AccountId: 011433970860
ContactId: ccc97be7-8649-4fcd-9004-e74966d04157
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 124599 ms
Total Talk Time (AGENT): 38940 ms
Total Talk Time (CUSTOMER): 93550 ms
Interruptions: 4
Overall Sentiment: AGENT=1.7, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/14/ccc97be7-8649-4fcd-9004-e74966d04157_20250414T12:42_UTC.wav
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[AGENT][POSITIVE] Thanks for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hey [PII], it's [PII]. I just have a quick question. How are you today? First off, I'm good, thank you. So I have a provider on this line who they filed a claim back in the fall. We paid the $50 benefit on it, but she's saying that they filed it incorrectly. It was should have been a $300 copay instead of a $50 so she's.
[AGENT][POSITIVE] Sure. Good. How are you?
[CUSTOMER][NEUTRAL] And does she need to submit an entirely corrected claim with a correct EOB or just the EOB?
[AGENT][NEUTRAL] Uh oh. You were breaking up. You, you cut out there for a minute. You had cut out there briefly.
[CUSTOMER][NEUTRAL] I don't know what's wrong with this phone system and I'm sorry, it's the phone system I called I see. They can't help me, so I don't know what to do. Um, OK, we process the claim.
[AGENT][NEUTRAL] So I've missed some of what you said. OK.
[CUSTOMER][NEGATIVE] OK, so we processed the claim back in the fall. We paid a $50 benefit on it. However, the provider is saying that they had initially filed it incorrectly or whatever, so that it should have been a $300.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] What they submitted should have been for 3.
[AGENT][NEGATIVE] Uh oh, I lost you again. When you get to the $300 cut out.
[CUSTOMER][NEUTRAL] $100 so she's wanting to know should it have different pilots.
[AGENT][NEUTRAL] So she's, she's saying that she should have it there was $300 benefit that they submitted versus the $50.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] On the claim
[CUSTOMER][NEUTRAL] Yeah, they need to submit it should have been a 300, right, so do they need to submit a corrected claim and new EOB or just another the EOB showing.
[AGENT][NEUTRAL] And this is the provider, correct?
[CUSTOMER][NEUTRAL] That it was 3. Yes, uh-huh, it is.
[AGENT][NEUTRAL] Yeah, we need to correct the claim with that updated EOB reflecting that out of pocket changed, yes.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK. I thought that's right, but I just wanted to double check it.
[AGENT][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, [PII]. Well, thank you so much and I hope you have a great day.
[AGENT][POSITIVE] You're welcome. You too.
[CUSTOMER][NEUTRAL] All right. Thanks. Bye-bye.
[AGENT][POSITIVE] You're welcome, bye.