AccountId: 011433970860
ContactId: 699199f2-adf4-4cb1-8b4f-9ce2e9663bec
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 238320 ms
Total Talk Time (AGENT): 66904 ms
Total Talk Time (CUSTOMER): 131044 ms
Interruptions: 1
Overall Sentiment: AGENT=0.5, CUSTOMER=0.8
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/25/699199f2-adf4-4cb1-8b4f-9ce2e9663bec_20250425T13:42_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Yes, hi, my name is [PII]. Um, I have, um, uh, received explanation of benefits on a claim that was processed, uh, through you guys, and I noticed that on two different dates, uh, you guys paid the exact same claim.
[CUSTOMER][NEUTRAL] And so I was calling to um make you guys aware that you basically paid twice the same, the same.
[CUSTOMER][NEUTRAL] You know, the same procedure, the same uh uh claim. They have the same amount, the same, uh, bill charges, the same amount that you paid, uh, but under two different claim numbers and there should only be one.
[AGENT][NEUTRAL] OK. And are you calling from the provider's office?
[CUSTOMER][NEUTRAL] No, I'm the patient.
[AGENT][NEUTRAL] OK. [PII], could I get a good callback number just in case we're disconnected?
[CUSTOMER][NEUTRAL] Yeah, [PII].
[AGENT][NEUTRAL] Thank you. Now, could I get your policy number, please?
[CUSTOMER][NEUTRAL] Hold on a second let me grab that.
[AGENT][NEUTRAL] Sure
[CUSTOMER][NEUTRAL] Sorry, I didn't have that.
[AGENT][POSITIVE] Uh, no problem.
[CUSTOMER][NEUTRAL] All right. So, uh, uh, certificate number 02145414 M as in Mary, L as in Larry 8.
[AGENT][NEUTRAL] Thank you. Now, please verify your first and last name and your date of birth.
[CUSTOMER][NEUTRAL] [PII] can, [PII].
[AGENT][NEUTRAL] OK. Thank you, [PII]. Now, please verify your mailing address and your email address.
[CUSTOMER][NEUTRAL] Mailing address is [PII] and uh oh you said email address should be [PII].
[CUSTOMER][NEUTRAL] And it's not that [PII].
[AGENT][NEUTRAL] OK, that's the one we're showing. OK, and what's the date of service for the claim you're calling about?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] And is the claim for you or one of your dependents?
[CUSTOMER][NEUTRAL] For me.
[AGENT][NEUTRAL] OK.
[AGENT][NEGATIVE] OK, yes, ma'am. I do show where that claim um paid out twice and actually the first check was not cashed by the provider. It was actually voided, so they only received one payment. Once that first check was um voided, a new check was issued to them because they never did receive that one.
[CUSTOMER][POSITIVE] Got it. OK, I was very surprised because you guys are very thorough. You're the only that you're very thorough with the claims, and I was like, I can't imagine them doing this by mistake. That, that doesn't cause I've received sometimes when people have like, you know, providers have sent, uh, uh, they, you know, they don't wanna wait too long. They they.
[AGENT][NEUTRAL] Yeah, so they were actually pay once.
[CUSTOMER][NEUTRAL] You know, resubmit it again or whatever, and then I receive notification, hey, this, this is a duplicate one. And so when I saw both of them paid, I go, 00 OK. So, so the first one is actually void and the second one is the one that counts.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right.
[AGENT][NEUTRAL] Yeah.
[AGENT][POSITIVE] That's correct. Yes, ma'am.
[CUSTOMER][POSITIVE] OK, perfect. That's all I wanted to double check.
[AGENT][NEUTRAL] OK. Is there anything else I can assist you with?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] That's it. That's it. I just wanted to make sure you didn't pay twice for one service.
[AGENT][POSITIVE] OK. Well, I thank you, [PII] for calling ATL. You have a great weekend.
[CUSTOMER][POSITIVE] You too, take care.
[AGENT][NEUTRAL] Mhm. You do the same. Mm bye