AccountId: 011433970860
ContactId: 37296f57-6985-4e5e-a005-4a9c40b3299d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 282640 ms
Total Talk Time (AGENT): 135867 ms
Total Talk Time (CUSTOMER): 131848 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.5
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/05/37296f57-6985-4e5e-a005-4a9c40b3299d_20250505T17:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII] speaking. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], it's [PII] in the care team.
[CUSTOMER][NEUTRAL] I've got um Ms. [PII] on the phone. Let me give you her policy number. It's 255-088-8.
[CUSTOMER][NEUTRAL] And she's been verified.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So she was calling about um claim number 3579555 was paid $3000 to the facility with check number 2034761.
[CUSTOMER][NEGATIVE] The facility sent the check back to us because or or sent us a refund because the $3000 from what the insured is saying should have been paid to her.
[CUSTOMER][NEUTRAL] Um
[CUSTOMER][NEUTRAL] And so I looked and I saw that um they replaced the claim number I just gave you with this new 1 359-6856.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEGATIVE] And it says refund was received and no further action is needed, but the insured wants to know when is she gonna be getting her $3000 that should have been paid to her originally that the.
[CUSTOMER][NEUTRAL] Facility refunded us she's on the other line.
[AGENT][NEUTRAL] OK, let me.
[CUSTOMER][NEGATIVE] And I can't see anything in the notes that states that the check was sent to her.
[CUSTOMER][NEUTRAL] For the payment.
[AGENT][NEUTRAL] OK, so what I'm gonna do at this point is I'll go ahead and, and, uh, you can transfer her and I'm gonna send an inquiry to um the adjuster and just see if she's reprocessing that amount. She sent that out and put that note in on 52, but I don't see any further updates, so yeah.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Right. That's the same thing I.
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] was saying too, OK.
[AGENT][NEUTRAL] And what's her callback number to?
[CUSTOMER][NEUTRAL] All right, [PII].
[AGENT][NEUTRAL] Do you have her call back?
[CUSTOMER][NEUTRAL] Oh, her callback number is the one she's calling from yes [PII].
[AGENT][NEUTRAL] Uh huh.
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] You can go ahead and transfer her when you're ready, bless you.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] OK. Thanks, [PII]. Thank you. Bye-bye.
[AGENT][NEUTRAL] You're welcome, [PII].
[AGENT][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] Hello?
[AGENT][NEUTRAL] Hi Ms. [PII].
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Can you hear me OK?
[CUSTOMER][NEUTRAL] Yes ma'am mhm.
[AGENT][NEUTRAL] OK, thank you. My name is [PII]. I'm on the claims support team and uh Miss [PII] transferred you over to me um and I need to uh further investigate this issue so if you don't mind, I'm going to um I'm gonna send a message and uh wait for a reply and, and can I call you back on the number you provided us, the [PII]?
[CUSTOMER][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] That's a good number to contact you, OK, so what I'm gonna do is, um, it looks like there was some uh information added on 552, so I'm just gonna follow up which was Friday, so I'm just gonna follow up with that adjuster and make sure that that um information that we received from the provider that refund that we received is gonna be sent out to you so if you can give me a little bit of time to research that and I'll give you a call back shortly.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, uh, like I just, I just wanna make sure that I guess we're on the same page because you guys sent them the refund. They sent it back to I guess they didn't need it anymore, so the next step could be that they could get the refund back again or.
[CUSTOMER][NEUTRAL] You don't know yet.
[AGENT][NEUTRAL] Well it no it does look like they have sent them uh they sent it back to us from the provider's office so um what I'm just gonna do now is follow up with the uh adjuster who put the notes in here and just make sure that we're going to be sending out that um uh disbursement to you so just give me a little bit of time and I'll get that uh I'll get that answer for you and I'll call you back shortly.
[CUSTOMER][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] If that's OK.
[CUSTOMER][POSITIVE] Perfect. OK, thank you. That's OK, thank you.
[AGENT][NEUTRAL] Did you have any other questions at this time, Ms. [PII]?
[CUSTOMER][NEUTRAL] No, that's, that's my question. The 3000. What's happening with the 3000. Thank you.
[AGENT][POSITIVE] OK, all right, yes, yes, and I'll, uh, like I said, I'll reach back out to you shortly. Thank you for your patience. We appreciate that. Have a great day and I'll call you back shortly. Thank you. Bye bye.
[CUSTOMER][POSITIVE] Perfect.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] Alright thank you.
[CUSTOMER][POSITIVE] You too. Thank you. Bye.