PII] for yourself for [PII], is that correct?
[CUSTOMER][NEUTRAL] Yes, yes.
[AGENT][NEUTRAL] OK, let me, let me see what the remarks on it are. We have some remarks from the claims department.
[AGENT][NEUTRAL] It says that this submitted claim.
[AGENT][NEUTRAL] Is a duplicate of a previous submitted claim.
[AGENT][NEUTRAL] And check the date of service. So it looks like they sent it twice.
[CUSTOMER][NEUTRAL] You know
[AGENT][NEUTRAL] And let me see, I'm just gonna.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] I'm gonna look up the data service and see when the other one was sent so we can.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] uh
[CUSTOMER][NEUTRAL] I don't know. They, they had me confused on the phone at the office.
[AGENT][NEUTRAL] Yes, sir.
[AGENT][NEUTRAL] Yes sir, let's look and see.
[AGENT][NEUTRAL] 18.
[AGENT][NEUTRAL] So now let me look and see what all has been sent in for November.
[AGENT][NEUTRAL] It's gonna be just a minute. I'm doing a little research here to make sure that I get all the right information for you.
[CUSTOMER][POSITIVE] Oh, I appreciate that.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK, so it looks like on um data service they did submit it twice. The first time that they submitted it.
[AGENT][NEUTRAL] We paid $55 on the claim with check number 2017261.
[AGENT][NEUTRAL] Uh, the only charge that they sent.
[AGENT][NEGATIVE] That was not paid. Let me see if there's a remark why it wasn't paid real quick.
[AGENT][NEUTRAL] The there's an amount on there for $77 that was applied towards your deductible.
[AGENT][NEUTRAL] So that's why that wasn't paid $77 that was for procedure code and if you wanna write all this down if you need to call them back that way they know.
[AGENT][NEUTRAL] It was procedure code, yes sir, it was procedure code 00274 and that amount of $77 was applied towards your deductible.
[CUSTOMER][NEUTRAL] That's what I'm doing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] That might be what's up things confused.
[AGENT][NEUTRAL] Yes, sir. And let me.
[CUSTOMER][NEUTRAL] And then they since you didn't pay that they resend it I guess.
[AGENT][NEUTRAL] They may have, yeah, but then it came back as a duplicate because they'd already sent it. Let me give you the codes that were paid so that you can give them that information.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] You said it was
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Um, procedure code 00.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 120.
[AGENT][NEUTRAL] was paid $15.
[CUSTOMER][NEUTRAL] And this is all for [PII].
[AGENT][NEUTRAL] And it was
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII], I'm sorry.
[AGENT][NEUTRAL] Yes sir.
[CUSTOMER][NEUTRAL] I got my date bro.
[AGENT][NEUTRAL] They charge they charged you, they charged you $69 but $15 was paid.
[CUSTOMER][NEUTRAL] OK, $15.
[AGENT][NEUTRAL] According to your policy and then procedure code 01110.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] They charged $115.
[AGENT][NEUTRAL] And we paid 40.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] And in the same uh scenario 00274.
[CUSTOMER][NEUTRAL] Was not paid for $77 is that right? We went to the deductible, I should say.
[AGENT][POSITIVE] Yes, sir. That's correct.
[CUSTOMER][NEUTRAL] That's all the same, the same thing, OK.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] OK, is that all of it?
[AGENT][NEUTRAL] That's all of it. They just had those 3 charges for you.
[CUSTOMER][NEUTRAL] Because that, that explains.
[CUSTOMER][NEUTRAL] Because my wife's going again tomorrow and I, I want to be sure and get a phone call with you. I'll make sure it'll be paid. Will she also have a $77 deductible, or is it just a family deductible?
[AGENT][NEUTRAL] Uh, it's gonna be individual for up to 2 people and then after family, it goes up to, um,
[CUSTOMER][MIXED] OK, but it's just the two of us, the rest of them have flown uh the mess.
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][POSITIVE] All right. Well, I sure appreciate your help.
[AGENT][POSITIVE] Well, we appreciate you, Mr. [PII]. I'm glad I was, I'm glad I was able to break it down for you so you could [PII]r understand it cause you're right, it can be confusing sometimes.
[CUSTOMER][POSITIVE] That takes care of my concerns.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] We've only been with y'all since.
[CUSTOMER][NEUTRAL] What's that 96.
[CUSTOMER][NEUTRAL] I believe
[AGENT][POSITIVE] Yeah, thank you for staying with us for so long. We, we appreciate you as a, as a customer. Thank you.
[CUSTOMER][NEUTRAL] Long time.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] All right, mhm, right, bye bye.
[AGENT][POSITIVE] Alright you take care sir. Alright, you, you take care and thanks for calling APL.
[AGENT][NEUTRAL] Bye-bye, Mr. [PII].
[CUSTOMER][NEUTRAL] All right bye bye.