AccountId: 011433970860
ContactId: f7235d65-6fb8-4678-b5d9-dbb2bcd16270
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 576320 ms
Total Talk Time (AGENT): 92566 ms
Total Talk Time (CUSTOMER): 134358 ms
Interruptions: 0
Overall Sentiment: AGENT=1.3, CUSTOMER=-1.6
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/21/f7235d65-6fb8-4678-b5d9-dbb2bcd16270_20250121T16:57_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling from Doctor for Cory's office.
[CUSTOMER][NEUTRAL] Hey this is [PII]. I'm calling you.
[AGENT][NEUTRAL] I can.
[CUSTOMER][NEUTRAL] I'm sorry, dear?
[AGENT][POSITIVE] How can I assist you today?
[CUSTOMER][NEUTRAL] We have a patient who submits her claims to you guys and for some reason she was told that a check was issued here we never received it and then she said to call and tell you guys to resend the check because we never received it um can I give you the claim number or her ID number?
[AGENT][NEUTRAL] Can I have a callback number for you just in case the call is disconnected?
[CUSTOMER][NEUTRAL] Oh sure honey [PII].
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And what is the policy number, [PII]?
[CUSTOMER][NEUTRAL] It is 450759.
[AGENT][NEUTRAL] And what is the member's name and date of birth?
[CUSTOMER][NEUTRAL] It is uh her name is [PII].
[CUSTOMER][NEUTRAL] And let me get her date of birth for you.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you. And what is the date of service she's inquiring about?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Let me pull up the policy, the claim to verify what's going on.
[CUSTOMER][NEGATIVE] I think she said it was $40 but like I said we never received it.
[CUSTOMER][NEGATIVE] And so she's trying to get reimbursed, but for some reason you know that she's come here for years we've never had anything ever be sent directly to us from you guys.
[CUSTOMER][NEUTRAL] But didn't we make it.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] I see all of her claims have been sent to her.
[CUSTOMER][NEUTRAL] I think that's a.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Or sometimes down here too, but I think it's.
[CUSTOMER][POSITIVE] Just because I can uh maybe you put it like in a great.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Let me just see here they are.
[AGENT][NEUTRAL] 2010842
[CUSTOMER][NEUTRAL] I have a, I have a
[AGENT][NEUTRAL] Not sure why I was signed. I'm looking up the claim itself to make sure that the assignment of benefits are not signed.
[CUSTOMER][NEUTRAL] Say that again honey.
[AGENT][NEUTRAL] I was looking up the claim to verify if the assignment of benefits had a signature on it and that was the reason we sent the check to you, but I don't see one.
[CUSTOMER][NEUTRAL] Oh, I see.
[CUSTOMER][NEGATIVE] Yeah, because we never ever, we, we weren't looking for it, but because we never got anything before from you guys.
[AGENT][NEUTRAL] May I place you on a brief hold?
[CUSTOMER][POSITIVE] Yeah, go right ahead, honey.
[AGENT][POSITIVE] Thank you, I'll be right back.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] Signature.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][NEUTRAL] 37.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEGATIVE] You are on hold.
[CUSTOMER][NEUTRAL] Back at you I always saying.
[AGENT][POSITIVE] Thank you for holding. I apologize for the inconvenience, [PII]. So I've sent that information over to the adjuster for her to review and reprocess the claim and submitted to the insured.
[CUSTOMER][NEUTRAL] Yes,
[CUSTOMER][POSITIVE] Oh, OK, so you OK, perfect, honey, we appreciate it so.
[AGENT][NEUTRAL] Let me give you a check number. It shows that it's outstanding. Let me give you a check number so you can verify if it's in your system or not just in case you have to send a refund letter. It's 2010842. That's 2010842.
[CUSTOMER][NEUTRAL] Yeah, because we
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And when was it issued?
[AGENT][NEUTRAL] The check was issued [PII].
[CUSTOMER][NEUTRAL] Alright, let me do a quick search hold on dear.
[CUSTOMER][POSITIVE] We appreciate your patience while waiting and assure you that assistance is just a moment away. Your call is very important to us and we look forward to speaking with you.
[CUSTOMER][NEUTRAL] Yeah, no, honey, we don't have any amount for $40 during that time period, so.
[AGENT][POSITIVE] All righty. Is there anything else that I can assist you with?
[CUSTOMER][NEUTRAL] Alright, so you guys are gonna, how long does that normally take?
[AGENT][NEUTRAL] I'm not sure because I wasn't the adjuster who processed dental claims.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But I did send it over to the adjuster.
[CUSTOMER][POSITIVE] OK honey thank you so much.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL and have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.