AccountId: 011433970860
ContactId: e1b71bdd-65be-4e85-bade-6da9b6511023
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 419119 ms
Total Talk Time (AGENT): 150942 ms
Total Talk Time (CUSTOMER): 221946 ms
Interruptions: 3
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/04/e1b71bdd-65be-4e85-bade-6da9b6511023_20250304T17:07_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, yes, my name is [PII]. I'm calling from a provider's office. I was calling to follow up on the status of a claim for a patient, but then they redirected me to you.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, and [PII], what is your callback number if we are disconnected please?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Thank you. What is the policy number please?
[CUSTOMER][NEUTRAL] It is
[CUSTOMER][NEUTRAL] 5 consecutive zeros.
[CUSTOMER][NEUTRAL] 249-873-1
[AGENT][NEUTRAL] Thank you and verify the patient's name and date of birth, please.
[CUSTOMER][NEUTRAL] [PII], I don't know why I struggle that so bad.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you so much. I have them pulled up and you're calling for claim status. I can certainly help you. Thank you. And what's that date of service and the total charge amount please?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] $21725527.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] I will tell you that we have no claims at all on file.
[CUSTOMER][NEGATIVE] Oh jeez, OK, that's scary.
[AGENT][NEUTRAL] I can provide you with our fax number, verify mailing address, payer ID.
[CUSTOMER][NEUTRAL] Um, let's start with the fax number and then I'll, then I'll compare that I have the information correct.
[AGENT][NEUTRAL] OK, our fax number is [PII].
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, let me, and then let me go to this other screen and um compare data.
[AGENT][NEUTRAL] Of course.
[CUSTOMER][NEUTRAL] I know I have the payer ID correct at least compare um based off of what the last rep told me. Well, I take that back.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I can verify it.
[CUSTOMER][NEUTRAL] 60601.
[AGENT][NEUTRAL] No, no, it's 60801.
[CUSTOMER][NEUTRAL] OK, I see.
[CUSTOMER][NEUTRAL] 60801
[AGENT][NEUTRAL] Yes, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And group number Alpha Mary Bravo indigo Charlie.
[AGENT][NEUTRAL] I'm sorry, let me check the group number for you. The group number for this number is 70056.
[CUSTOMER][NEUTRAL] See, he gave me letters.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Let's do that again 705.
[AGENT][NEUTRAL] Uh, no, it's 70056.
[CUSTOMER][NEUTRAL] 70056 OK.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Alrighty I will try to update the um.
[CUSTOMER][NEUTRAL] The payer ID, I don't know that the system will let me though, um, otherwise I'll just fax it.
[AGENT][NEUTRAL] OK, I can also verify your mailing address just to make certain that you have it.
[CUSTOMER][NEUTRAL] I have [PII] there we go, [PII].
[AGENT][NEUTRAL] Mm, OK, give me one second. Now you're calling for dental, is that correct? I just wanna make sure.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, now that is not our mail address, please.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] Man, this is bad. OK, hang on, let me get to the screen so I can fix it.
[AGENT][POSITIVE] OK, no problem.
[CUSTOMER][NEUTRAL] All right, let's try that again. Go ahead.
[AGENT][NEUTRAL] OK, it is APL claims [PII].
[CUSTOMER][NEUTRAL] Now
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII] City, [PII].
[CUSTOMER][NEUTRAL] Oh man.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] So I do have that so.
[AGENT][POSITIVE] And the zip code is [PII]. I'm so sorry.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]. OK, can I get the correct phone number because I don't even know that I have that right.
[AGENT][NEUTRAL] Yeah
[AGENT][POSITIVE] OK, yes, I'm so sorry. Our number is [PII].
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] My goodness.
[AGENT][NEUTRAL] Now the mailing address that you provided me, that is actually for medical. That's why I was asking to make certain that you're calling for dental.
[CUSTOMER][NEUTRAL] I.
[CUSTOMER][NEUTRAL] Uh, yeah, no, I'm calling for dinner.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, um [PII]. OK, my goodness, let me try that again.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK. OK.
[CUSTOMER][NEUTRAL] Oh man, let me ask you this because this patient's actually in the office right now for.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um,
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] The claim in which I was calling about is for a full mouth debridement.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Code being 4355.
[CUSTOMER][NEUTRAL] I'm assuming since uh I guess what my question is is do I need to send any information with it and if so I guess that means I have to do it via mail and not fax.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] Well, now, to um go back to that, that full mouth debridement. um this particular policy, um [PII] does not cover any major services at all.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, it looks like they paid for it out of pocket anyway.
[AGENT][NEUTRAL] And that
[CUSTOMER][NEUTRAL] We must have known that, so I guess it's just X-rays then.
[AGENT][NEUTRAL] Uh, it will also cover, um, composite, I'm sorry, fillings and a simple tooth extraction.
[CUSTOMER][NEUTRAL] It will
[AGENT][NEUTRAL] Yes, not surgical though.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Simple but not surgical.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] This is a very interesting plan. I've got some crazy insurances today. I'm just gonna be on it.
[CUSTOMER][NEUTRAL] OK, so today I think the plan is just for an exam.
[AGENT][NEUTRAL] It's OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] So hopefully that'll get covered. All right.
[AGENT][NEUTRAL] What, what exam?
[CUSTOMER][NEUTRAL] I'm gonna fax that one a comp because he's a new patient.
[AGENT][NEUTRAL] 0150. OK, yes, that's a cover benefit, yes.
[CUSTOMER][NEUTRAL] Yes
[CUSTOMER][NEUTRAL] OK, I'm gonna wait until he's done because then I'll just send this old claim and his claim from today. I'll just send it at the same time.
[AGENT][POSITIVE] OK, that sounds great, [PII].
[CUSTOMER][POSITIVE] Perfect thank you so much I really appreciate your help.
[AGENT][NEUTRAL] You're welcome, [PII]. Anything else I can help you with?
[CUSTOMER][NEUTRAL] No, ma'am, that's it.
[AGENT][POSITIVE] You have a great day. Thank you so much for calling APL thank you bye bye.
[CUSTOMER][POSITIVE] You too thanks uh huh bye bye.