AccountId: 011433970860
ContactId: bed56737-e389-4d9d-8a54-5597c801db64
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 332440 ms
Total Talk Time (AGENT): 101239 ms
Total Talk Time (CUSTOMER): 72660 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/01/bed56737-e389-4d9d-8a54-5597c801db64_20250501T19:32_UTC.wav
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[AGENT][POSITIVE] Thank you for calling
[CUSTOMER][NEUTRAL] You
[AGENT][NEUTRAL] This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm calling from the provider's office. Can you help me with the patient's dental claim, please?
[AGENT][NEUTRAL] Yes, I can help you, [PII], um, with the dental claim, can I please get your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Yes, ma'am. It is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, Ms. [PII]. And then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Um, the policy number is 23,879,860.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][POSITIVE] Thank you. OK, let me look this up real quick.
[CUSTOMER][POSITIVE] Thank you
[AGENT][NEUTRAL] And that was 238-798-60?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] OK, that policy number is not pulling up for me.
[CUSTOMER][NEUTRAL] Wait, let me just uh recheck it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is 238.
[CUSTOMER][NEUTRAL] 79
[CUSTOMER][NEUTRAL] 80.
[AGENT][POSITIVE] OK thank you so much I appreciate you verifying that for me and I do see [PII] and then um what is the patients.
[AGENT][NEUTRAL] Date of service and charge amount?
[CUSTOMER][NEUTRAL] Um, the data of service is [PII].
[CUSTOMER][NEUTRAL] With the charge amount being 2603.
[AGENT][NEUTRAL] $2,603.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK. And what is the name of the facility?
[CUSTOMER][NEUTRAL] Riverfront Dental care.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold while I look up this claim and I will be right back, Ms. [PII].
[CUSTOMER][POSITIVE] All right, thank you.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hi, Ms. [PII], this is [PII] back with you again. Can you give me the name of the dentist?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yes, ma'am. Uh, the name of the dentist, Doctor [PII].
[AGENT][NEUTRAL] OK, thank you so much. Um, I do have the claim information for you and let me give you the claim number. The claim number is 355.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] 9388.
[CUSTOMER][NEUTRAL] 35593888
[AGENT][NEUTRAL] That's correct. And the claim was denied as non-covered procedures.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][POSITIVE] Awesome. Um,
[CUSTOMER][NEUTRAL] Ma'am, do you mind also telling me what is the annual maximum for the patient available right now?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] You, you want the balance as of today?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[AGENT][NEUTRAL] OK, OK. Let me look that up for you real quick.
[AGENT][NEUTRAL] OK. As of today, um, they still have their $50 deductible left to pay and they still have their $500 maximum left.
[CUSTOMER][POSITIVE] 5. Perfect. Thank you.