AccountId: 011433970860
ContactId: c7516682-1cbc-4a36-b1ad-493dbba9e339
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 428079 ms
Total Talk Time (AGENT): 92432 ms
Total Talk Time (CUSTOMER): 138912 ms
Interruptions: 2
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/18/c7516682-1cbc-4a36-b1ad-493dbba9e339_20250618T16:11_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, I'm trying to get claim status for a dental claim for a patient and the um the first number that I called said they weren't able to find the patient. However, we do have an EOB from you guys, so I know the patient has coverage through you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can help you with claim status. um, and who am I speaking with again?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] [PII] from Park Dental.
[AGENT][NEUTRAL] And [PII], what's a good callback number in case we get disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what's the policy number?
[CUSTOMER][NEUTRAL] Uh, it's gonna be, hold on one sec.
[CUSTOMER][NEUTRAL] 17635716
[AGENT][NEUTRAL] OK, just to verify, I have 17635716.
[CUSTOMER][NEUTRAL] Right
[AGENT][NEUTRAL] OK, give me just a moment.
[AGENT][NEUTRAL] OK, what is the last name? I'm not able to find it from that policy number.
[CUSTOMER][NEUTRAL] So it's [PII]
[AGENT][NEUTRAL] And first name?
[CUSTOMER][NEUTRAL] Uh, it's under [PII]. His name's [PII], but it looks like his dental card says [PII].
[AGENT][NEUTRAL] [PII], OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] That's [PII]
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Yeah, I don't know if.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] I have a claim number from data service 22725.
[CUSTOMER][NEUTRAL] And it denied as patient has not met required waiting periods or waiting requirements.
[AGENT][NEUTRAL] Does it say when the policy was active?
[CUSTOMER][NEUTRAL] On 227 of 25 it was.
[AGENT][POSITIVE] Oh, so it would definitely be in here if we had it.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Does that have a group number on there?
[CUSTOMER][NEUTRAL] Uh, group plan 230,800.
[AGENT][NEUTRAL] OK, yeah, that's not our that's not our group member. Alright, let me look.
[CUSTOMER][NEUTRAL] Uh, because it's planned administrators incorporated, right?
[AGENT][NEUTRAL] Oh, that's that's not a group number we would assign them um our ours ours aren't that long.
[CUSTOMER][NEUTRAL] Through mass
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] Um, that's why I was wondering if I could look it up by the group.
[CUSTOMER][NEUTRAL] Um, master's person.
[CUSTOMER][NEUTRAL] Yeah, let me see on the card.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, group 230,800, but it says first Health dead to Max.
[CUSTOMER][NEUTRAL] Uh, see if I can make this bigger.
[CUSTOMER][NEUTRAL] Our expense um but not.
[CUSTOMER][NEUTRAL] Yeah it's through Masterson Personnel Incorporated is the.
[CUSTOMER][NEUTRAL] It says essential staff care limited benefit plan.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] Says healthcare provider. I don't know if this is the dental part, but it says file claims to [PII].
[AGENT][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Wow.
[AGENT][NEUTRAL] That doesn't sound like ours because the only other
[CUSTOMER][NEUTRAL] No
[AGENT][NEUTRAL] Um, place we send claims to is IMA and that's for, uh, medical.
[CUSTOMER][NEUTRAL] Does he have maybe dental benefits embedded into his medical possibly?
[AGENT][NEUTRAL] Um, if he did, that wouldn't be through us, but I would still be able to search for him by his last name, and I'm not able to.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEGATIVE] It's weird that we received uh.
[AGENT][NEUTRAL] I know.
[CUSTOMER][NEUTRAL] Claim ID 381-358-301 through uh payee Planned administrators incorporated through [PII].
[AGENT][NEUTRAL] OK, and that's who the EOB was, was from?
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, cause this is American public life.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I, I, I haven't heard of that um company before, so.
[CUSTOMER][NEUTRAL] Hm.
[AGENT][NEUTRAL] I would, I would call the, the patient and see who.
[CUSTOMER][NEGATIVE] We have a wrong phone number.
[AGENT][NEUTRAL] Yeah, because this is APL, this is American public.
[CUSTOMER][NEUTRAL] Unless we have a wrong phone number listed on there.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll maybe call the number on because it doesn't show the dental, it just has the medical.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Card but it says that he had on here through Dentamax.
[CUSTOMER][NEUTRAL] OK, I'll maybe try the phone number on this card.
[AGENT][NEUTRAL] Oh yeah, that, that wouldn't be us.
[CUSTOMER][NEUTRAL] OK, OK, I'll try a different phone number thank you.
[AGENT][POSITIVE] All right, thank you so much for calling APL. Have a great day.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye.