AccountId: 011433970860
ContactId: e1645102-4e45-429d-8d3a-24bc053cfdca
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 228979 ms
Total Talk Time (AGENT): 82416 ms
Total Talk Time (CUSTOMER): 44794 ms
Interruptions: 0
Overall Sentiment: AGENT=1, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/15/e1645102-4e45-429d-8d3a-24bc053cfdca_20250515T16:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII] calling for Night and Day Dental. I was calling to check on the status of a claim.
[AGENT][NEUTRAL] OK, I can help you, Ms. [PII] with the status of a claim. Um, may I please get your callback number just in case the call is disconnected?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you ma'am and then what is the patient's name, date of birth, and policy number?
[CUSTOMER][NEUTRAL] Uh, [PII] [PII] and the policy number is 02153331.
[AGENT][NEUTRAL] OK, let me pull up that policy real quick.
[AGENT][NEUTRAL] Alright, and then what is the data service and the charge amount?
[CUSTOMER][NEUTRAL] 4 16 2025 $578.
[AGENT][NEUTRAL] OK. And then what is the name of the dentist?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, I'm gonna put you on a quick hold, Miss [PII], while I look up this claim and I'll be right back, ma'am.
[CUSTOMER][POSITIVE] OK, thank you.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK Ms. [PII], this is [PII] I do find a claim for that data service but it's not under the provider name that you've given me. Could it be under a different name or a different dental office?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, well, the tax name is O'Brien and West CMD.
[AGENT][POSITIVE] Yes, that's right. That's good. Thank you. Let me give you that claim number.
[AGENT][NEUTRAL] It's 359-828-6.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And the claim was denied because this policy does not provide benefits for any procedure or service not listed on the scheduled to covered dental services, so it's denied as non-covered.
[CUSTOMER][NEUTRAL] OK, and the patient's responsibility is the full 578 I'm assuming?
[AGENT][NEUTRAL] Uh, we don't give patient responsibility. We let the provider determine that.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][POSITIVE] All right perfect I think that's everything thank you so much.
[AGENT][POSITIVE] You're very welcome, Ms. [PII]. I hope you have a wonderful day and thank you for calling APL.
[CUSTOMER][POSITIVE] You too thank you.
[AGENT][NEUTRAL] Bye bye