AccountId: 011433970860
ContactId: 174cb9e6-8eab-428f-abab-8fce58579e6e
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 530969 ms
Total Talk Time (AGENT): 128643 ms
Total Talk Time (CUSTOMER): 152088 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=1.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/174cb9e6-8eab-428f-abab-8fce58579e6e_20250219T16:55_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] Hi, [PII]. My name is [PII] calling for Kids Medical Services Incorporated to inquire on a refund status. Please be informed that this call is being recorded and monitored for quality and training purposes.
[AGENT][NEUTRAL] Good morning, [PII]. What is a good callback number please sir?
[CUSTOMER][NEUTRAL] [PII]. No extension.
[AGENT][NEUTRAL] Thank you, [PII], and what is the policy number for the patient, please, sir?
[CUSTOMER][NEUTRAL] 244-3500.
[AGENT][NEUTRAL] Thank you and the patient's name and date of birth please, sir?
[CUSTOMER][NEUTRAL] Patient's name, [PII]. Date of birth [PII].
[AGENT][POSITIVE] Thank you.
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] And it would be my pleasure to assist you with this policy information for [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Regarding a claim, we requested for a recoupment on [PII]. So, today, we are checking if that recoupment is completed or not.
[AGENT][NEUTRAL] And what was the date of service, please?
[CUSTOMER][NEUTRAL] The service for [PII].
[AGENT][NEUTRAL] I'm checking on that, bear with me just one moment please sir.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And what is the facility name?
[CUSTOMER][NEUTRAL] Facility name is Kids Medical Services Incorporated.
[AGENT][NEUTRAL] Mhm
[AGENT][NEUTRAL] And what was the bill amount?
[CUSTOMER][NEUTRAL] $618 even?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] That was the bill amount on the poli on the claim?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] But there was a payment of $78.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And you said that was sent on.
[CUSTOMER][NEUTRAL] [PII] we also received a letter.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Dd [PII].
[AGENT][NEUTRAL] I'm checking.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] You received a letter from APL for [PII]?
[CUSTOMER][POSITIVE] Yes, that's correct.
[AGENT][NEUTRAL] And what does that letter say?
[CUSTOMER][NEGATIVE] On the letter they mentioned letters sent to provider requesting a refund of an overpayment of benefits.
[AGENT][NEUTRAL] I'm checking.
[CUSTOMER][NEUTRAL] Sure
[AGENT][NEUTRAL] And that was for the day the service of [PII]?
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] Did did y'all receive the refund request?
[CUSTOMER][NEUTRAL] Yes, we received this letter dated.
[CUSTOMER][NEUTRAL] [PII] on the second page that we received they mentioned.
[CUSTOMER][NEUTRAL] A remark description stating that.
[CUSTOMER][NEUTRAL] Letter sent to provider requesting refund of an overpayment of benefits.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] On the letter, the claim number is mentioned as 3552369.
[AGENT][NEUTRAL] Oh, what was that claim number again if you don't mind, please, sir?
[CUSTOMER][NEUTRAL] 3552369
[AGENT][NEUTRAL] Mhm.
[AGENT][POSITIVE] Thank you. I'm just trying to locate everything, bear with me just one moment.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, so it appears that the claim was originally processed.
[AGENT][NEUTRAL] For [PII].
[AGENT][NEUTRAL] And it looks like that they are requesting that refund amount now the claim has been reprocessed and paid under Victoria.
[AGENT][NEUTRAL] So
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The charge for Nicholas, they're requesting that refund amount.
[CUSTOMER][NEUTRAL] So we need to submit a refund check from our end.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Yes sir, for the claim, um, that claim number 3552369.
[AGENT][NEGATIVE] That needs to be refunded.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] Because it was paid incorrectly.
[CUSTOMER][POSITIVE] Thank you so much. Will there be any interest on the refund amount?
[AGENT][NEGATIVE] There would not be any interest, no, sir.
[CUSTOMER][POSITIVE] Thank you so much, [PII]. I have a mailing address on this letter. Can I verify that with you?
[AGENT][NEUTRAL] Yes, sir.
[CUSTOMER][NEUTRAL] American Public Life Insurance Company, [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] That is correct.
[CUSTOMER][POSITIVE] Thank you so much. That's all I need for today, [PII]. Can I have a call reference number for this call, please?
[AGENT][NEUTRAL] It would be my name and today's date, and I spell my name [PII] First initial of my last name is [PII].
[CUSTOMER][POSITIVE] Thank you so much, [PII]. That's all I need for today. Have a great day. Take care. Bye-bye.
[AGENT][POSITIVE] Mm, [PII], thank, thank you for calling APL. It was a pleasure to assist you and I hope you have a wonderful day as well. Take care.
[CUSTOMER][NEUTRAL] You too bye bye.
[AGENT][NEUTRAL] Bye bye.