AccountId: 011433970860
ContactId: 38946d94-d759-4df3-8419-17725f9c06ff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 393739 ms
Total Talk Time (AGENT): 106755 ms
Total Talk Time (CUSTOMER): 200581 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0.4
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/09/38946d94-d759-4df3-8419-17725f9c06ff_20250409T14:50_UTC.wav
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[AGENT][NEUTRAL] This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hi Ms. [PII], this is [PII]. I've got a provider on the phone. She is calling about policy number 1656458.
[CUSTOMER][NEUTRAL] And she is calling at number 3.
[CUSTOMER][NEUTRAL] The
[AGENT][NEGATIVE] The phone's cutting out. I can't hear you.
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] 2024 but it came back on the EOB as 318.
[AGENT][NEGATIVE] I didn't get any of that. Your phone cut out. I didn't get the claim number or anything.
[CUSTOMER][NEUTRAL] I'm sorry.
[CUSTOMER][NEUTRAL] I'm sorry Ms. [PII], the claim number is 3582373.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEGATIVE] And she's calling because the day the service on the claim is incorrect.
[CUSTOMER][NEUTRAL] She um said the data service. Can you hear me, Ms. [PII]?
[AGENT][NEUTRAL] Yeah, I can hear you now.
[CUSTOMER][NEUTRAL] OK, she said the data service should be 3-18 of [PII], which is what she sent in but the claim came back with data service 318 of [PII].
[CUSTOMER][NEUTRAL] And she just needs to speak to somebody about that.
[AGENT][NEUTRAL] OK, I'll have to send in a hub to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, if we can just give her some kind of answer, thank you so much for helping.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] This is [PII]. May I help you?
[CUSTOMER][NEUTRAL] Hello, my name's [PII] and I'm calling from a um a provider's office, and I just have a question about an EOB and a correction I need to make.
[AGENT][NEUTRAL] OK, [PII], do you have a callback number and in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] It's [PII].
[AGENT][NEUTRAL] OK, and she gave me the policy number. What was the patient's name?
[CUSTOMER][NEUTRAL] [PII] [PII].
[AGENT][POSITIVE] Thank you, [PII].
[AGENT][NEUTRAL] And she was saying it had the wrong data service on it.
[CUSTOMER][NEUTRAL] Yeah, so, um, we submitted a claim for date of service [PII], but when we received the, um, EOB, it had [PII] is the year, so I need to see about how how to get that corrected to the correct date of service.
[AGENT][NEUTRAL] OK, do you have the check?
[CUSTOMER][NEUTRAL] The check?
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Um, I mean, we, we cashed it.
[AGENT][NEUTRAL] OK, we'll have to ask for a refund and then process it under.
[CUSTOMER][NEUTRAL] Oh, you guys can't just correct the date of like can you guys not like reference the original claim that we sent and just correct the date since you guys are the ones that.
[AGENT][NEUTRAL] No, ma'am, we can't I don't think we can correct the data service, but I can find out and give you a call back we may.
[CUSTOMER][POSITIVE] Because we because um because we build it correctly so it's not like a mistake on our part.
[AGENT][NEUTRAL] Right, I know, but to correct the history, we'll probably have to ask for a refund.
[CUSTOMER][NEUTRAL] Um
[AGENT][NEUTRAL] But I'll send it back to be reviewed, um, and if they have to ask for a refund, they'll send a letter.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] OK, but then will they send us our like money in exchange or like are we gonna have to.
[AGENT][NEUTRAL] Right, they'll reprocess it once we get that refund back, they'll reprocess it with the correct data service.
[CUSTOMER][NEUTRAL] OK, so, so we're gonna be without our money for 10 amount of time. I just, I mean that's fine. It just seems really unfair to us, but I mean that's whatever. Can you tell me why bye wings? Can you tell me why the bite wings were denied?
[AGENT][NEUTRAL] Right, I know it was our fault.
[AGENT][NEUTRAL] Hold on just a second and I'll look at it. It may be because of that data service. Let me get the claim pulled up.
[CUSTOMER][NEUTRAL] So there's
[CUSTOMER][NEUTRAL] Um.
[CUSTOMER][NEUTRAL] Oh, OK, we're we're gonna do [PII] yeah.
[CUSTOMER][NEUTRAL] Um, [PII]:40 we can do 9:40, yeah.
[CUSTOMER][NEUTRAL] I was gonna put in my.
[AGENT][NEUTRAL] That was on [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Oh, OK, OK, got you, yeah, 9:45, but it is actually.
[AGENT][NEUTRAL] Let's see, so it's [PII] and.
[AGENT][NEGATIVE] It was because she put in the wrong date of service.
[AGENT][NEUTRAL] It should be paid once they change that date of service to [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] I'll put um detailed notes in here and I mean but you guys will reprocess it automatically with the right date of service and issue our check there's nothing we have to do I just wanna be very clear about that.
[AGENT][NEUTRAL] Right.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] I will send it back for them to reprocess and get it.
[CUSTOMER][NEUTRAL] OK, alright, I will, um, load some notes about this. Is there a reference number I need to write down?
[AGENT][POSITIVE] Correct and.
[AGENT][NEUTRAL] We do not have reference numbers. You can use my name in today's date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] All right well thank you so much for your help I appreciate it.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day.
[CUSTOMER][NEUTRAL] You
[CUSTOMER][POSITIVE] Thanks you too bye.