AccountId: 011433970860
ContactId: bb9b2039-787d-45d3-a377-e59d5c03e5f3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 279510 ms
Total Talk Time (AGENT): 116966 ms
Total Talk Time (CUSTOMER): 64164 ms
Interruptions: 1
Overall Sentiment: AGENT=1.1, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/bb9b2039-787d-45d3-a377-e59d5c03e5f3_20250425T18:13_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] Yes ma'am, my name is [PII]. I'm calling from Main Street Family Dentistry.
[CUSTOMER][NEUTRAL] And I have a question about a claim.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] OK, sure, I can assist you with Miss [PII]. And may I have a callback number just in case we get disconnected?
[CUSTOMER][NEUTRAL] Yes, it's [PII].
[AGENT][NEUTRAL] OK, thank you. And may I have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it is 02597844.
[AGENT][POSITIVE] Alright thank you one moment.
[AGENT][NEUTRAL] OK. May I have the name and date of birth of the patient, Ms. [PII]?
[CUSTOMER][NEUTRAL] Yes, the patient's name is [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[AGENT][POSITIVE] Perfect. And may I have the date of service and the amount of the claim?
[CUSTOMER][NEUTRAL] Uh, the date of service is [PII].
[CUSTOMER][NEUTRAL] Total that was submitted was 464.
[AGENT][NEUTRAL] All right
[AGENT][NEUTRAL] Let me pull the explanation of benefits, one moment.
[AGENT][NEUTRAL] I'm still waiting on the system.
[AGENT][NEUTRAL] OK, um, so it looks like we processed the claim on [PII], but we're waiting, um, information to confirm eligibility with the benefits in the car, which is the third party that works together with the employer to continue the processing of the claim. So once we receive that information, we'll reprocess the claim.
[CUSTOMER][NEUTRAL] OK, um, can you tell me that again the phone was cutting in and out?
[AGENT][NEUTRAL] Oh, I'm sorry, uh, we are waiting information.
[CUSTOMER][NEUTRAL] That's OK. So you said you did receive it.
[AGENT][NEUTRAL] We did receive and we processed. It was processed [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Now right now is in pending mode basically um because we're waiting information to confirm eligibility with benefits on a card which is the third party that works directly with the employer so once we receive that information we'll reprocess the claim.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and who was the third party that you said you were waiting on?
[AGENT][POSITIVE] Benefits in a card.
[CUSTOMER][NEUTRAL] Benefit
[CUSTOMER][NEUTRAL] You said benefits a card?
[AGENT][NEUTRAL] In a card.
[CUSTOMER][NEUTRAL] In a card like CARD.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, alright, if I could just have a call reference number please.
[AGENT][NEUTRAL] We don't have reference numbers. You can use my name in today's date if you will. Do you need the spelling of my name or any other information?
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] Sure. That's [PII].
[CUSTOMER][POSITIVE] OK, alright, thank you, ma'am.
[AGENT][NEUTRAL] You're welcome. Do you need the claim number or any other information?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah, let me just get the, let me get the claim number for this client.
[AGENT][NEUTRAL] OK, um, let me know when you're ready.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] OK, the claim number is 3586827.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] You're welcome and thank you for calling APO. Have a good weekend.