AccountId: 011433970860
ContactId: ceb43d7e-ae90-4e1b-a030-59b798622421
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 402739 ms
Total Talk Time (AGENT): 106733 ms
Total Talk Time (CUSTOMER): 99182 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/03/ceb43d7e-ae90-4e1b-a030-59b798622421_20250603T19:36_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Good afternoon, [PII]. My name is [PII]. I'm calling from a dental provider's office. I'm trying to obtain claim status.
[AGENT][NEUTRAL] OK, Miss [PII], I can help you with claim status. May I please get your callback number, ma'am, just in case the call is disconnected.
[CUSTOMER][NEUTRAL] Callback number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Extension [PII].
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the member's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Date of birth is [PII].
[CUSTOMER][NEUTRAL] And the policy number is
[CUSTOMER][NEUTRAL] 02511267.
[AGENT][NEUTRAL] OK, let me look up that policy.
[AGENT][NEUTRAL] And then may I get [PII]'s data service and charge amount?
[CUSTOMER][NEUTRAL] Yes, uh, the date of service is.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And the charge amount is.
[CUSTOMER][NEUTRAL] 376.
[AGENT][NEUTRAL] OK, and then what is the name of the office you're calling from?
[CUSTOMER][NEUTRAL] Treasure Coast Community Health.
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold, Miss [PII], while I look up this claim for us and I'll be right back, ma'am.
[CUSTOMER][NEUTRAL] OK, um, just one thing, the claim might have split. I'm looking here and the claim might have split, um, so you might see 364 and then 1 for 12, which is the oral hygiene instructions. So just in case it's split, just give you those. Thank you.
[AGENT][POSITIVE] Thank you. Uh-huh.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, yes.
[AGENT][POSITIVE] Yes, thank you for letting me know that too that makes life a little easier. I appreciate it.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, it's gonna be a brief hold, you.
[CUSTOMER][POSITIVE] You're welcome.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] 350-7558
[AGENT][NEUTRAL] 3507542
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Miss that uh [PII], what is the um.
[AGENT][NEUTRAL] The dentist's name that did the procedure.
[CUSTOMER][NEUTRAL] Uh, let me get that for you.
[CUSTOMER][NEUTRAL] It is under.
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Yes ma'am, I've got the claim pulled up now. OK, so for the dental hygiene, the claim number is 3507558.
[AGENT][NEUTRAL] And it was denied as non-covered according to the patient's plan.
[AGENT][NEUTRAL] And then the one, the one for [PII], that one is 3507542.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it has a remark this policy's required waiting period of 12 months for major services has not been met.
[CUSTOMER][NEUTRAL] OK. And you said it's a 12 month waiting period?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] All righty. So I'll go ahead and um
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Notate that for um the the claim here with us. Would you be able to provide a reference number for our call today?
[AGENT][NEUTRAL] Yes, ma'am, um, you can use my name [PII] in today's date.
[CUSTOMER][POSITIVE] All right well thank you so much hope you have a good day.
[AGENT][POSITIVE] You too, Ms. [PII]. Thank you so much for calling APL. You have a good day also. Bye-bye.
[CUSTOMER][POSITIVE] Thanks bye bye.