AccountId: 011433970860
ContactId: edffdb2f-5bb7-42be-9e69-a8793c94d9d1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 281619 ms
Total Talk Time (AGENT): 136356 ms
Total Talk Time (CUSTOMER): 66476 ms
Interruptions: 1
Overall Sentiment: AGENT=1.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/27/edffdb2f-5bb7-42be-9e69-a8793c94d9d1_20250227T18:12_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], this is [PII] from University Dental Care. I'm calling on a claim.
[AGENT][NEUTRAL] OK, [PII], you're needing to check claim status, is that correct?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][POSITIVE] Yes, ma'am. I can help you with that. And what is a good callback number for you, please?
[CUSTOMER][NEUTRAL] Um, [PII].
[CUSTOMER][NEUTRAL] Oh.
[AGENT][NEUTRAL] Thank you. And what is the member's policy number, please, [PII]?
[CUSTOMER][NEUTRAL] 02495609
[AGENT][NEUTRAL] OK, thank you. One moment, please.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, and [PII], any information that I do provide for you today would be a verification of benefits and not a guarantee of payment. What is your patient's name and their date of birth?
[CUSTOMER][NEUTRAL] Um, it's [PII] and it's [PII]. Birthday [PII].
[AGENT][NEUTRAL] Mhm. Mhm.
[AGENT][NEUTRAL] OK, thank you. And the date of service and total bill amount, please?
[CUSTOMER][NEUTRAL] Data service is 129-2024. The the total amount is 168.
[AGENT][NEUTRAL] OK, thank you. One moment.
[CUSTOMER][NEUTRAL] Don't stop.
[AGENT][NEUTRAL] OK, so this claim was received, [PII] on [PII] and it was processed on the same date.
[AGENT][NEUTRAL] The claim number for this is 3543782.
[AGENT][NEUTRAL] This claim has been denied at this point, [PII]. The remarks state our records indicate that premium for this service date was not received. Therefore, benefits are not payable.
[CUSTOMER][NEUTRAL] What's that mean, hon?
[AGENT][NEUTRAL] That means that as of now we are still awaiting the premium for this service date from the
[AGENT][NEUTRAL] From the member
[CUSTOMER][NEGATIVE] So they're not paying their insurance.
[AGENT][NEGATIVE] As of now, we have not received the confirmation.
[AGENT][NEUTRAL] Of that being received from the employer at this time.
[CUSTOMER][NEUTRAL] So they
[CUSTOMER][NEUTRAL] It's from the employer, OK.
[AGENT][NEUTRAL] Mhm. Yes. So once that has been
[CUSTOMER][NEUTRAL] So that's that's the that's the only way you can get this paid correct?
[AGENT][NEUTRAL] Correct. Yes, ma'am. So once we receive that confirmation, then
[AGENT][NEUTRAL] The con the claim would continue to be processed.
[CUSTOMER][NEUTRAL] OK, I don't know how to get that.
[AGENT][NEUTRAL] And if you need a cop and if you need a copy of that explanation of benefits with those remarks on there, you can print it directly from our portal [PII] by going to [PII].
[CUSTOMER][NEUTRAL] What is it?
[AGENT][POSITIVE] Secured.
[CUSTOMER][NEUTRAL] OK so.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] I'm, I'm just secure what?
[AGENT][NEUTRAL] It's secured. Make sure you put ad on there. [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][POSITIVE] OK, thank you very much.
[AGENT][POSITIVE] Well, you are certainly very welcome. Is there anything else that I can help you with?
[CUSTOMER][NEUTRAL] No, that's it.
[AGENT][POSITIVE] OK, [PII]. Well then, thank you again for calling APL and I hope you have a great rest of your day.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][POSITIVE] Yes, ma'am. Thank you. Bye-bye.
[CUSTOMER][NEUTRAL] Bye.