AccountId: 011433970860
ContactId: c4577275-060f-40d4-a4c9-69e162424735
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 224179 ms
Total Talk Time (AGENT): 95605 ms
Total Talk Time (CUSTOMER): 75654 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/13/c4577275-060f-40d4-a4c9-69e162424735_20250213T18:31_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm calling from Dentistry to get an EOB for a denial claim or a claim of denial.
[AGENT][NEUTRAL] OK. Give me
[AGENT][NEUTRAL] OK. Give me your name again.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Oh, and what's the claim number? I mean the.
[CUSTOMER][NEUTRAL] What was your name? I'm sorry?
[AGENT][NEUTRAL] My name is [PII], first initial last is [PII] Let me have the policy number and then a good phone number in case we're disconnected.
[CUSTOMER][NEUTRAL] OK, the policy number is 02511222, and a good call back number is [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And you did say you're checking for a claim status?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, what is the patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], I believe is how you pronounce it, and the date of birth is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And I have his information pulled up to help you. What's the date of service?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And the total build?
[CUSTOMER][NEUTRAL] 1,828.
[AGENT][NEUTRAL] And you, are you calling from a dental provider's office?
[CUSTOMER][NEUTRAL] Yes, for ment dentistry.
[AGENT][NEUTRAL] OK. Is this for [PII]?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] All right, so, uh, there was not a payment made on this claim. It was processed on [PII]. There is a 12, there is a 12 month waiting period for major services, so this patient is not eligible until September of this year.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] OK, yeah, that's why I was calling because I spoke with somebody previously to get an EOB, a copy of the ELB. They were supposed to email it to me but I never got it.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, we don't email the EOB. You can download it from our online service center if you'd like.
[CUSTOMER][NEUTRAL] Do I have to create an account?
[AGENT][NEUTRAL] You do.
[AGENT][NEUTRAL] Because it's a sec secured account uh uh website.
[CUSTOMER][NEUTRAL] OK, uh.
[CUSTOMER][NEUTRAL] Alright, well I guess I'll create an accountant or try to. What's the reference number?
[AGENT][NEUTRAL] Do, do you have the
[AGENT][NEUTRAL] It's gonna be my name in today's date, [PII]. Do you have the website?
[CUSTOMER][NEUTRAL] No, I don't have a login for the website.
[AGENT][POSITIVE] OK, it's secured.
[AGENT][NEUTRAL] 0.0 you know the website? OK.
[CUSTOMER][NEUTRAL] Yeah, I, I know I know what what the website is. I'm just saying I don't know.
[AGENT][NEUTRAL] You've not created an account yet.
[CUSTOMER][NEUTRAL] Yeah, it's asking.
[CUSTOMER][NEUTRAL] No, and it's asking for a patient account number, so where do I get that from?
[AGENT][NEUTRAL] That's gonna be on the ADA form that you sent that was sent to us.
[CUSTOMER][NEUTRAL] What would that be the member ID?
[AGENT][NEUTRAL] And so if you're on the spot to create it it at the bottom of that, it should say for a dental claim that number could be located and it'll tell you the box number.
[AGENT][NEUTRAL] Or that can be found.
[CUSTOMER][NEUTRAL] All right.
[AGENT][NEUTRAL] You see that
[CUSTOMER][POSITIVE] OK, well you have a great day yeah I I got it thank you so much you have a good day.