AccountId: 011433970860
ContactId: d2ec6e14-1cb1-47ff-a4ad-fc457f8492cc
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 378420 ms
Total Talk Time (AGENT): 127847 ms
Total Talk Time (CUSTOMER): 154181 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.1, CUSTOMER=0.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/d2ec6e14-1cb1-47ff-a4ad-fc457f8492cc_20250320T13:55_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good morning. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] with all the streets.
[CUSTOMER][NEUTRAL] [PII], I'm calling to check on to see why a claim wasn't paid.
[AGENT][NEUTRAL] OK, may I ask who's calling?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] And do you have a callback number?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Um, 00608817.
[AGENT][NEUTRAL] Thank you, [PII]. Hold on one moment please.
[CUSTOMER][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Well
[CUSTOMER][NEUTRAL] If you come from where the airport is, you wouldn't even go by the Popeyes. We are before that.
[AGENT][NEUTRAL] And what's that patient's name?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] And her date of birth?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] Thank you, [PII], and you're just needing to check on a claim.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] OK, I can help you with that. What date of service was it for?
[CUSTOMER][NEUTRAL] Uh, it is for [PII].
[CUSTOMER][NEUTRAL] Well, some people calling it like they have insurance. I'm like, well it depends on your insurance company is what I come out and tell them.
[AGENT][NEUTRAL] OK, hold on just a moment. Let me look at it for you. Uh, we do have it in. Let me see what's going on with it.
[CUSTOMER][NEUTRAL] He's in the kitchen.
[CUSTOMER][NEUTRAL] OK, OK.
[CUSTOMER][NEUTRAL] I'm just gonna say in the Maxis, so he's in the computer but his insurance is not put in.
[CUSTOMER][NEUTRAL] Oh for for his social, yeah.
[CUSTOMER][NEUTRAL] I wonder if he's in X-rays.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] Oh lovely.
[AGENT][NEUTRAL] OK. Did she come in? I'm sorry, did she come in in January?
[CUSTOMER][NEUTRAL] Not
[AGENT][NEUTRAL] The [PII]
[CUSTOMER][NEUTRAL] In [PII]. Oh.
[CUSTOMER][POSITIVE] You know what? I actually, I remember her calling something about that's my fault, something about uh her son had taken her appointment on the [PII]. Let me see something. I apologize, thought I was prepared.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Because we paid.
[CUSTOMER][NEUTRAL] I get
[AGENT][NEGATIVE] For [PII] and then we denied the [PII].
[CUSTOMER][NEUTRAL] OK um.
[AGENT][NEUTRAL] That's what I'm saying.
[CUSTOMER][NEUTRAL] Let's see, um, yeah, because she actually, whatever, it was an accident because she had her son come at the same time or blah blah blah, but she didn't have her teeth cleaned on um the [PII]. She actually did come in on the [PII].
[AGENT][NEGATIVE] She did not have her teeth cleaned on the [PII].
[CUSTOMER][NEUTRAL] Right.
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEUTRAL] So, I mean,
[CUSTOMER][NEUTRAL] I mean, with, uh, I'm thinking her next cleaning is after way after 6 months anyway.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] To get it corrected in our system, we'll probably have to ask for a refund on that [PII] to [PII].
[CUSTOMER][NEUTRAL] Let me see
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] And then [PII].
[AGENT][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] OK, um, let me see.
[CUSTOMER][NEUTRAL] It's there
[CUSTOMER][NEUTRAL] OK, is, is there, um, when was it paid for the [PII]?
[AGENT][NEGATIVE] The [PII], we didn't pay anything.
[CUSTOMER][POSITIVE] I apologize, I apologize. I see it right there and.
[AGENT][NEUTRAL] Because we paid the one fixed.
[CUSTOMER][NEUTRAL] On
[CUSTOMER][NEUTRAL] The [PII]. OK, is there any way I can get a um explanation of benefits for the [PII]?
[AGENT][NEUTRAL] Uh, yes, ma'am.
[CUSTOMER][NEUTRAL] Via email.
[AGENT][NEUTRAL] So you're saying she did not come in at all on [PII]?
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] It was just accidentally filed because her she wanted her son to take her spot and stuff like that, but I mean, I mean her next appointment it would come out to, you know, being 6 months later anyway.
[AGENT][NEUTRAL] Well, we'll have to get it corrected in the system if she didn't have her services on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Um, what was your name? [PII]. OK, I'm sorry about that.
[CUSTOMER][NEUTRAL] [PII], mhm.
[CUSTOMER][POSITIVE] No, you're good.
[AGENT][NEUTRAL] It's early this morning, um.
[AGENT][NEUTRAL] Let me ask, I'm gonna ask my supervisor, but I'm pretty sure she's gonna get us to ask for a refund for the [PII].
[AGENT][NEUTRAL] And then reprocess.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] The data service for the [PII], so it'll be correct in the system.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But I'm gonna ask her to make sure, um.
[AGENT][NEUTRAL] And if she requested that money back, you will get a letter requesting that money back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Is there anything else I can help you with?
[CUSTOMER][NEUTRAL] No ma'am, mm mm.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day and I'll get with her on how she wants to fix this problem.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] So from here on out, we're just gonna get something in the mail.
[AGENT][NEUTRAL] Yes, ma'am. Mhm.
[CUSTOMER][NEUTRAL] Right, right, OK. Is there a reference number to the phone call?
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] I apologize. What is your name?
[AGENT][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][POSITIVE] Got it. OK, thank you so much.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day as well.
[CUSTOMER][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] You too bye bye bye.
[AGENT][NEUTRAL] Bye bye.