AccountId: 011433970860
ContactId: eb6af920-1af3-48cf-a243-ba4f3f2288cf
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 355350 ms
Total Talk Time (AGENT): 60622 ms
Total Talk Time (CUSTOMER): 67130 ms
Interruptions: 0
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/28/eb6af920-1af3-48cf-a243-ba4f3f2288cf_20250128T18:01_UTC.wav
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[AGENT][NEUTRAL] For calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I'm calling with Lock Family Dentistry, and I'm calling in reference to a claim.
[AGENT][POSITIVE] OK, I'll be happy to assist with the claim.
[AGENT][NEUTRAL] And what's your first name?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] [PII]? OK, and [PII], if I can get a good call back number for you?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And what is the policy number?
[CUSTOMER][NEUTRAL] Oh wait, that's my fax number.
[AGENT][NEUTRAL] Oh, I'm sorry, go ahead.
[CUSTOMER][NEUTRAL] Uh, I'm so used to giving out that [PII].
[AGENT][NEUTRAL] OK, and what is the policy number?
[CUSTOMER][NEUTRAL] 00604708.
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] [PII] and his date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that. Please be advised the verification of coverage is not a guarantee of payment. And what is the date of service?
[CUSTOMER][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] Um.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] I'm showing the CPT code 01354 was denied because it's not covered.
[AGENT][NEUTRAL] And CPT 02752.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I'm showing.
[AGENT][NEUTRAL] $50 was applied to the deductible.
[CUSTOMER][NEUTRAL] So why didn't they pay on any any more of it?
[CUSTOMER][NEUTRAL] Does it
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Yeah, it looks like they only applied.
[CUSTOMER][NEGATIVE] And there was no other explanation as to why they didn't pay anything else and they only applied $50 to the deductible, so.
[CUSTOMER][NEUTRAL] Excuse me.
[AGENT][NEUTRAL] OK, I'm gonna have to send this claim back to be reprocessed.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'm
[CUSTOMER][NEUTRAL] or do you think
[CUSTOMER][NEUTRAL] You don't have any
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] so
[AGENT][NEUTRAL] OK, I've sent that back for reprocessing. If you can allow 7 to 10 business days to get an updated EOB.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Was there anything else I can assist with today?
[CUSTOMER][NEUTRAL] Uh, I think that was it. What was your name again? I'm sorry.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] [PII], all right, thank you [PII]. I really appreciate you uh helping me with this.
[AGENT][POSITIVE] Oh my pleasure and thank you for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] You too bye bye.