AccountId: 011433970860
ContactId: ffe1c048-16b1-4881-8de6-bbbe9c5372f5
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316989 ms
Total Talk Time (AGENT): 112188 ms
Total Talk Time (CUSTOMER): 134861 ms
Interruptions: 0
Overall Sentiment: AGENT=0.5, CUSTOMER=-0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/21/ffe1c048-16b1-4881-8de6-bbbe9c5372f5_20250521T21:09_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Um, yes, I was just calling from a dental office to check on a couple of claims.
[AGENT][NEUTRAL] OK. I can verify claim status for you and your name is?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And Ms. [PII], what is that policy number, please?
[CUSTOMER][NEUTRAL] 02576308
[AGENT][POSITIVE] Thank you. Give me one moment.
[AGENT][NEUTRAL] And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][POSITIVE] Thank you ma'am and give me one moment.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] [PII], [PII].
[AGENT][NEUTRAL] OK, and what was the date of service and amount of the charge or dates of service and amount of the charge?
[CUSTOMER][NEUTRAL] Yeah, so there's 47, and 56. There's the dates of service, the exact amount I don't know because we bill out our full office fees and what I reflect is the contract rate.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and this is for this year?
[CUSTOMER][NEUTRAL] So it's on.
[CUSTOMER][NEGATIVE] Yeah, uh huh, so on the 4/7 appointment date I called in on the [PII] and they said that a check was sent on [PII] for $210.40 but we never got anything.
[AGENT][NEUTRAL] OK, one moment.
[CUSTOMER][NEUTRAL] So I was like, OK, that's like over a month ago or almost a month ago. I'm like, that's weird.
[AGENT][NEUTRAL] And what's the name of the provider's office?
[CUSTOMER][NEUTRAL] Um, Henriot and Paper Dental Corp or it might say [PII]. I'm not sure what you guys have it under.
[AGENT][NEUTRAL] OK, give me one moment, excuse me.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I see.
[CUSTOMER][NEUTRAL] You know it's kind of weird too as I'm just realizing for that other data service, the 561, I just got something in the mail today and it's like giving some reason code and I can remember this happening on the other claim about waiting information to confirm eligibility from benefits and a card, whatever that means.
[AGENT][NEUTRAL] Mm.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, and then I noticed at the top it says insured [PII], but we're showing her as the insured, maybe we have something in there wrong.
[AGENT][NEUTRAL] Well, she is the spouse on the plan. He is the policyholder.
[CUSTOMER][NEUTRAL] Who's the policy?
[CUSTOMER][NEUTRAL] Oh, OK, you know what we didn't put this in right, but I don't know if that's messing you guys up or not because it looks like whoever entered it in our system put her as the policy holder.
[AGENT][NEUTRAL] No.
[AGENT][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] I need to fix that.
[CUSTOMER][NEGATIVE] Yeah, we don't even have him in our system. That's so weird.
[CUSTOMER][NEUTRAL] OK, hm.
[AGENT][NEUTRAL] Yeah, because on the 47 data service a check was mailed in the amount of 21,040. Can you verify that mailing address to make sure we have it correct?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, and that's the address we have. So I'll send a, yes, ma'am. I'll send a request to have a check verification. If the check has not cleared, then they'll void and reissue.
[CUSTOMER][NEUTRAL] Do you have the suite number?
[AGENT][NEUTRAL] Uh, but the other date you said was for [PII] for her?
[AGENT][NEUTRAL] OK, yeah, and that one we're waiting eligibility, um, benefits in a card is.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] What does that mean?
[AGENT][NEUTRAL] Benefits in a card is the one that facilitate the policies with the insurance group and so we're waiting for them to send us information showing the patient was eligible for the data service.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And once they send that information, then the claim would be released.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, so just the the basically that one's OK, just wait on it. The other one you'll reissue the check.
[AGENT][NEUTRAL] Um, I'll send a check verification if it hasn't, um, cleared, then they'll.
[AGENT][NEUTRAL] Board and reissue.
[CUSTOMER][NEUTRAL] OK, OK, and could I get a reference number for our call?
[AGENT][NEUTRAL] Uh, if you like, you may use my name at today's date.
[CUSTOMER][NEUTRAL] Tell me your name again?
[AGENT][NEUTRAL] It's [PII], last initial [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right, very good, thank you so much.
[AGENT][POSITIVE] Alright, yes ma'am, thank you for calling APL. Have a great day, Miss [PII].
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye.