AccountId: 011433970860
ContactId: aaf2f980-b208-4026-b869-0351a1e98d73
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 363170 ms
Total Talk Time (AGENT): 57060 ms
Total Talk Time (CUSTOMER): 195067 ms
Interruptions: 1
Overall Sentiment: AGENT=1.7, CUSTOMER=-0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/13/aaf2f980-b208-4026-b869-0351a1e98d73_20250513T18:54_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thanks for calling APO. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey, [PII], it's [PII].
[CUSTOMER][NEUTRAL] Hi, can you hear me?
[CUSTOMER][NEUTRAL] OK, so this is, um, OK, so I have a provider's office on the line who was calling regarding a check that they say they have not received and they have been given claim status on before it does [PII] gave them claim status.
[CUSTOMER][NEGATIVE] But the problem and the reason for the transfer is they still don't have this check and they're wanting to request it to be reissued. However,
[CUSTOMER][NEUTRAL] The bill amount that she's giving me.
[CUSTOMER][NEUTRAL] Is not for the claim that we have on file. It is the same provider it is the same code. I verified that information, but she cannot come up.
[CUSTOMER][NEUTRAL] With the bill amount that's actually on the claim form that we received because I'm looking at it.
[AGENT][NEUTRAL] OK, what was the policy number?
[CUSTOMER][NEUTRAL] So the policy number is 251-5748.
[CUSTOMER][NEUTRAL] But [PII]'s note didn't have the I mean she doesn't have the amount she just gave her the claim number and the check number.
[CUSTOMER][NEUTRAL] But again,
[CUSTOMER][NEGATIVE] The bill I, I'm not requesting the check to be reissued because I just told her we have a claim for this provider in the same data service and codes but it doesn't match.
[CUSTOMER][NEUTRAL] The amount she's giving me.
[CUSTOMER][NEUTRAL] She says that on code 01 and it's part two. I'm so sorry, part two and there's only one claim on file.
[AGENT][NEUTRAL] Both the claim
[AGENT][NEUTRAL] OK. Give me just a second.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] And she's asking she she resubmit a claim. Well I wanted to get denied as a duplicate, but I'm not gonna send a a check request. I mean, if you're comfortable with doing that, but I, because she can't tell me what the bill amount on this claim is because what she's giving me is less than what the claim was for.
[AGENT][NEUTRAL] and then I'll be ready.
[CUSTOMER][NEUTRAL] Yeah, yeah, you're fine. I'm still working on my night.
[AGENT][NEUTRAL] OK, what was the provider's name?
[CUSTOMER][NEUTRAL] Um, the lady on the line, her name is [PII].
[CUSTOMER][NEUTRAL] And her callback number, [PII] is [PII].
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] And again I did not tell her how much the claim that we have on file is for. I just told her that her amounts.
[CUSTOMER][NEUTRAL] You know, so I, I'm not sending a request to have that check reissued because I can't fully verify that that's the claim.
[AGENT][NEUTRAL] It help her and
[CUSTOMER][NEUTRAL] I mean [PII] had given her their check number yeah [PII] had I mean she had the check number, the check issue date, but.
[AGENT][NEUTRAL] You said that you didn't give her the the check amount or the total amount of the.
[CUSTOMER][NEUTRAL] I did not, no, [PII] had, no, [PII] had given her the check amount and check date and all that, but I didn't give her any of that because again she's saying the total bill amount is 278.
[CUSTOMER][NEUTRAL] And the claim we have on file is for 316.
[AGENT][NEUTRAL] Right
[CUSTOMER][NEUTRAL] She says, so I don't know how to handle that.
[AGENT][NEUTRAL] OK. Well, I can go ahead and help her.
[CUSTOMER][NEUTRAL] Yeah, OK, perfect. Will you let me know how this one turns out, I mean to not hold up the phone line but and keep her on hold, but I'm curious as to how.
[CUSTOMER][NEUTRAL] This would need to be handled moving forward in this scenario.
[AGENT][NEUTRAL] In in my opinion, if, if what she's giving us is not the is not matching on the claim that we received, I'm just gonna ask her to resend it.
[CUSTOMER][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] So that we can review.
[CUSTOMER][NEUTRAL] OK, I can just, I can tell her that, [PII], if, if it's just to resubmit the claim.
[CUSTOMER][NEUTRAL] I'll tell her to do that. I just didn't want to get denied as a duplicate.
[AGENT][NEUTRAL] Yeah, and then.
[AGENT][NEUTRAL] Well, I'll notify the adjuster just to look out for it and kind of let her know kind of what's going on, but I'll just let, I, I would just say, you know, we're gonna have to review your claim because if it's not matching up then it, it's not, it may not be the same because.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Why would the amount be different?
[CUSTOMER][NEUTRAL] OK, I'll just tell her that to yes, to send it um just to resubmit the claim then.
[AGENT][POSITIVE] Thank you.
[CUSTOMER][POSITIVE] Yeah, you're welcome [PII], and I appreciate you helping me with that, OK? Yeah, there's no need for me to transfer her to you. OK, thanks. All right, bye-bye.
[AGENT][POSITIVE] Oh, you're welcome.
[AGENT][POSITIVE] OK. All right, sounds good. You're welcome. Bye-bye.