AccountId: 011433970860
ContactId: 408b764b-3f1e-49b9-bd5a-ee3c2e205b7b
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 447230 ms
Total Talk Time (AGENT): 151561 ms
Total Talk Time (CUSTOMER): 238084 ms
Interruptions: 2
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/13/408b764b-3f1e-49b9-bd5a-ee3c2e205b7b_20250113T21:02_UTC.wav
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[AGENT][NEUTRAL] This is [PII].
[CUSTOMER][NEUTRAL] Hi Miss [PII], it's [PII] in the care team um.
[AGENT][NEUTRAL] Hey, [PII].
[CUSTOMER][NEUTRAL] Hi, I have Miss uh [PII] on the phone. I had sent a hub request in earlier for somebody to research her policy and call her back, and she did get a call back but she missed it. Um, on the notes it has [PII]. I don't know who that is.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Mm, I don't know who that is either. [PII].
[CUSTOMER][NEUTRAL] Yeah, yeah.
[CUSTOMER][NEUTRAL] I looked in teams and Google or Googled searched the name and I couldn't find but she's returning the call because she missed the call and they called it uh let's see [PII].
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] [PII] at [PII], so that's not been very much time passed.
[AGENT][NEUTRAL] OK. What's her policy number?
[CUSTOMER][NEUTRAL] Her policy number is 1,888,560.
[CUSTOMER][NEUTRAL] And on the hub request I stated that um when I told her about the claim number 355-0282.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] The claim was paid to the provider and she said that's incorrect, it should not have been paid to the provider that we've got things mixed up.
[AGENT][NEUTRAL] Mm, OK. OK, you can send her over. I can see if I can help her or find out who called her back.
[CUSTOMER][POSITIVE] OK, thank you so much and I did verify her policy and her callback number is the one that's showing up.
[AGENT][POSITIVE] OK, I appreciate it.
[CUSTOMER][NEUTRAL] OK, bye-bye.
[AGENT][POSITIVE] Bye, thanks.
[CUSTOMER][NEUTRAL] whiskey and get more money and all like that.
[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Uh, what's your name?
[AGENT][NEUTRAL] Um, my name is [PII].
[CUSTOMER][NEUTRAL] OK. [PII], hi, my name is [PII]. Uh, I'm calling. I spoke to someone, uh, this morning about my claim, and she said they would pay directly to the hospital in [PII].
[CUSTOMER][NEGATIVE] [PII]. I said, how is that when I just made a claim on the [PII], and y'all paid it in [PII]. That doesn't make sense.
[AGENT][NEUTRAL] OK, one moment. Let's see here.
[CUSTOMER][NEUTRAL] Do a
[CUSTOMER][NEUTRAL] You don't behave and see how fast I will.
[AGENT][NEUTRAL] And do you have the claim number?
[CUSTOMER][NEUTRAL] No, I don't, I don't have the claim number.
[AGENT][NEUTRAL] What's the date of service on the claim?
[CUSTOMER][NEUTRAL] Uh, [PII].
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] You mean for a [PII]?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] No, ma'am, I mean [PII].
[AGENT][NEUTRAL] Well,
[CUSTOMER][NEUTRAL] I was in a car accident.
[CUSTOMER][NEUTRAL] You what you talking about, uh, [PII] I had surgery.
[AGENT][NEUTRAL] OK, because I'm not showing actually, I'm not showing any claims on file for you for [PII].
[CUSTOMER][NEUTRAL] Y'all didn't get a fight?
[AGENT][NEUTRAL] No, ma'am. The last claim I'm showing on file for you was for a date of service [PII].
[CUSTOMER][NEGATIVE] Now they sure don't have.
[CUSTOMER][NEUTRAL] right.
[AGENT][NEUTRAL] Yeah. So you said we should have received the claim for [PII]?
[CUSTOMER][NEUTRAL] Yeah, uh, [PII], um, my, uh.
[CUSTOMER][NEUTRAL] HR person, uh.
[CUSTOMER][NEUTRAL] Said he faxed it last week.
[AGENT][NEUTRAL] Yes, ma'am. I am showing that claim, but that claim is for um [PII], not [PII].
[CUSTOMER][NEUTRAL] Why is that?
[AGENT][NEUTRAL] And
[CUSTOMER][NEUTRAL] Was it, was it for a hostel?
[CUSTOMER][NEUTRAL] Uh,
[CUSTOMER][NEUTRAL] Oh, for a car accident.
[AGENT][NEUTRAL] Yeah, these are for hos this was for the hospital charges for the service that took place on [PII]. And let's see what type of service was this for, one moment at the hospital.
[CUSTOMER][NEUTRAL] Maybe I was the wrong date, uh, uh.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yes, ma'am. It was for date of service, [PII] and the claim denied because we received the claim from the hospital first and the claim was paid to the hospital, and that's why the claim that the um that your HR person submitted for you, that's why that claim denied because we had already paid the hospital.
[CUSTOMER][NEGATIVE] Yeah, I couldn't have paid the house cause I paid the hospital bill.
[AGENT][NEUTRAL] Well, maybe you need to reach out to the hospital. Maybe they were paid twice, yeah.
[CUSTOMER][NEUTRAL] Oh, I'm telling y'all, yo.
[CUSTOMER][NEUTRAL] Ma'am, let
[AGENT][NEUTRAL] Because we, we paid them on [PII].
[CUSTOMER][NEUTRAL] Mail
[CUSTOMER][NEUTRAL] Ma'am.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] This happened by accident, car accident happened in [PII].
[CUSTOMER][NEUTRAL] But
[AGENT][NEUTRAL] OK. Well, they need to submit that claim because I'm not showing a claim on file for [PII].
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEGATIVE] I'll get, I'll get him to uh fax it over again so how can y'all pay something for.
[CUSTOMER][NEUTRAL] That happened in based on in [PII] that happened in [PII].
[AGENT][NEUTRAL] Yeah, according to the dates of service that we see on this, um, claim, it took place in [PII]. So yeah, when they send us in.
[CUSTOMER][NEUTRAL] Did it, did it show, does it show what are y'all who, what hospital you paid?
[AGENT][NEUTRAL] Yeah, for this, um, for this occurrence that took place in [PII], this was paid to, let's see.
[AGENT][NEUTRAL] Saint John, Broken Arrow.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah, see, all that is wrong, cause I had this accident in [PII].
[AGENT][NEUTRAL] Has
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] The accident took place in [PII].
[AGENT][NEUTRAL] OK. Yes, ma'am. So, yeah, they would need to submit the correct documentation to us then because according to what we have, again, this took place in [PII].
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] OK. Is there anything else that I can assist you with?
[CUSTOMER][POSITIVE] No ma'am, that'll be all thank you.
[AGENT][POSITIVE] Mhm. Thank you again for calling ATL Ms. [PII]. You have a great rest of your day. Bye.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] You too. Bye-bye.
[AGENT][POSITIVE] Mm, thank you.