AccountId: 011433970860
ContactId: fd80d0fd-7613-4e60-a775-920d84e78397
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 615799 ms
Total Talk Time (AGENT): 170203 ms
Total Talk Time (CUSTOMER): 253363 ms
Interruptions: 4
Overall Sentiment: AGENT=1.3, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/13/fd80d0fd-7613-4e60-a775-920d84e78397_20250313T15:31_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] OK
[CUSTOMER][NEUTRAL] Yes, good morning [PII]. My name is [PII] and I'm calling from a provider's office and I was just following up on a claim that I had sent back for um reconsideration uh for dental.
[AGENT][POSITIVE] Well, [PII] it would be my pleasure to assist you. What is a good callback number please, ma'am?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, [PII]. And what is the patient's policy number?
[CUSTOMER][NEUTRAL] It is gonna be 062-3765, the patient's name is [PII].
[AGENT][NEUTRAL] And what is [PII]'s date of birth?
[CUSTOMER][NEUTRAL] Um, [PII].
[AGENT][POSITIVE] All right, thank you.
[AGENT][NEUTRAL] And what was the date of service for [PII]?
[CUSTOMER][NEUTRAL] Uh, [PII] $25 for $1200.
[CUSTOMER][NEGATIVE] And they had denied it and then I talked with a rep, uh.
[CUSTOMER][NEGATIVE] [PII], uh, on the [PII] and she was sending it back through. She said she did not see why it was.
[CUSTOMER][NEUTRAL] Oh, she did say it was an incorrect code that was entered from the insurance company, not on the claim, but um it was an incorrect code on y'all's end and she was putting it back through.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Well, let me just take a look and see what's going on. Bear with me just one second.
[CUSTOMER][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] Is that Clinton Dental Care?
[CUSTOMER][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Alright, uh, give me just a second to research this if you don't mind.
[CUSTOMER][NEUTRAL] Alright.
[CUSTOMER][NEUTRAL] $20.
[CUSTOMER][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I apologize. It just takes me a minute to go through these, so bear with me.
[CUSTOMER][NEUTRAL] That's OK.
[CUSTOMER][NEUTRAL] I don't think I'm all the way back.
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][POSITIVE] I mean that that was really good.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You really need to do both of them. I, I do both.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Hey, hey, I sent you a text message. You don't look at your text messages? Well, I told you I said I said [PII].
[CUSTOMER][NEUTRAL] What he did is I got to plug in right here. Uh, but I don't know why you don't check your messages. I sent it right after I talked to you. I sent it right after I talked to you. I said [PII] had one.
[CUSTOMER][NEGATIVE] I mean I'm already almost charged.
[CUSTOMER][NEUTRAL] I'll take you back home then.
[CUSTOMER][NEUTRAL] What did uh Mr [PII].
[CUSTOMER][NEUTRAL] Hey, I'm still here. Are you looking?
[AGENT][NEUTRAL] Yes, I'm still looking.
[CUSTOMER][NEUTRAL] Oh, OK, I'm sorry. I, I, I just put it on mute so you don't hear all my conversation on this end.
[AGENT][POSITIVE] Well, I think I figured that's what you were doing, not a problem.
[CUSTOMER][NEUTRAL] OK, OK. OK, thank you, thank you. I know my phone was dying. My husband brought me a charger. Oh, OK, thanks.
[AGENT][NEUTRAL] I got.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][POSITIVE] Oh, that's funny.
[AGENT][NEUTRAL] And this is 22,740.
[AGENT][NEUTRAL] So, OK.
[AGENT][NEUTRAL] Whenever you're ready. OK.
[CUSTOMER][NEUTRAL] OK, I'm back.
[CUSTOMER][POSITIVE] Yeah, I'm ready.
[AGENT][NEUTRAL] Oh, I understand multitasking so.
[CUSTOMER][NEUTRAL] And I
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEGATIVE] I know my phone was dead.
[AGENT][NEUTRAL] And tell me what uh procedure that was for.
[CUSTOMER][NEUTRAL] It was for a 27 0 hold on.
[CUSTOMER][NEUTRAL] Do you need the claim number? I probably have that scanned and you. OK, yeah, it was for 2740.
[AGENT][NEUTRAL] I've got it pulled up.
[AGENT][NEUTRAL] I've got it pulled up.
[AGENT][NEUTRAL] I see. OK, I don't see that that has been reprocessed, but I tell you what, I'm gonna send it back to our claims department. I don't know if she sent an email or she sent a uh.
[AGENT][NEUTRAL] Reprocess notification, but what I'm gonna do, Pat, is I am putting in that request right now it'll go straight to claims.
[AGENT][NEUTRAL] And to reprocess correctly.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, perfect. That's OK. I was trying to see what code, um, she said that they used, but I don't see. Oh, it had a 2 in front of it, 22,740 instead of a 02.
[AGENT][NEUTRAL] And I do apologize. I just don't see it. I was.
[AGENT][NEUTRAL] 22 740.
[CUSTOMER][NEUTRAL] Listen, the correct code ADA is 02740, and on the denial that I got the ADA code is 22,740.
[AGENT][NEUTRAL] So
[AGENT][NEUTRAL] Right.
[AGENT][POSITIVE] And I do wanna pull up that claim just super quick. Let's just make sure we've got everything hunky dory so we can get it taken care of.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] So give me just one more quick second if you don't mind.
[CUSTOMER][POSITIVE] No, no, you're fine, thank you.
[AGENT][POSITIVE] I appreciate it.
[AGENT][NEUTRAL] Computer's coming up slowly but surely.
[CUSTOMER][NEGATIVE] I know mine didn't want to get up and go and neither did I actually.
[AGENT][NEUTRAL] I
[AGENT][POSITIVE] I'm like, I'll go get me a cup of coffee if you want one too, computer.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] I know it. That's what I'm just sitting here drinking me some coffee. I know we only worked yesterday and today and our normal hours are Monday through Thursday from [PII]. And so to make up a little bit for the first part of the week, we worked 7 to 5 and 7 to 5 a day with no lunch break. Well, we did, we did get a lunch break, you know, we just kind of eat whenever, but oh it was a long day yesterday.
[AGENT][POSITIVE] Oh my goodness.
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] With the time changed too.
[AGENT][NEUTRAL] That sounds like a, yeah, and that'll get you. Yeah, I had, uh, Monday and Tuesday off.
[AGENT][NEUTRAL] And coming back after, after time.
[CUSTOMER][POSITIVE] Oh, we did too. We enjoyed it.
[AGENT][NEGATIVE] Change was just tough.
[CUSTOMER][NEUTRAL] It was, it was hard to get up.
[AGENT][NEUTRAL] After being off 2 days and then the time changed, I'm like, wait a minute, what have I done to myself?
[CUSTOMER][NEUTRAL] I know it. I I understand, I understand.
[AGENT][NEUTRAL] All right, so I do see that and I am putting in that request right now to our claims department to reprocess the claim. I do apologize.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, that's OK. So you know, things happen and that's understandable.
[AGENT][NEUTRAL] For any inconvenience.
[AGENT][NEUTRAL] And um hopefully within 7 to 10 days, usually quicker than that, but I would give it about 7 to 10 business days.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK, alrighty and what's the reference number for this call please ma'am?
[AGENT][NEUTRAL] It's going to be my name in today's date, and I spell my name [PII].
[AGENT][POSITIVE] And it's been a pleasure to assist you. Anything else I can help you with today?
[CUSTOMER][NEUTRAL] Today's date.
[CUSTOMER][POSITIVE] OK, well thank you.
[CUSTOMER][POSITIVE] Thank you so, no, ma'am, that's all, and I appreciate your help. You have a great day.
[AGENT][POSITIVE] And thank you for calling APL. Take care. Bye-bye.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You too. All right, bye-bye.