AccountId: 011433970860
ContactId: e5726476-d535-4dbd-bd7a-4dba4216270a
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 608010 ms
Total Talk Time (AGENT): 197039 ms
Total Talk Time (CUSTOMER): 152116 ms
Interruptions: 2
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/26/e5726476-d535-4dbd-bd7a-4dba4216270a_20250326T14:18_UTC.wav
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[AGENT][POSITIVE] Thank you for calling this is how can I help you?
[CUSTOMER][NEUTRAL] Um, yes, yes, my name is [PII]. I'm calling from a dental office. It's Hannah Family Dentistry. Um, we have a, um, a claim in an EOB that came back to us that, uh, EOB we got it's on, uh, patient [PII]. Do you need the claim number to maybe look at it?
[AGENT][NEUTRAL] I will, um, but before that, what is your callback number if we're disconnected please?
[CUSTOMER][POSITIVE] Thank
[CUSTOMER][NEUTRAL] OK [PII].
[AGENT][NEUTRAL] OK, and what's that policy number on that ELV?
[CUSTOMER][NEUTRAL] OK, policy number is let's see 00613760.
[AGENT][NEUTRAL] OK, one moment.
[AGENT][NEUTRAL] And verify the member's date of birth.
[CUSTOMER][NEUTRAL] OK, give me just a second.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] OK, thank you very much for the information and you have a an ELB claim number I can provide, excuse me if you would provide it to me.
[CUSTOMER][NEUTRAL] OK, um, let's see claim number is 35780887.
[AGENT][NEUTRAL] OK, that was 35780887. Thank you. One moment please.
[AGENT][NEUTRAL] OK, I have that pulled up. Yes ma'am and how can I help you with this particular claim?
[CUSTOMER][NEUTRAL] OK, so we received a check for $69 going towards it, but we also got for the same date of service, same service fees for his wife.
[CUSTOMER][NEGATIVE] And got a check for $29 different claim number and so but nothing was done with the wife so I feel like there was a mistake.
[AGENT][NEUTRAL] OK, so what's the wife's claim number?
[CUSTOMER][NEUTRAL] OK, the wife's claim number is 3578081.
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, alright.
[AGENT][NEUTRAL] OK, so in regards to Mr. [PII], he was paid for 2950. OK, so let me just check, take a look at the wife's.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 3 10 2025.
[AGENT][NEUTRAL] 3 10 3 1029 50.
[AGENT][NEUTRAL] OK, give me one moment here to pull so you're calling in regards to the wife's ELB, not, not the husband's, is that correct? OK, alright, so let me.
[CUSTOMER][NEUTRAL] Right, right, the husband did the, did the service on that date. The wife did not.
[AGENT][NEUTRAL] OK, so the one did not. OK, thank you one moment.
[AGENT][NEUTRAL] Bear with me.
[AGENT][NEUTRAL] Excuse me, give me one moment please, bear with me.
[CUSTOMER][NEUTRAL] Mhm sure.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, so that was [PII].
[AGENT][POSITIVE] So that shows I'm sorry, I'm so sorry. Can I place you on hold? I'm sorry, I don't you hear me talking to myself. OK, thank you. I appreciate that. One moment. Thank you.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah, no, it's OK.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Oh OK
[AGENT][NEUTRAL] 31
[AGENT][NEUTRAL] Hm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] [PII], this is correct. 319.
[AGENT][NEUTRAL] 25.
[AGENT][NEUTRAL] 563.
[AGENT][NEUTRAL] But it's just not.
[AGENT][NEUTRAL] Let's see so
[AGENT][NEUTRAL] Thank you so much for your patience with me, [PII]. I'm so sorry about that. OK, so what we'll have to do is I do show that the claim was just submitted for Mr. um, [PII]. Um, what we have to do is request that refund of 60, excuse me, $29 for the wife for that data service.
[CUSTOMER][NEUTRAL] Because our checklist
[CUSTOMER][NEUTRAL] Yes, OK, yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, I haven't we have, I haven't done anything with it, so can I just mail it back to you?
[AGENT][NEUTRAL] OK, give me one second so I just make to verify that check number with you, um, 203-374-6.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes
[AGENT][NEUTRAL] That was on the [PII]. OK, can I place you back on hold, [PII], and again, thank you for your patience. OK, thank you.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] OK, thank you, Ms. [PII]. If you could, yes ma'am, if you could mail that back to us and with a note stating that that the insurer was not seen on that date of service.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, yes ma'am, and I can provide you that mailing address please.
[CUSTOMER][NEUTRAL] OK, go ahead.
[AGENT][NEUTRAL] OK, it will be [PII].
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] OK, say that again.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] I'm sorry, that would be [PII], [PII].
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] is it on?
[CUSTOMER][NEUTRAL] OK, and just put the insured not seen, is there a reference number?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] It will be my name, [PII]. My last initial is [PII]
[CUSTOMER][NEUTRAL] Bye
[AGENT][NEUTRAL] And today's date please and I'll make a notation in it as well.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] And can I just re-verify that that mailing address with you? I'm sorry because I was talking, I'm sorry. OK, that was, um, [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] [PII], yes, ma'am.
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, I think I've got it and I'll just um.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Uh, it's the EOB and the check attached, so I'll just, um, we put it mailed back to you. I appreciate it. Thank you so much.
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] I appreciate you. Thank you very much for your patience with me. Thank you.
[CUSTOMER][POSITIVE] Yeah sure no worries OK alright bye.
[AGENT][NEUTRAL] Yes sir bye bye.