AccountId: 011433970860
ContactId: ba4b5e1d-b9eb-49f4-863d-8b6a825e797e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 542679 ms
Total Talk Time (AGENT): 102986 ms
Total Talk Time (CUSTOMER): 66105 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=-1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/08/ba4b5e1d-b9eb-49f4-863d-8b6a825e797e_20250108T20:43_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, so this is [PII]. I needed to get a dental claim status.
[AGENT][NEUTRAL] OK, sure, I can assist you with claim status, Miss [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's gonna be [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, 025.
[CUSTOMER][NEUTRAL] 38737.
[AGENT][NEUTRAL] May I have the name and date of birth of the patient?
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] Alright, thank you. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Date of service is [PII] bill amount $245.
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] I have that claim and for future you can check claim status online through our website at [PII]. That's just optional.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah let's see [PII]. OK, let me pull this OK one moment.
[AGENT][NEUTRAL] I'm waiting on the system.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Um, looks like it was processed twice, so let me get the most recent one.
[AGENT][NEUTRAL] OK, so it looks like we processed the claim on [PII].
[AGENT][NEUTRAL] And see looks like the claim was denied. Let me get the denial reason.
[AGENT][NEUTRAL] OK, so the service will render following the termination of the coverage.
[CUSTOMER][NEUTRAL] And when was that patient's termination date?
[AGENT][NEUTRAL] OK. It looks like it was terminated on [PII].
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And do you need the claim number?
[CUSTOMER][NEUTRAL] Are you able to
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh, yeah, are you able to fax me an EOB?
[AGENT][NEUTRAL] Yes, mhm. What is the fax number?
[CUSTOMER][NEUTRAL] It's gonna be [PII].
[CUSTOMER][NEUTRAL] 4982573.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, [PII] to your attention.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK. Do you mind holding for me while I send this out to you while I got you on the line?
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you. 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.
[AGENT][POSITIVE] Thank you for holding and being patient for Ms. [PII]. Yeah, I went ahead and send that over to you. Should be there in a few minutes. Is there anything else I may help you with today?
[CUSTOMER][NEUTRAL] Uh, just a reference number and that should be all.
[AGENT][NEUTRAL] We don't have a reference numbers. You can use my name in today's date if you will.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much for your help.
[AGENT][POSITIVE] You're welcome, Ms. [PII], and thank you for calling APL. Have a good afternoon.
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Thank you