AccountId: 011433970860
ContactId: d68e5425-6e11-4cad-9bf3-12160c61c6d7
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 441329 ms
Total Talk Time (AGENT): 113140 ms
Total Talk Time (CUSTOMER): 58389 ms
Interruptions: 1
Overall Sentiment: AGENT=0.9, CUSTOMER=-2.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/30/d68e5425-6e11-4cad-9bf3-12160c61c6d7_20250130T15:24_UTC.wav
--------------------------------------------
[AGENT][POSITIVE] Thank you for calling American Public Life. [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, this is [PII] at Castlewood Dental Clinic. I need to ask a question about a claim, please.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I can help you with that, [PII]. Could I get a callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. Policy number you're calling on?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Uh, oh, I would just write the wrong one down 006 07899.
[CUSTOMER][POSITIVE] That's the right number.
[AGENT][NEUTRAL] The patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII], let me get back to the date of birth. I think I wrote the wrong one down.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you for verifying the policy and you did say status today. What is the date of service you're checking?
[CUSTOMER][NEUTRAL] Well, I have the EOB 11 [PII].
[AGENT][NEUTRAL] Total bill?
[CUSTOMER][NEUTRAL] Uh, 1500.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I just need to know if you could tell me what the PPO fee is.
[CUSTOMER][NEUTRAL] So I can bill him for this crown.
[AGENT][NEUTRAL] The PPO fee.
[CUSTOMER][NEUTRAL] The network fee uh huh.
[AGENT][NEUTRAL] OK, let me send I'm not sure if we hold one moment please, let me research it.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] What? Girl?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Under what?
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] This shit is annoying.
[AGENT][NEUTRAL] Uh
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Hey girl, how you doing?
[AGENT][NEUTRAL] I'm good. OK, this is a crazy question to me. I guess I've never had it. So it's a provider calling on a claim we denied and she's asking for.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] The fee amount, so she can bill the patient. Now, it was denied by us and uh benefits not listed in the fee schedule. So it's not a covered procedure. It's not on their fee schedule.
[AGENT][NEUTRAL] I'm just assuming she's asking.
[AGENT][NEUTRAL] For the usual and customary amount.
[AGENT][NEUTRAL] But we wouldn't allow. It's not a cover. Yeah, I that before I told her because that's what I was about to tell her. We wouldn't have that fee because it's not a covered procedure, but I don't know if that would, that's correct.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] OK, let me call you. OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] OK, will do. Thank you. Bye.
[AGENT][NEUTRAL] OK, thank you for holding. I apologize for the wait, [PII]. Uh, so it looks like this procedure is not one of, uh, is not a procedure that we cover. It's not on the fee schedule, so we would not have the, um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] the allowed amount for this particular procedure.
[CUSTOMER][POSITIVE] OK alrighty thank you so much.
[AGENT][POSITIVE] You're welcome. Is there anything else I can help you with?
[CUSTOMER][POSITIVE] No, ma'am, that's all thank you.
[AGENT][POSITIVE] OK. You're welcome. Have a wonderful day. Thank you for calling APO. Bye bye.
[CUSTOMER][NEUTRAL] Mm you too bye bye.