AccountId: 011433970860
ContactId: dc95da1b-7f3f-41d8-91d8-c9508cb107ac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 463859 ms
Total Talk Time (AGENT): 134247 ms
Total Talk Time (CUSTOMER): 100529 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=1.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/16/dc95da1b-7f3f-41d8-91d8-c9508cb107ac_20250416T18:59_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]. I am calling from a dental provider's office, and how are you today?
[AGENT][POSITIVE] I'm good. How are you?
[CUSTOMER][POSITIVE] I'm doing well, thank you. Um, I have some claims here that I need some help with, uh, cause I've never called American public life before, so what do you need from me first?
[AGENT][NEUTRAL] OK, yeah, let's start with, do you have the patient's policy number?
[CUSTOMER][NEUTRAL] Yes, it looks like it's 02293914.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And then do you have a good callback number?
[CUSTOMER][NEUTRAL] Yes, it's the direct line [PII].
[AGENT][NEUTRAL] OK. Thank you. And then what is the patient name and date of birth?
[CUSTOMER][NEUTRAL] It's [PII], and her date of birth is [PII].
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] And then uh what is the date of service?
[CUSTOMER][NEUTRAL] Uh she has a few of them, but we'll start with the first one. It's [PII].
[AGENT][NEUTRAL] OK. And then do we have a bill amount?
[CUSTOMER][NEUTRAL] It was for $650.
[AGENT][NEUTRAL] So, first date of service looks like we did get a claim. I don't know if you need the received date, um.
[AGENT][NEUTRAL] Claim is received, it looks like [PII].
[AGENT][NEUTRAL] It was denied on [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, looks like the policy does not provide any benefits for the procedures services listed.
[CUSTOMER][NEUTRAL] Oh, you know.
[CUSTOMER][POSITIVE] Perfect. And is it possible to get that you'll be faxed over to me?
[AGENT][POSITIVE] Yeah, absolutely.
[AGENT][NEUTRAL] What is a good fax number?
[CUSTOMER][NEUTRAL] It's [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK. And do we need to mark attention to anybody on that?
[CUSTOMER][NEUTRAL] No, that's fine.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, give me just one second to get this sent over to you and then we can go on to the next one here.
[AGENT][NEUTRAL] Do you need the claim number?
[CUSTOMER][POSITIVE] Perfect. Thank you.
[CUSTOMER][POSITIVE] Um, no, it'll probably be on the EOB, but thank you.
[AGENT][NEUTRAL] Yeah, it will be.
[AGENT][NEUTRAL] OK, what's the next date of service?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] it's [PII], yes, it is [PII].
[AGENT][NEUTRAL] OK, and then do we have a billing amount for that?
[CUSTOMER][NEUTRAL] Yes, $685.
[CUSTOMER][NEUTRAL] I'm gonna think it's gonna be the same thing, but I just wanna verify it.
[AGENT][NEUTRAL] Yeah, looks like it is.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] All right. Let's see.
[AGENT][NEUTRAL] Uh
[AGENT][NEGATIVE] Yeah, it looks like it's gonna be the same denial policy just doesn't provide any benefits.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] But I can definitely fax this one to you. Give me just a second here.
[CUSTOMER][POSITIVE] Perfect.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, that one's on its way. Then what's the next date?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK. And do we have a build amount for that?
[CUSTOMER][NEUTRAL] Yes, $298.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so this claim.
[AGENT][NEGATIVE] Pay it looks like $72 towards procedure code $0120. Looks like the other two were denied. Um, it looks like policy just does not provide benefits on it.
[CUSTOMER][POSITIVE] OK, perfect.
[AGENT][NEUTRAL] Did you need me to fax this one over to?
[CUSTOMER][NEUTRAL] Yes, please.
[AGENT][POSITIVE] OK, not a problem.
[AGENT][NEUTRAL] OK, that one's on its way to you and do we have any others?
[CUSTOMER][NEUTRAL] Uh, no, I think I have to submit these other ones. They have not been submitted to you all yet. So if I can just have a reference number, sir, I would appreciate that.
[AGENT][NEUTRAL] Yeah, no problem. Call reference is my name with my last initial and then today's date. So my name again is [PII], that's spelled [PII] My last initial is [PII], and then just today's date.
[CUSTOMER][POSITIVE] Perfect. Thank you so much and you have a great rest of the day.
[AGENT][POSITIVE] You too. Take care.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.