AccountId: 011433970860
ContactId: 267d37b1-d2c6-4aad-9afb-5b2ae6955ee3
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 270040 ms
Total Talk Time (AGENT): 130978 ms
Total Talk Time (CUSTOMER): 68293 ms
Interruptions: 0
Overall Sentiment: AGENT=1.5, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/20/267d37b1-d2c6-4aad-9afb-5b2ae6955ee3_20250320T20:17_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII]. I have a question on a claim.
[AGENT][NEUTRAL] OK, what is your callback number, [PII]?
[CUSTOMER][NEUTRAL] My direct line is [PII].
[AGENT][POSITIVE] Thank you and spell your first name for me?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK, I have that correct. Thank you. And what is that policy number, please?
[CUSTOMER][NEUTRAL] Well, I have an ID number 60801. I don't know if that's right.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] No, that is our payer ID actually. uh, do you have a claim number perhaps?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh I think so. Let me pull it up here.
[CUSTOMER][NEUTRAL] Claim number I have here is 3569584.
[AGENT][POSITIVE] OK, thank you very much one moment please.
[AGENT][NEUTRAL] OK, that was 3569584.
[AGENT][NEUTRAL] OK, let's see.
[AGENT][NEUTRAL] OK, and verify the patient's name and date of birth.
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][NEUTRAL] OK, thank you, and that policy number should be on the EOB and it is 251-072-3 maybe pre 0 ahead of that, but I have that pulled up and that claim number, so let me look at that for you.
[AGENT][NEUTRAL] It shows lab and again you're calling in regards to this claim and how can I help you please?
[CUSTOMER][NEUTRAL] Well, the two CPT codes that you guys paid on that claim, the 88313 and the 88342.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Her primary insurance reprocessed.
[CUSTOMER][NEGATIVE] And paid on those two codes, so now we're overpaid.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK, so we'll get that. We'll request a refund then. OK, let me just take a look at something real quick here, [PII]. I'm sorry, one moment.
[CUSTOMER][NEUTRAL] That's fine.
[AGENT][NEUTRAL] So I'll get through real quick.
[AGENT][NEUTRAL] OK, so that is procedure codes 88313 and 88342.
[AGENT][NEUTRAL] 883138031. I'm just talking to myself out loud here maybe 31.
[AGENT][NEUTRAL] And then 103 28 for the other.
[AGENT][NEUTRAL] 842.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Yeah
[AGENT][NEUTRAL] OK, I appreciate your patience. Uh, we will have to the adjuster will have to request the refund.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And
[AGENT][POSITIVE] That process may start as early as tomorrow. If not, it'll be the first part of next week, but we appreciate you calling us to informing us to let us know that it was reprocessed and paid by the primary, so we'll have to of course recoup that money. I'm sorry and thank you for that information.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yep, no, that's, that's what I what I wanted, so my, my credit goes away.
[AGENT][POSITIVE] OK, yes, of course.
[CUSTOMER][NEUTRAL] OK, could I just get a reference number for our call today, please?
[AGENT][NEUTRAL] We do not use reference numbers. You can use my name. No problem. Use my name [PII] last initials [PII], and today's date please.
[CUSTOMER][NEUTRAL] Oh, OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, we will wait for that letter and get that sent back when we get the letter.
[AGENT][POSITIVE] OK, thank you very much appreciate that [PII].
[CUSTOMER][POSITIVE] OK. Thank you. Bye-bye.
[AGENT][POSITIVE] Thank you.
[AGENT][POSITIVE] Bye bye thanks for calling APO.