AccountId: 011433970860
ContactId: e0c172ec-55a7-4f3c-a484-3a9e73c9a5be
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 367700 ms
Total Talk Time (AGENT): 128481 ms
Total Talk Time (CUSTOMER): 144243 ms
Interruptions: 1
Overall Sentiment: AGENT=1.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/31/e0c172ec-55a7-4f3c-a484-3a9e73c9a5be_20250131T15:58_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hey [PII], my name is [PII]. I'm calling you from the Spine Hospital of Louisiana.
[CUSTOMER][NEUTRAL] I'm actually calling you in reference to an overpayment that was an overpayment that was made uh by you guys and a rep there said that she would.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Let's see what she said.
[CUSTOMER][NEUTRAL] She told us to allow 7 to 10 business days. This was in [PII].
[AGENT][NEUTRAL] Oh my.
[CUSTOMER][NEGATIVE] And you guys, you guys have never recouped or send refund requests or anything. Can I give you the patient information?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Yes please Miss [PII] first can I get your call back number though in case our call is disconnected?
[CUSTOMER][NEUTRAL] Yes, [PII].
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] It's a direct line.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Thank you, ma'am. And then what is the patient's name?
[CUSTOMER][NEUTRAL] [PII], date of birth [PII].
[AGENT][NEUTRAL] OK, and what's [PII]'s policy number?
[CUSTOMER][NEUTRAL] 01262595
[AGENT][NEUTRAL] OK, let me look that up real quick.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what was the claim number for [PII]?
[CUSTOMER][NEUTRAL] The claim number let's see.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] Hold on, she didn't put a claim number in here.
[CUSTOMER][NEUTRAL] Hold on, let me see if I can refer to an EOB because I don't know any claim number.
[AGENT][NEUTRAL] Yes ma'am.
[CUSTOMER][NEUTRAL] Hold on, let's see.
[CUSTOMER][POSITIVE] Let's get out of that. Let's go here.
[CUSTOMER][NEUTRAL] Bear with me I'm searching through some.
[AGENT][POSITIVE] OK, that's all right.
[CUSTOMER][NEUTRAL] Prior ELBs um here it is, it looks to be.
[CUSTOMER][NEUTRAL] OK, let me put my eyes on claim number here it is 3346543.
[AGENT][NEUTRAL] OK, let me pull up that claim real quick.
[CUSTOMER][NEUTRAL] That was.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, that's fine.
[CUSTOMER][NEUTRAL] See if they gonna fix us a nice hearty meal, Miss [PII].
[CUSTOMER][NEGATIVE] See, the patient had a primary insurance and then you guys paid but you overpaid.
[CUSTOMER][NEUTRAL] You overpaid by $571.57.
[AGENT][NEUTRAL] Oh, what was that amount? $551 and
[CUSTOMER][NEUTRAL] But the rep that 5 571 571 and 57 cents.
[CUSTOMER][NEUTRAL] 571 57
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Alright, so what I'm gonna do is, um, can you give me, give me the check number please?
[CUSTOMER][NEUTRAL] I just had it. Hold on, I'm gonna tell you all of that that number on that explanation it looks to be.
[AGENT][NEUTRAL] OK
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] 18060007
[AGENT][NEUTRAL] OK, what I'm gonna do is I'm gonna.
[AGENT][NEUTRAL] I gathered all this information so I could go ahead and transfer you on over to the claims department so that you can speak to an examiner. I'm gonna give them the information that you gave me so that you don't have to repeat that again and look it up again.
[AGENT][NEUTRAL] So it's going to be a brief hold while I transfer you on over, and what was the name of your facility one more time, please?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] That's fine. That's fine Hospital of Louisiana.
[AGENT][POSITIVE] OK, thank you so much.
[AGENT][POSITIVE] Alright, it's gonna be a brief hold, Miss [PII]. Thank you so much for calling APL and I hope you have a blessed weekend.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] You too.
[AGENT][NEUTRAL] Bye-bye, ma'am.
[CUSTOMER][NEUTRAL] Bye bye.
[CUSTOMER][NEUTRAL] Transferring.
[CUSTOMER][NEUTRAL] This is. How may I help you?
[AGENT][NEUTRAL] Hi, this is [PII] in the care team. I've got, um, Miss [PII] on the phone. She is with the provider's office of Spine Hospital of Louisiana.
[AGENT][NEUTRAL] She is calling because back in [PII], she said that we should have requested a refund for claim number 3346543.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] In the amount of $571.57 and the check number is 18060007.
[AGENT][NEUTRAL] For
[CUSTOMER][NEUTRAL] I see.
[AGENT][NEUTRAL] Policy, you, you've got it pulled up?
[CUSTOMER][NEUTRAL] Um, yeah, I do. Uh.
[AGENT][POSITIVE] OK, OK, cool.
[AGENT][POSITIVE] All right, well, I'm gonna go ahead and release the call and let you speak with her because she wants to make sure that we get our money back.
[CUSTOMER][POSITIVE] Oh, OK. OK, thank you. Yeah, I can.
[AGENT][POSITIVE] OK. You're welcome. Bye-bye.