AccountId: 011433970860
ContactId: a85651c1-c06b-4ef8-a42e-43d01b5f1c6d
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 305980 ms
Total Talk Time (AGENT): 86507 ms
Total Talk Time (CUSTOMER): 122528 ms
Interruptions: 0
Overall Sentiment: AGENT=1.1, CUSTOMER=1.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/28/a85651c1-c06b-4ef8-a42e-43d01b5f1c6d_20250328T13:06_UTC.wav
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[AGENT][POSITIVE] Good morning. Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][NEUTRAL] I'm doing well. I have a um provider on the other line who needs to speak with someone in claims um can I give you the policy number?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] It is 21754445.
[CUSTOMER][NEUTRAL] It's so it's a few different claims like they submitted it multiple times. Should I just give you the date of service?
[AGENT][NEUTRAL] Oh yes, is that on part one?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Part 3.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And it's data service [PII]?
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, total bill is $74.80. So they, they submitted it several times. They changed the amount, um, but this claim for the 7480 was denied as a due because we paid out one of the claims they sent in prior. So I've explained that to her in detail.
[CUSTOMER][NEGATIVE] Um, and she still wants to know why the 7480 was denied as a dupe.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Uh, because we already paid the 4313.
[AGENT][NEUTRAL] Uh, let's see.
[AGENT][NEUTRAL] I'll look at it and see if uh we should have paid additional amounts.
[CUSTOMER][NEUTRAL] OK, um.
[AGENT][NEUTRAL] I'll look at that one.
[CUSTOMER][NEUTRAL] Hold on 1 2nd.
[CUSTOMER][NEUTRAL] OK, you ready?
[AGENT][NEUTRAL] Uh, and what's her name?
[CUSTOMER][NEUTRAL] Her name is [PII].
[AGENT][NEUTRAL] OK, alright, you can send her on over.
[CUSTOMER][NEUTRAL] OK, thank you, [PII] hold on one moment.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Hello [PII].
[CUSTOMER][POSITIVE] Yeah, I'm still here. Thank you so much for holding. I have [PII] on the line and she'll be assisting you further, OK?
[CUSTOMER][NEUTRAL] OK, sure.
[CUSTOMER][POSITIVE] Thanks for calling EPO.
[CUSTOMER][POSITIVE] Bye bye take care.
[AGENT][POSITIVE] Alright, good morning. Thanks for calling ATO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hello, this is [PII] calling from provider's office to check up on a claim status.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] And the data service you gave me was 3 I'm sorry 10-28-2024, is that correct?
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] Yeah, that's right. Uh, before we move further, can you help me with your name? Like, can you spell out your name for me?
[AGENT][NEUTRAL] Yes, ma'am, it's [PII]
[CUSTOMER][POSITIVE] OK, thank you so much, [PII].
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, let's see.
[AGENT][NEUTRAL] And I believe she stated, you stated that the claim was denied as a duplicate.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And it's not a duplicate.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] That's right.
[AGENT][POSITIVE] OK, it looks like that is correct. Uh, what I'll do is go ahead and have this claim reprocessed for you.
[AGENT][NEUTRAL] Uh, because they are two different claims, right, was there anything else I can help you with on today?
[CUSTOMER][POSITIVE] Thank you so much.
[CUSTOMER][NEUTRAL] Like
[CUSTOMER][NEUTRAL] Uh, yeah, can you help me with the claim receive date?
[AGENT][NEUTRAL] Uh, yes.
[CUSTOMER][NEUTRAL] And in all there as well.
[AGENT][NEUTRAL] Sure.
[AGENT][NEUTRAL] OK, [PII], I'm showing that that claim was received on [PII].
[AGENT][NEUTRAL] And we uh process the claim on [PII].
[CUSTOMER][NEUTRAL] January
[CUSTOMER][NEUTRAL] [PII]. OK. OK, sure. Uh, can you help me with the turnaround time?
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Uh, that's usually anywhere from 5 to 7 business days.
[CUSTOMER][NEUTRAL] Also, can you help me with the claim number?
[AGENT][NEUTRAL] Claim number 355.
[CUSTOMER][NEUTRAL] I.
[AGENT][NEUTRAL] 1510.
[CUSTOMER][NEUTRAL] OK, and you said the turnaround time would be 30 business days?
[AGENT][POSITIVE] Yes ma'am, but we're gonna go ahead and get this one expedited for you since it was denied incorrectly.
[CUSTOMER][POSITIVE] OK, sure. Thank you so much for your help, [PII].
[AGENT][POSITIVE] OK [PII], if there's nothing else, have a great day and thanks for calling APO.
[CUSTOMER][POSITIVE] Have a great day. Bye-bye, take care.
[AGENT][NEUTRAL] Bye bye.