AccountId: 011433970860
ContactId: b7ab0a42-3e6d-4eae-b668-98b811263233
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 1371140 ms
Total Talk Time (AGENT): 243771 ms
Total Talk Time (CUSTOMER): 236999 ms
Interruptions: 5
Overall Sentiment: AGENT=1.2, CUSTOMER=-1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/17/b7ab0a42-3e6d-4eae-b668-98b811263233_20250217T18:17_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Yes, I'm calling to verify insurance for a patient.
[AGENT][NEUTRAL] OK, sure, I can assist you with the eligibility and benefits, and may I have your name?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] May I have a callback number just in case we get disconnected, Ms. [PII]?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. And where are you calling from, Ms. [PII]?
[CUSTOMER][NEUTRAL] I'm calling from um it's Riceboro Dental Clinic.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Great, thank you. And do you have the patient's policy number, Miss [PII]?
[CUSTOMER][NEUTRAL] Um, yes.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, let's see, it is row 2.
[CUSTOMER][NEUTRAL] 484-915
[AGENT][POSITIVE] Perfect, thank you. May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] Um, his name is [PII]. Date of birth [PII].
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] OK, perfect. Thank you.
[AGENT][NEUTRAL] All right. And do you need um eligibility and benefits, the benefits you needed given to you verbally or faxed over to you, Miss [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, they could be faxed.
[AGENT][NEUTRAL] OK. All right. Um, so we have an effective date of [PII]. It is showing active at the moment. And what is the fax number?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] 738.
[CUSTOMER][NEUTRAL] 2630, now question, it is a dental benefits you have, correct?
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Correct, yeah, this is dental, I dental. OK, let me go ahead and get this out to you. Do you mind holding for me while I send this out to you?
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah, that's fine.
[AGENT][NEUTRAL] OK, and how do you spell your name so I can spell it correctly on the system.
[CUSTOMER][NEUTRAL] Um, it's [PII]
[AGENT][POSITIVE] Thank you. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] You.
[CUSTOMER][NEUTRAL] I got [PII]
[AGENT][POSITIVE] Thank you for holding and being patient for Miss [PII]. I went ahead and send that over to you. It should be there in a few minutes. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yes, um, it's a claims question.
[AGENT][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Um, can I still speak with you about that?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm, yes, yes, go ahead.
[CUSTOMER][NEUTRAL] OK, so we sent a claim, um, data service [PII], but insurance sent back an EOB saying that they needed, um, information to confirm eligibility, and we've sent in um stuff for well we sent in his card, the card that he gave us, but we still haven't gotten any payment or anything for his claim.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, do you have
[AGENT][NEUTRAL] What is the date of service?
[CUSTOMER][NEUTRAL] Um, was actually the first one was [PII].
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] And then the other one is for [PII].
[AGENT][NEUTRAL] OK, let me check on those claims. One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Who do I do a little time.
[CUSTOMER][NEUTRAL] Oh, you passed me one of them blue sheets behind.
[CUSTOMER][POSITIVE] Thank you.
[AGENT][NEUTRAL] OK, I found one for [PII], um, and that was for a panel.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Let me pull the details.
[AGENT][NEUTRAL] OK, looks like we have processed the claim on the last time that it was processed, uh, was [PII] and we send a benefit amount of $96.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][POSITIVE] Wow
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, now do you know if it was a check you sent out or OK oh hold on, I don't I went to the wrong patient. OK, and you said you did it was for the data service [PII] for that panel, OK. Do you know when that check was sent out?
[AGENT][NEUTRAL] Mhm. It was a trip.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Yes, [PII], yes, for the panel, mhm.
[AGENT][NEUTRAL] Uh, let's see, so it was, bear with me, let me look at the calendar really quick. Um, go back to that month.
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, so it went out on the [PII] by mail, um, then we have the holidays, so it could take a, yeah, it should have been there by now. It's been 30 days, but yeah, it will send out like a [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, now on your end, does it show that it's been cash because we haven't received anything.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, let me check our system.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] We'll be here for the [PII].
[AGENT][POSITIVE] OK, it's still showing outstanding. What is the address?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's [PII].
[AGENT][NEUTRAL] OK, that is the address that we send it to.
[CUSTOMER][POSITIVE] Oh wow
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, I'm not sure why I didn't get there, but yeah, we did send it out, but it has not been cash just yet.
[CUSTOMER][NEUTRAL] Oh, a few days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Um, is there a way we could put into re seeing, like I say, it's, it's [PII], I mean [PII], and we haven't received anything.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I can um I can go ahead and request a um research to see if they have anything different in their end and then um if it needs to be reissued, they will go ahead and reissue at that time. Um, yeah, I will have to send the request over. Do you mind holding for me while I send this request then?
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] I would love it.
[CUSTOMER][NEUTRAL] Yeah, yeah, that's fine.
[AGENT][NEUTRAL] OK. OK, but before I do that, let me go ahead and check on another one just to make sure we don't have to do the same. OK, one moment. Uh, let's see, hold the other one.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] And you said the other one was on [PII], correct?
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Let this one.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, so for this one, this comprehensive evaluation.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] An X-ray.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Like
[AGENT][NEUTRAL] OK, so this one we send the benefit amount of $180. Um, let me check and see if this one is clear.
[CUSTOMER][NEUTRAL] I mean you don't care.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Um-hum.
[CUSTOMER][NEUTRAL] you
[AGENT][NEUTRAL] OK, so it should have gone to the same address and it's still showing outstanding as well. So yeah, I'll have to go in and just report both of them and see if they can do a research on those two checks. Um, it's gonna be a few minutes. I need to report both of them, OK? Do you mind holding for me?
[CUSTOMER][NEUTRAL] OK, yeah.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] No ma'am, I don't.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Thank you for holding and being patient for me. OK, I went ahead and send both up for review. Is there anything else I may help you with today, [PII]?
[CUSTOMER][NEUTRAL] No, ma'am, that's all.
[AGENT][NEUTRAL] OK, well thank you for calling APL. They should be working on it within 24 to 48 hours, OK?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] You're welcome. Have a good day, Miss. [PII].
[CUSTOMER][POSITIVE] You you too bye bye.
[AGENT][POSITIVE] Thank you. Bye bye.