AccountId: 011433970860
ContactId: dc4010c7-fc24-4702-be3c-2f81c3a9e72a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 641900 ms
Total Talk Time (AGENT): 169437 ms
Total Talk Time (CUSTOMER): 177848 ms
Interruptions: 1
Overall Sentiment: AGENT=1, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/dc4010c7-fc24-4702-be3c-2f81c3a9e72a_20250328T18:04_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] calling from product office.
[AGENT][NEUTRAL] Hi, and you said your name was [PII]?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] No, it is [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, [PII]. Thank you for calling.
[CUSTOMER][NEUTRAL] Could you spell out your name, please, for me?
[AGENT][NEUTRAL] Yes, it's [PII]
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And your for claim status you said?
[CUSTOMER][NEUTRAL] Yes, it is for client status.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and what is your callback number just in case our call is disconnected?
[CUSTOMER][NEUTRAL] OK, yeah, the callback number would be [PII]. Yeah, the patient name is [PII], and the date of birth is [PII], [PII].
[AGENT][NEUTRAL] Thank you. And then can you please give me the patient's name, date of birth, and policy number?
[AGENT][NEUTRAL] OK. And then what is the policy number, please?
[CUSTOMER][NEUTRAL] 02555694.
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I've got the patient pulled up now. uh, can you please give me the date of service?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yes, it is [PII].
[AGENT][NEUTRAL] And the charge amount?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I don't have that information on my side.
[CUSTOMER][NEUTRAL] How only the data service.
[AGENT][NEUTRAL] OK, do you have the facility name that you're calling for?
[CUSTOMER][NEUTRAL] Yes. The facility name is Pro Smiles Dental.
[AGENT][POSITIVE] Pro smiles Dental.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, I'm going to put you on a brief hold while I look up this claim and I will be right back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEGATIVE] Oh shit
[AGENT][NEUTRAL] Hm
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Thank you for holding for me. Uh, do you happen to see the doctor's name?
[CUSTOMER][NEUTRAL] So yeah, the doctor's name is [PII].
[AGENT][NEUTRAL] OK. And the date of service was [PII]?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] No, it is [PII].
[AGENT][POSITIVE] OK, got you, thank you so much. All right, so looking at um that data service.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEGATIVE] The policy was not paid because these services were rendered after coverage was terminated.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK, so the claim is denied for.
[CUSTOMER][NEUTRAL] Not, not covered or inactive?
[AGENT][NEUTRAL] Right, inactive, yes, ma'am.
[CUSTOMER][NEUTRAL] OK, OK, so the client is denied, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, can I have the receipt date of this client?
[AGENT][NEUTRAL] OK, let me put finish my note real quick.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] It
[AGENT][NEUTRAL] OK, we received the claim on [PII].
[CUSTOMER][NEUTRAL] Uh
[AGENT][NEUTRAL] And process the claim on the same day of [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK and.
[CUSTOMER][NEUTRAL] Just give me a second, I have to note it down.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Just bear with me, OK?
[AGENT][POSITIVE] Yes ma'am, take your time.
[CUSTOMER][POSITIVE] Yeah, thank you so much.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] And can I have the effective date and the date of this policy?
[AGENT][NEUTRAL] Yes, the effective date was [PII].
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And the policy lapsed on [PII].
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] It's just one month.
[CUSTOMER][NEUTRAL] It's [PII], is that right?
[AGENT][POSITIVE] Yes, that's correct.
[CUSTOMER][POSITIVE] OK, that's perfect. Can I have the client number, please?
[AGENT][NEUTRAL] Yes, ma'am, that claim number is going to be
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 3543824
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK. Can I have the reference number, please?
[AGENT][NEUTRAL] Yes ma'am, you can use my name and today's date. My name is [PII]
[CUSTOMER][POSITIVE] Exactly
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] OK. Sorry, and [PII], is that right?
[AGENT][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] Yeah, [PII], OK.
[CUSTOMER][NEUTRAL] And.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK, that's perfect. OK, yeah, that's it for today, um, [PII], and could you please send a copy of your bill through fax.
[AGENT][NEUTRAL] Yes, what is your fax number please?
[CUSTOMER][NEUTRAL] Yeah. It is [PII].
[AGENT][NEUTRAL] OK, can
[AGENT][POSITIVE] For make sure I've got it correct.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh yeah.
[AGENT][NEUTRAL] You said [PII]. What was the rest?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, it's [PII].
[AGENT][NEUTRAL] [PII]. OK. And how do I spell your name again, please?
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII]. OK. All right. I'm gonna put you on a brief hold while I get that fax ready for you, that EOB and I'll be right back.
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Thank you, ma'am.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Oh
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] All right, thank you for holding for me. I've got that fax on the way to you now.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] OK, thank you so much, Joy. Thank you for listening and that's it for the day. Yeah, that's it for today. Thank you so much.
[AGENT][POSITIVE] You're welcome.
[AGENT][NEUTRAL] OK, well, you have
[AGENT][POSITIVE] You're welcome. You have a wonderful weekend and thank you for calling APL.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] You too. Thank you, bye.
[AGENT][NEUTRAL] Mm bye-bye.