AccountId: 011433970860
ContactId: eaa580e6-a446-407d-9895-92c239e0f7f2
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 583799 ms
Total Talk Time (AGENT): 250231 ms
Total Talk Time (CUSTOMER): 237842 ms
Interruptions: 3
Overall Sentiment: AGENT=1.2, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/24/eaa580e6-a446-407d-9895-92c239e0f7f2_20250124T17:04_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] [PII], my name is [PII]. I'm calling you on behalf of provider office for dental claim status.
[AGENT][NEUTRAL] OK
[AGENT][POSITIVE] It would be my pleasure to assist you. Can you spell your name for documentation, please?
[CUSTOMER][NEUTRAL] Extension.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Patient name I have is
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][NEUTRAL] Can you spell your name for documentation please?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] And a callback number?
[AGENT][NEUTRAL] Thank you. And what is the policy number for the patient?
[CUSTOMER][NEUTRAL] 025365557
[AGENT][NEUTRAL] Like
[AGENT][NEUTRAL] And what is the patient's name again and date of birth, please?
[CUSTOMER][NEUTRAL] in
[CUSTOMER][NEUTRAL] [PII]. Date of birth is [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And I understand you're needing dental claim status and it would be my pleasure to assist you. What is the date of service, please?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I'm looking for date of service [PII].
[CUSTOMER][NEUTRAL] You're getting
[AGENT][NEUTRAL] And what is the facility name please?
[CUSTOMER][NEUTRAL] Sure, it is Hickory Creek Dental Group and Orthodontics.
[AGENT][NEUTRAL] Like
[AGENT][POSITIVE] Alright thank you and I'm checking that claim for you bear with me.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] one
[AGENT][NEUTRAL] [PII], I'm showing that we received that claim on 11-62024.
[CUSTOMER][NEUTRAL] to
[AGENT][NEUTRAL] The claim was processed on 117-2024.
[CUSTOMER][NEUTRAL] I
[AGENT][NEUTRAL] With a payment of $342.60 to Hickory Creek Dental Group and Orthodontics.
[CUSTOMER][NEUTRAL] All right. So have you made the payment for the 015003300210?
[AGENT][NEUTRAL] Let me check
[AGENT][NEUTRAL] Yes, sir, we did.
[CUSTOMER][NEUTRAL] OK. Now, my question is this claim was processed as an in-network or out of network?
[AGENT][NEUTRAL] So the policy participates in the Carrington PPO network, but it's not required for benefit payment.
[CUSTOMER][NEUTRAL] So it was processing network, right?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] And how much was paid?
[AGENT][NEUTRAL] $342.60.
[CUSTOMER][NEUTRAL] OK, so this payment was paid as an in-network provider 3402 60, right? On which date?
[AGENT][NEUTRAL] On [PII], I'm sorry, 11-7-2024.
[CUSTOMER][NEUTRAL] OK, paid with the single check, bulk check, or it was an EFT payment?
[AGENT][NEUTRAL] Single paper check.
[CUSTOMER][NEUTRAL] Check number.
[AGENT][NEUTRAL] 2012422.
[CUSTOMER][NEUTRAL] Check was sent at which address.
[CUSTOMER][NEGATIVE] They don't have any actual policy.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Check if gastro still outstanding.
[AGENT][NEUTRAL] Cleared on [PII].
[CUSTOMER][NEUTRAL] [PII]. And the claim number?
[AGENT][NEUTRAL] Claim number 352-3501.
[CUSTOMER][NEUTRAL] Can you fax this EOB at our fax number?
[AGENT][NEUTRAL] Bear with me one moment.
[AGENT][NEUTRAL] We also have a provider portal at secured.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII], that is actually the quickest way to get an EOB.
[CUSTOMER][NEUTRAL] Alright
[CUSTOMER][NEUTRAL] You cannot fax it over.
[AGENT][NEUTRAL] I'm faxing it over for you just wanted to give you that option.
[CUSTOMER][NEUTRAL] OK, and also one more patient under the same ID?
[AGENT][POSITIVE] OK, if you don't mind holding just one moment, and that takes me a minute to get that fax ready for you, so bear with me just one moment. Thank you.
[CUSTOMER][NEUTRAL] So,
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And can I put this fax to your attention, [PII]?
[CUSTOMER][NEUTRAL] Yes, that's fine.
[AGENT][NEUTRAL] Alright thank you give me just a moment and then I'll get that fax number.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Are you
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] [PII] and I'm ready for that fax number. What is that?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, one moment and just to verify that fax number [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah his name is uh.
[AGENT][POSITIVE] All right, [PII], that is on the way for you.
[AGENT][POSITIVE] And it would be a pleasure to assist you with additional claim status for a different patient.
[AGENT][NEUTRAL] And I am ready for that, uh, claim number whenever, I'm sorry, the policy number whenever you're ready.
[CUSTOMER][NEUTRAL] Same, same policy, just the patient is different.
[AGENT][NEUTRAL] OK. And what is the patient's name?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] And what is that date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] All right thank you you did a great job on that name.
[CUSTOMER][NEUTRAL] Yes, it's a very huge name.
[AGENT][NEGATIVE] I could, I don't think I could have done that.
[AGENT][POSITIVE] Good job. What is that data service?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Date of service I have is [PII].
[AGENT][NEUTRAL] Same and the same provider, correct?
[CUSTOMER][NEUTRAL] Yes, same provider.
[AGENT][POSITIVE] Alright thank you one moment.
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] That claim we received on [PII].
[CUSTOMER][NEUTRAL] Oh
[AGENT][NEUTRAL] And processed on [PII], there was a payment of $500 made to Hickory Creek Dental Group.
[CUSTOMER][NEUTRAL] And I'm gonna
[CUSTOMER][NEUTRAL] 649.
[CUSTOMER][NEUTRAL] OK. On, uh, which date you made the payment, [PII]?
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Let's
[CUSTOMER][NEUTRAL] [PII] single check or bulk check?
[AGENT][NEUTRAL] Single?
[CUSTOMER][NEUTRAL] What's the check number?
[AGENT][NEUTRAL] 201
[CUSTOMER][NEUTRAL] OK
[AGENT][NEUTRAL] 3470.
[CUSTOMER][NEUTRAL] Check was sent at same address provider address, right? and cash date.
[AGENT][POSITIVE] That is correct.
[AGENT][NEUTRAL] Uh, [PII].
[CUSTOMER][NEUTRAL] [PII], OK.
[AGENT][NEUTRAL] And it's the same information.
[CUSTOMER][NEUTRAL] Just bear with me.
[AGENT][NEUTRAL] As far as network and everything.
[CUSTOMER][NEUTRAL] Claim number, please? Sure.
[AGENT][NEUTRAL] Claim number 352.
[AGENT][NEUTRAL] 9871.
[CUSTOMER][NEUTRAL] $700.
[CUSTOMER][NEUTRAL] Can you fax this UB at our fax number, please?
[AGENT][POSITIVE] I'm working on that right now for you, bear with me just one moment please.
[CUSTOMER][NEUTRAL] OK. Uh, at least uh once you fax the EOP, like how much time it takes to receive that?
[AGENT][NEUTRAL] It just depends. That other one is already on the way for you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] So I would say within the next 10 to 15 minutes easily just depends on how long it takes to get to you and again with that um portal then you have instant access to ELBs and claim status.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] All right. So have you faxed that?
[AGENT][NEUTRAL] As an option.
[AGENT][NEUTRAL] Yeah give me just one moment, please.
[CUSTOMER][NEUTRAL] So, once you are done, just let me know, OK?
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And that's the same fax number, right?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][POSITIVE] Perfect, let's see.
[CUSTOMER][NEUTRAL] No
[CUSTOMER][NEUTRAL] Uh
[AGENT][POSITIVE] All right, that is on the way for you.
[CUSTOMER][POSITIVE] I like.
[AGENT][NEUTRAL] Anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] No, that's fine. Thank you very much for all the information which you provided today. Just give me the reference number on this call.
[AGENT][NEUTRAL] The reference number would be my name and today's date, and I spell my name [PII].
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] The.
[AGENT][POSITIVE] And [PII], it was a pleasure to assist you with that claim status today. Thank you for calling APL and I hope you have a great weekend.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][POSITIVE] You too. Thank you uh very much and you have great day.
[AGENT][POSITIVE] Thank you bye bye.
[CUSTOMER][NEUTRAL] And uh may I know the reason why.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm, I'm
[CUSTOMER][NEUTRAL] Yeah