AccountId: 011433970860
ContactId: dbeec3e7-c549-4466-94e3-ff204a56057e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 495420 ms
Total Talk Time (AGENT): 170653 ms
Total Talk Time (CUSTOMER): 109200 ms
Interruptions: 0
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/08/dbeec3e7-c549-4466-94e3-ff204a56057e_20250408T18:40_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling from the Loveland Dental Group. Um, I was just calling in regards to a claim.
[AGENT][NEUTRAL] OK, [PII], what is your callback number please?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you so much. And what is the policy number, please?
[CUSTOMER][NEUTRAL] Um, 00775405.
[AGENT][NEUTRAL] OK, let me just repeat that to confirm. I have that as 00775405.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] And verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] Um, so the patient that I'm calling about is [PII]. Uh, date of birth is [PII].
[AGENT][POSITIVE] Thank you so much for that.
[CUSTOMER][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] Yeah, actually.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, we'll start with that one
[AGENT][NEUTRAL] OK, alright, no problem. OK, you're call for claims status. Give me one moment, I can help you.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] OK, what's that date of service and the total charge amount?
[CUSTOMER][NEUTRAL] OK, so it's actually so the EOB that I have is for him, but um it should be for the father, so the correct birthday is [PII].
[CUSTOMER][NEUTRAL] And data service is 9924 [PII] filled amount is uh 384.
[AGENT][NEUTRAL] OK, and what's that claim number on that ELB?
[CUSTOMER][NEUTRAL] 3,584,720
[AGENT][POSITIVE] OK, thank you. Give me one moment.
[AGENT][NEUTRAL] 720.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] 4720.
[CUSTOMER][NEUTRAL] And I know so back on um [PII] we had a coworker contact you guys and um the claim was reissued but it looks like when it was reissued it was processed under the child so it was a no payment due to being maxed out but it should have been processed under um the father if that makes sense.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you. One moment. Can I place you on hold please, [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] OK, thank you.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh
[AGENT][NEUTRAL] OK, so this is for father.
[AGENT][NEUTRAL] 264264.
[AGENT][NEUTRAL] OK, 4720.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 4720.
[AGENT][NEGATIVE] It should have been on that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Patient.
[AGENT][NEUTRAL] OK, so this is the.
[AGENT][NEUTRAL] Patient.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] Yep.
[AGENT][NEUTRAL] Claim
[AGENT][NEUTRAL] 2,022,023,023,210.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Get that reissued process.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII], oh, OK, I'm so sorry about that if I lost you. OK, so we will have to get that claim reprocessed. It was processed on the, um, dependent, but it should have, like you said, been processed on the policy holder. So we apologize for that. Um, please allow a few days for that to be reprocessed. Um, today is [PII].
[CUSTOMER][NEUTRAL] I'm here.
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] A
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yeah, let's see here.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] Let's see, I was just give me one moment here. I'm just thinking out loud.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so that was processed. So the claim that we pro I'm sorry, the check that was voided was under claim number 3,512,240.
[AGENT][NEGATIVE] And then it was supposed to be a reissue because the check was never received.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] OK, so again talking to myself. OK, thank you so much for uh reify. OK, OK, OK, so we will get that reprocessed and paid on the correct, um, or process on the correct participant, which is participant one, and we apologize for that, um, inconvenience. Sorry about that.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] It's OK.
[CUSTOMER][NEUTRAL] That's OK, that's all right, um, OK, so, and then it usually takes how long? 7 to 10 days?
[AGENT][NEUTRAL] Usually it takes up to 7 to 10 business days for it to be a claim to be processed, but it may take sooner than that, maybe sooner than that, of course.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, OK, alright and then um if you just have a reference number and that's all I need.
[AGENT][NEUTRAL] OK, we do not use reference numbers. Please use my name [PII] last initials [PII] like [PII], and today's date.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] All right, that's all I needed.
[AGENT][POSITIVE] OK, well thank you [PII]. You have a great day and thanks for calling APL and take care.
[CUSTOMER][POSITIVE] Thank you you too.
[AGENT][POSITIVE] Thank you bye bye.