AccountId: 011433970860
ContactId: d22ff63a-f5a8-41eb-8bff-1226f7d121a5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 609869 ms
Total Talk Time (AGENT): 143076 ms
Total Talk Time (CUSTOMER): 79433 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/d22ff63a-f5a8-41eb-8bff-1226f7d121a5_20250219T15:44_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, my name is [PII]. I'm calling from Mins Dentistry to get the status of a claim.
[AGENT][NEUTRAL] And [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] What is the policy number please [PII]?
[CUSTOMER][NEUTRAL] 02465237
[AGENT][NEUTRAL] Thank you. One moment please, and again you're calling for claim status. One moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] To verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you. And also you can check claim status by visiting our secure portal at [PII]. Give me one moment please, [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Thank you. And what is that date of service and the total charge amount please?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] 1228 24 for 2,967.
[AGENT][NEUTRAL] OK, that was 1228 2024 2967.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, shows that the claim was received the payment was made. One moment please.
[AGENT][NEUTRAL] 28.
[AGENT][NEUTRAL] Can you please verify the procedure codes billed for this service date?
[CUSTOMER][NEUTRAL] Um, sure, it's uh D0150.
[CUSTOMER][NEUTRAL] D02740330023002202394 for 4 fillings.
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] Let me place you on a brief hold please thank you one moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Let me see.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you so much for your patience, [PII]. I appreciate that. Yes, sir, again we did receive the claim and a payment was made on that, and it appears that an overpayment was made, um, on the claim, but the initial payment was $2,148.20.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, so you guys took the entire payment as an overpayment or partial?
[AGENT][NEUTRAL] The calendar year max is $1500.
[CUSTOMER][NEUTRAL] Oh, so you guys overpaid by like 700, 600 bucks?
[AGENT][NEGATIVE] Yes, it was overpaid and we will um of course have to.
[AGENT][POSITIVE] We will send a letter as far as refund letters, yes, but it was received and the payment was made. I have the check number for you if you want that.
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][NEUTRAL] OK, it's check number 2022058.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] And the claim was processed on I'm sorry, the check was processed on [PII] and this currently shows outstanding.
[AGENT][NEUTRAL] Let me just verify that mailing address please with you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] No problem.
[AGENT][NEUTRAL] OK, it was sent to Lancaster Mint Dentistry PLLC [PII].
[CUSTOMER][POSITIVE] That is correct.
[AGENT][POSITIVE] OK, alright, and again it currently shows outstanding um.
[AGENT][NEUTRAL] And technically it's over 30 days, so.
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] I can stop payment on the check?
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] We
[CUSTOMER][NEUTRAL] No, that's OK. I was gonna say we have a policy that we have to wait 75 business days before we, uh, reissue any payments just to give it time to get received. So, uh, I'll definitely call back uh whenever the time comes for that. Can I get your name again?
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Of course, my name is [PII], last initials [PII].
[CUSTOMER][NEUTRAL] And uh do you have a reference number by any chance?
[AGENT][NEUTRAL] Uh, no, but you can use my name in today's date.
[CUSTOMER][POSITIVE] OK, thank you so much you have a blessed day.
[AGENT][POSITIVE] You as well, [PII], and thank you for calling APL bye.