AccountId: 011433970860
ContactId: 8849ef16-1f3a-41c7-ba7b-9afe63b0a372
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 200880 ms
Total Talk Time (AGENT): 71128 ms
Total Talk Time (CUSTOMER): 57941 ms
Interruptions: 1
Overall Sentiment: AGENT=0.2, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/22/8849ef16-1f3a-41c7-ba7b-9afe63b0a372_20250522T16:49_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], how you doing?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm good. It's [PII]. Um, can you help me with this refund claim?
[AGENT][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, it's policy number 20064887.
[AGENT][NEUTRAL] Part one.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, the, the original claim is 3595515.
[AGENT][NEUTRAL] Uh, 5515. OK, so we originally paid 264.
[CUSTOMER][NEUTRAL] And then that last
[AGENT][NEUTRAL] Midli claim, OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] I found the letter in OnBase explaining why we need the refund, but it's to the patient. Am I supposed to be telling this to the provider?
[CUSTOMER][NEUTRAL] Because the provider is on the line.
[CUSTOMER][NEUTRAL] I just didn't know if I was allowed to tell the provider.
[AGENT][NEUTRAL] 5515 well we paid the provider initially.
[AGENT][NEUTRAL] So the refund, so the insured will also get a letter?
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] But
[AGENT][NEUTRAL] Yeah, hang on let me pull this up and kinda see what's going on here.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] Alright, we're requesting $91.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] 173 and 91.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, I see the one for the provider here. I just clicked on the one for the patient.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] So, oh, OK, so we're requesting a refund for that G code because that's not a covered service, so we wouldn't have covered, we wouldn't have provided payment for that $91 that would have been paid, so that's why.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEGATIVE] Because we're we're not gonna pay benefits for non-covered services.
[CUSTOMER][NEUTRAL] OK. I just didn't.
[CUSTOMER][NEUTRAL] Right, OK, I just clicked on the page and I'm like, should I tell them this, but I didn't see the, I didn't see this letter here for the provider, so I'm like, I don't know if I could tell them or not. OK. Well, thank you.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Yup.
[AGENT][POSITIVE] You're welcome.
[CUSTOMER][POSITIVE] All right, have a good day.
[AGENT][NEUTRAL] Alright. You too.
[CUSTOMER][NEUTRAL] Bye bye.
[AGENT][NEUTRAL] Bye.