AccountId: 011433970860
ContactId: e0955d97-5704-4023-8e52-f12bf9f5a3ae
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 352420 ms
Total Talk Time (AGENT): 168589 ms
Total Talk Time (CUSTOMER): 128730 ms
Interruptions: 4
Overall Sentiment: AGENT=1.8, CUSTOMER=1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/09/e0955d97-5704-4023-8e52-f12bf9f5a3ae_20250509T13:54_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Well, hello [PII], this is [PII], and I'm calling from a dental office. I have a question I'm hoping maybe you can help me with about a patient that comes here that has your insurance.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, [PII], are you needing to get eligibility or a fax back of benefits? What can I help you with?
[CUSTOMER][NEUTRAL] No, I am not. Well, I'm calling. We sent in paperwork to try to get a pre-approval for the patient for Crown, and we haven't heard anything back, and I was just calling to check the status of that.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] I say this is for a predetermination, is that correct?
[CUSTOMER][POSITIVE] That's correct.
[AGENT][NEUTRAL] OK, [PII], I can help you with this. And what is your callback number?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you. And [PII], how do you spell your name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, and mine[PII] Mine ends in [PII] [PII] All right, [PII]. And what is the member's policy number, please?
[CUSTOMER][NEUTRAL] And how do you spell yours? OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] The policy number for this member is 02296314.
[AGENT][NEUTRAL] OK, [PII], thank you. One moment while I get all of the members' information pulled up.
[CUSTOMER][POSITIVE] No worries.
[AGENT][NEUTRAL] And any information that is provided would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] OK, thank you.
[AGENT][NEUTRAL] And what were the codes that you sent in for the pre-determination on, [PII]?
[CUSTOMER][NEUTRAL] Um, 2950 and a 2750, a corner in a crown number 13.
[AGENT][NEUTRAL] Alright, give me just a moment.
[CUSTOMER][NEUTRAL] And the total of the bill was 1195.
[AGENT][NEUTRAL] OK, just a moment. Let me pull up some additional information.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] It just is taking a moment to load the information for me.
[CUSTOMER][POSITIVE] Oh, it's fine that's no problem.
[AGENT][POSITIVE] Thank you for understanding.
[CUSTOMER][NEUTRAL] It's Friday. It doesn't wanna work any more than we do. It's Friday. We could all use a break.
[AGENT][POSITIVE] I know, I'm with it. That's right, I'm with it.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK so let's see.
[AGENT][NEUTRAL] OK, so for the notes on this policy, um, for 2950, it says 110.
[AGENT][NEUTRAL] And for 275-0368. There was a, a, a pre-treatment estimate worksheet that was, has been mailed to you all. Now, this was just processed on [PII]. So it would not have gone out at least until the [PII]. Um, and I say that depending on what date that was on.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I'll just look for it then.
[AGENT][NEUTRAL] So that was a Thursday. So, it probably just hasn't had quite enough time, given the mail service these days to reach you, but that should be coming.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] We had a pandemic and the mail has never been the same since. Isn't that weird?
[AGENT][NEGATIVE] You're right, it sure has not.
[CUSTOMER][MIXED] Like we were closed down for 2 months, but when we came back to work it was business as usual. It wasn't all this messed up stuff, but it's like the postal service has completely changed.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] No, and now it's like it's reverted. Mhm. It's like it reverted to back to when, yes, yes.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yes, craziness. I think it'd be better for Pony Express.
[AGENT][NEUTRAL] Now,
[AGENT][NEUTRAL] Sometimes I think so too. But now, um, one additional thing for you, [PII] is if you all end up filing a claim for Mr. [PII] with us, once the claim has processed, you should be able to check that status in our portal and our portal website.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I secured. [PII].
[CUSTOMER][NEUTRAL] Uh huh.
[CUSTOMER][NEUTRAL] Secure. [PII].
[AGENT][POSITIVE] Correct.
[CUSTOMER][POSITIVE] All right well thank you so much I appreciate it.
[AGENT][POSITIVE] Well, you are certainly very welcome. And again, is there anything else that I could help you with this morning?
[CUSTOMER][NEUTRAL] That's all.
[AGENT][POSITIVE] OK, well, if that is all I can help you with, thank you so much for calling APL and I hope that you have a wonderful weekend.
[CUSTOMER][POSITIVE] You as well thank you so much.
[AGENT][POSITIVE] Yes, ma'am. You're welcome and thank you again. Bye-bye.
[CUSTOMER][POSITIVE] Bye-bye. Thanks. Bye bye.