AccountId: 011433970860
ContactId: 0acb5f1c-593a-4352-acc9-fb54b2d9be73
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 286190 ms
Total Talk Time (AGENT): 95091 ms
Total Talk Time (CUSTOMER): 151113 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/13/0acb5f1c-593a-4352-acc9-fb54b2d9be73_20250613T15:29_UTC.wav
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[AGENT][POSITIVE] Thank you for calling API this is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi, this is [PII], and my last name and actually is [PII] calling for Bates County Memorial Hospital to check on refund status. Please be informed that this call has been recorded and monitored for quality and training purposes. And I'm sorry, could you spell your first name, middle last name, and I should, please?
[AGENT][NEUTRAL] Sure, uh, it's [PII] and then my last initial is [PII], uh, would you mind spelling out your first name as well, please?
[CUSTOMER][NEUTRAL] You
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That's correct.
[CUSTOMER][NEUTRAL] Um, sure. My first name will be [PII]. It is [PII], and last name is [PII].
[AGENT][NEUTRAL] OK, thank you [PII] um, and I'm so sorry we're checking on a uh a claim, is that correct?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, yeah, I can check that for you. Can I get a good call back number from you first in case we're disconnected please?
[CUSTOMER][NEUTRAL] Um, sure. My callback number is [PII] direct line.
[AGENT][NEUTRAL] OK, thank you. And then, uh, do you have that policy number?
[CUSTOMER][NEUTRAL] Um, yes, the member's ID is 01835977.
[AGENT][NEUTRAL] OK and then what was the name and date of birth for the member please?
[CUSTOMER][NEUTRAL] Member's name is [PII] and the date of birth is [PII].
[AGENT][NEUTRAL] Perfect, thank you for verifying that and then uh what was the date of service for this claim, please?
[CUSTOMER][NEUTRAL] Date of service is [PII].
[AGENT][NEUTRAL] That was [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and what was that bill amount please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] But the amount is $39,688.52.
[AGENT][NEUTRAL] OK, was that the amount before or after a major medical paid?
[CUSTOMER][NEUTRAL] Um, I'm sorry, I don't have that information. We have just received a refund request letter for an overpaid amount. So I just want to know, do we need to send back that amount of the refund check or need to wait for in future offset?
[AGENT][NEUTRAL] Oh, I see. OK, you got, uh, excuse me, you've received an overpayment?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I'm sorry about the confusion. Do you have that claim number?
[CUSTOMER][NEUTRAL] Oh
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Yes, the claim number you have on the letter. It is 3567855.
[AGENT][NEUTRAL] OK thank you one moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, so I'm showing for this claim we pay the benefit of $1,074.30 is that correct?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][POSITIVE] OK, so that was, I'm sorry.
[CUSTOMER][NEUTRAL] Um, yes.
[CUSTOMER][NEUTRAL] It is $1,774.20.
[AGENT][NEUTRAL] OK, so we sent an overpayment of 10 cents?
[CUSTOMER][NEUTRAL] Uh, I'm sorry. I'm sorry. It's for 30 cents. Yes, the payment has been 10 cents and you should, uh, I'm sorry.
[AGENT][NEUTRAL] OK, OK.
[AGENT][POSITIVE] No no no you're perfectly fine, go ahead.
[CUSTOMER][NEGATIVE] Um, the overpaid amount is 10 cents and you should have been paid for $1,074.20.
[CUSTOMER][NEUTRAL] So for that overpaid amount of 10 cents, uh, do we need to send back that amount or we can we wait for the future equipment?
[AGENT][NEUTRAL] Uh, give me just a moment. I'm going to take a look because I am showing that what was submitted to us was the uh with the 30 cents. So give me just a moment, let me take a look here.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] My name is.
[CUSTOMER][NEUTRAL] Yeah yeah.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Maybe
[CUSTOMER][NEUTRAL] Um, I'm sorry, [PII], are you there? Oh, yes, the paid amount you're in, uh, yes, the paid amount you're in the OB is $1,074.30. So it's been overpaid by 10 cents.
[AGENT][POSITIVE] You're OK.
[AGENT][NEUTRAL] Go ahead, I'm sorry.
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Right, OK, I did just want to go, but excuse me, I wanted to double check what was submitted to us, um, and I do see what you're talking about with the 20 cents, so give me just a moment.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Sure.