AccountId: 011433970860
ContactId: 276a2c17-759d-4c7f-9dfb-a23ac7034eac
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 316859 ms
Total Talk Time (AGENT): 179158 ms
Total Talk Time (CUSTOMER): 130669 ms
Interruptions: 0
Overall Sentiment: AGENT=1.2, CUSTOMER=1.7
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/18/276a2c17-759d-4c7f-9dfb-a23ac7034eac_20250318T16:05_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], uh, my name's [PII]. Um, I have a quick question for you. Um, I have a claim that was filed um by the hospital and they did it in error.
[AGENT][NEUTRAL] Certainly.
[CUSTOMER][NEGATIVE] Um, because they had already collected the money from me, so they have double payment. I know that you guys are not able to do a refund. I've already called before to ask about this, so I'm trying to get the refund from the hospital and what they need now from you guys is to send over an explanation of benefits for that payment that you had made to them and then they should be able to refund me the difference.
[AGENT][NEUTRAL] My goodness. OK. Um, I can help you with that. Can you give me your policy number?
[CUSTOMER][NEGATIVE] Yeah, it's a mess.
[CUSTOMER][NEUTRAL] Yeah, um, OK, it is 02585874.
[AGENT][NEUTRAL] All right. Give me one moment.
[AGENT][NEUTRAL] And let's see.
[AGENT][NEUTRAL] We'll do just a real quick get uh verification and I'll let you know that once we, I'll do the verification part and then I'll transfer you to the area that can better assist you with. I can't even see your claims. I can't see your any of your information due to HIPAA.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] Got you OK.
[AGENT][NEUTRAL] So, all right, so may I have your last name please, ma'am?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Sure, it's [PII]. It's [PII].
[AGENT][NEUTRAL] Thank you. All right, let's start by verifying your date of birth and then your address.
[CUSTOMER][NEUTRAL] Sure it's [PII].
[CUSTOMER][NEUTRAL] And my address is [PII].
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Wonderful, thank you and it looks like you're calling from the number we have on file [PII]. Alright, and so, uh, the last bit of information, may we verify your email address please, ma'am?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][POSITIVE] Correct, mhm.
[CUSTOMER][NEUTRAL] Sure it's um
[CUSTOMER][NEUTRAL] [PII].
[AGENT][POSITIVE] Wonderful. Everything does match it is up to date. OK, so what I'm going to do now, um, since we verified your information and you won't have to go back through this, I'll send you on over to, uh, where they can assist you with your claim and getting that EOB and I'll let them know that so you know that's what you're looking are calling about. Anything else I can assist you with at the moment?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][POSITIVE] OK, sounds good thank you.
[AGENT][POSITIVE] All right. Well, thank you for calling APL. Give me just a moment, I'll transfer you all through. Have a wonderful day. One moment, please. Thank you.
[CUSTOMER][POSITIVE] Alrighty.
[CUSTOMER][NEUTRAL] You too.
[CUSTOMER][POSITIVE] Thanks
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][POSITIVE] Hi, thank you for calling APL. My name is [PII]. How may I help you?
[AGENT][NEUTRAL] Hello, [PII]. This is [PII].
[CUSTOMER][NEUTRAL] Hi, [PII].
[AGENT][NEUTRAL] Hello, my dear. How are you?
[CUSTOMER][POSITIVE] How are you? I'm good. How are you doing?
[AGENT][POSITIVE] I am just wonderful, wonderful, wonderful. It's Tuesday, so we're gonna, we're.
[CUSTOMER][NEUTRAL] It went, hey, it's another day closer.
[AGENT][POSITIVE] That's right. We're, we're gonna try to be positive today and get her done.
[CUSTOMER][POSITIVE] Get her done. That's right.
[AGENT][NEUTRAL] All right, Ms. [PII], uh, let me give you the policy number 1st. 258.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][POSITIVE] I'm ready.
[AGENT][NEUTRAL] 5874. Participant number one, Ms. [PII].
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] I have verified Ms. [PII]'s information.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK. She is needing a copy.
[AGENT][NEUTRAL] Of an EOB, let's see, um.
[AGENT][NEGATIVE] She paid the claim or something and then the hospital filed the claim in error and now they've been double paid and they will not refund her the difference.
[AGENT][NEUTRAL] Until, um,
[AGENT][NEUTRAL] She gets a copy of an EOB.
[CUSTOMER][POSITIVE] Got you.
[AGENT][NEUTRAL] And I'm sorry, I did not get a date.
[CUSTOMER][NEUTRAL] I, I, I got [PII]. I got her.
[AGENT][POSITIVE] OK. You are awesome. Thank you, dear. I, I, I, I'm not even sure I even explained that to you. [PII] bless her. When she got to explain it to me. I was like, oh my.
[CUSTOMER][POSITIVE] My pleasure.
[CUSTOMER][POSITIVE] Oh, I got you.
[CUSTOMER][POSITIVE] I got you. I'm already pulling it up and I'm ready to to email it to Ms. [PII] if we can do that.
[AGENT][NEUTRAL] You are
[AGENT][NEUTRAL] You're also, yes, her information has been verified.
[CUSTOMER][NEUTRAL] Oh, I know you did, girl.
[AGENT][POSITIVE] So everything's good, it's good. So uh, you have a great day and I verified her phone number. Do you want that? It's the same.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][NEUTRAL] Is it [PII]?
[CUSTOMER][NEUTRAL] [PII], got it. I got it.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] And it's the same as the system. You're awesome. Have a great day, [PII].
[CUSTOMER][POSITIVE] Thank you, [PII]. I appreciate it. Bye-bye.
[AGENT][NEUTRAL] My dear.