AccountId: 011433970860
ContactId: dae89dec-6a5e-4a32-b16d-85cd0ebdc2e1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 455549 ms
Total Talk Time (AGENT): 115331 ms
Total Talk Time (CUSTOMER): 174774 ms
Interruptions: 4
Overall Sentiment: AGENT=0.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/17/dae89dec-6a5e-4a32-b16d-85cd0ebdc2e1_20250417T15:13_UTC.wav
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[AGENT][NEUTRAL] For calling APL, this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] in the care team. I've got um a provider on the phone. Her name is [PII].
[CUSTOMER][NEUTRAL] She is calling about policy number 615476. She sent in a pre-treats, uh, let me give you the number, the claim number 359-027-6.
[CUSTOMER][NEUTRAL] Are you still there? Oh, she hung up. What in the world? OK, we'll have to call her back. I've got her number, but anyway, on the pre-treat it is showing that 0.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Benefit would be paid $0 for the benefit.
[CUSTOMER][NEUTRAL] So she asked me why would it be 0 because on the fax back on page 10.
[CUSTOMER][NEGATIVE] The last one, the last code on page 10 of the fax back is 2751 and it shows it pays $220 and she said it shouldn't be $0 if we're showing on the fax back that it pays $220 and she had further questions about the pre-treat that she sent in.
[AGENT][NEUTRAL] OK, let me get the document pulled up so I can see what you're looking at.
[CUSTOMER][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I had to look over it with her too, and she did point it out and it is there.
[CUSTOMER][NEUTRAL] And let me give you her call back number too since we're gonna have to call her back since she hung up.
[AGENT][NEUTRAL] Yeah, I have to look at it and see what's going on with it and get somebody in in dental to reach out to them.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] I'm not even able to pull up what you're looking at, let me see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] No documents attached to this claim, so let me look through each document here.
[CUSTOMER][NEUTRAL] Yes ma'am.
[AGENT][NEUTRAL] Let's see.
[AGENT][NEUTRAL] Email was on.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Punched the wrong button.
[AGENT][NEUTRAL] OK, you said uh it was a pre-treat is out here. I'm not finding it. I see the claim.
[CUSTOMER][NEUTRAL] Um, it's a
[AGENT][NEUTRAL] But I don't see the correspondence.
[CUSTOMER][NEUTRAL] Yeah, the pre-tre number is 359-027-6.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] With the the code the D701.
[CUSTOMER][NEUTRAL] At the end.
[AGENT][NEUTRAL] Yeah, but you said that the, the fax back is out here in in here as well, the correspondence they sent back, the fax back they sent back.
[CUSTOMER][NEUTRAL] No, the fax back, the fax back is on the SharePoint.
[AGENT][NEUTRAL] Oh, OK, so she's just referring to that.
[CUSTOMER][NEUTRAL] Right, which is what we send them to verify benefits.
[AGENT][NEUTRAL] OK, let me go out here and look.
[CUSTOMER][NEUTRAL] Oh, did I just say that?
[AGENT][NEUTRAL] And that's 2751.
[AGENT][NEUTRAL] 23.
[AGENT][NEUTRAL] I do see the 2751 on there. The 239 2392.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] I don't
[AGENT][NEUTRAL] C. 2392.
[CUSTOMER][NEUTRAL] Yes, I didn't see that one either.
[CUSTOMER][NEUTRAL] But I did see the
[CUSTOMER][NEUTRAL] The 2751.
[AGENT][NEUTRAL] OK, but you said she received something saying it wouldn't be covered from us?
[AGENT][NEUTRAL] The 2751.
[CUSTOMER][NEUTRAL] So under the the claim under the claim and M track when on the uh pre-treat when you click on it, the remarks state that it's.
[CUSTOMER][NEUTRAL] A pre-treat and benefits are not guaranteed, but on the claim itself up at the top where you would see where the payable would be, it's 0.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] When you click on it in M track and you look at the top where the payable would be, it says 0.
[AGENT][NEUTRAL] OK. Does it normally have an amount? Cause I, I'm gonna have to check with dental cause I'm new to this dental things cause I normally don't do dental. So, uh, I'll have to clarify with you with dental. I'm gonna have to get with [PII].
[CUSTOMER][NEUTRAL] Yes, and I am too. I am too we just started, we just.
[CUSTOMER][NEUTRAL] Yes, and then somebody.
[AGENT][NEUTRAL] And see if she can clarify. Is it normally, yeah, I'll have to see.
[CUSTOMER][NEUTRAL] OK, and if somebody could call her.
[CUSTOMER][NEUTRAL] Well, this is new. We just started doing the dental cue this week, so this is new also.
[AGENT][NEUTRAL] As far as on the pre-treat.
[AGENT][NEUTRAL] But I'll, I'll check into it and see.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And what's the callback number?
[CUSTOMER][NEUTRAL] Her callback number is [PII].
[CUSTOMER][NEUTRAL] [PII] and her name is [PII].
[AGENT][NEUTRAL] OK, I will get with [PII] to see if she can give her a call back regarding that and get some clarification.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] All right. Thanks.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] You're very welcome. Thank you so much for helping me.
[AGENT][POSITIVE] Oh, you're welcome.
[AGENT][NEUTRAL] Mm bye.
[CUSTOMER][NEUTRAL] All right, bye-bye.