AccountId: 011433970860
ContactId: ee663d8f-d334-4424-a394-30e4c02deaed
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 408220 ms
Total Talk Time (AGENT): 195006 ms
Total Talk Time (CUSTOMER): 158703 ms
Interruptions: 0
Overall Sentiment: AGENT=1.7, CUSTOMER=0.9
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/03/12/ee663d8f-d334-4424-a394-30e4c02deaed_20250312T22:09_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling ATL. This is [PII]. How can I help you?
[CUSTOMER][NEGATIVE] Yes, I received a letter saying that um a check was sent to me in error and that you're looking for a refund on this check. However, um, when I, um, I sent this information over to my biller and she said that there is no record of such check.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh-huh.
[AGENT][NEUTRAL] Interesting. OK, so is this for your individual policy?
[CUSTOMER][NEUTRAL] No, so this is Doctor [PII]'s office, and I guess.
[AGENT][NEUTRAL] This is for a provider, OK.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][POSITIVE] Got you alright and I'm so sorry, what did you say your name was?
[CUSTOMER][NEUTRAL] My name is [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] And then really quick [PII] if you don't mind, can I get a good call back number from you in case we're disconnected?
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] OK thank you um on that check, do you happen to have the claim number that was regarding?
[CUSTOMER][NEUTRAL] It says 353-2301.
[AGENT][NEUTRAL] OK thank you one moment please.
[AGENT][NEUTRAL] Was this for? I know this is gonna sound funny, but um is this for a patient that you did see?
[CUSTOMER][NEUTRAL] No, I did not see this patient.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] What was the name of your?
[CUSTOMER][NEUTRAL] It's just saying that you.
[AGENT][NEUTRAL] I'm sorry, no, you're fine, um, just wanting to see what who was, what is the name of your provider's office? I'm sorry.
[CUSTOMER][NEUTRAL] Yeah, go ahead.
[CUSTOMER][NEUTRAL] Dr. [PII]
[AGENT][NEUTRAL] OK, so that is who we have that going to, um, but you haven't seen this patient?
[CUSTOMER][NEUTRAL] So, let me double check.
[CUSTOMER][NEUTRAL] One second, let me double check.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, yeah, no, I don't have, according to this letter, it's giving me a name of a patient that is not in our system.
[AGENT][NEUTRAL] OK, so the patient that I have here is [PII]. Is that what you're seeing on the letter?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, but you've not seen him.
[CUSTOMER][NEUTRAL] No, and and.
[AGENT][NEUTRAL] Just wanna make sure we're on the same page with everything, OK.
[CUSTOMER][NEGATIVE] Yes, exactly. And I got a letter saying that you paid me $500 for seeing this patient and that you want the money back, and I don't have any record of such a check.
[AGENT][NEUTRAL] So, OK, I see. So you've not even received this check.
[CUSTOMER][POSITIVE] Correct.
[AGENT][NEUTRAL] OK, can you verify the address for your business?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK.
[AGENT][POSITIVE] Yeah, that's where we said we've sent this check and I see that it has cleared so yeah this is a bit of an interesting situation. OK, well I'm so sorry for the confusion um even if you don't mind I'm gonna put you on a brief hold I'm gonna reach out to some other departments see what we can find out about what's going on here.
[CUSTOMER][NEUTRAL] Hm
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, yeah, find out because I mean I, I would not be able to know but I sent this information to the filler and so she did, yeah.
[AGENT][POSITIVE] All right appreciate it yes ma'am.
[AGENT][NEUTRAL] Of course.
[AGENT][POSITIVE] OK, yes, give me just a moment I'll get right back with you OK?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] OK.
[AGENT][POSITIVE] Alright thank you one moment.
[CUSTOMER][NEGATIVE] You are on hold.
[AGENT][POSITIVE] Correct provider.
[AGENT][NEUTRAL] We
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You know, agents staffed. Goodbye.
[AGENT][NEUTRAL] Oh man.
[AGENT][NEUTRAL] I
[CUSTOMER][NEUTRAL] This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hi [PII], this is [PII] over on the care team. How are you?
[CUSTOMER][POSITIVE] I'm pretty good how are you?
[AGENT][NEUTRAL] Doing all right thank you. Um, I apologize ahead of time. This seems like quite a doozy of a situation and I'm not quite sure what to do. So I've got a uh a provider on the line, and she said that she received a letter from us, uh, stating that we sent her a check and it was sent to her in error and we need a refund. She has no record of seeing this patient nor of receiving a check at all. I was able to get the claim number.
[CUSTOMER][NEUTRAL] Sure.
[AGENT][NEUTRAL] And the check number of course the check number has her address that she verified and it does show that it cleared um and I pulled up the policy I do see a note um that uh they found an error while they were training I guess um that it was processed to the incorrect provider so but she's stating that she never received that check so I'm not quite sure what to do in this situation.
[CUSTOMER][NEUTRAL] OK, that's fine. What's the policy number?
[AGENT][NEUTRAL] Uh, the policy number is 24 excuse me, 2342994 and it is for part one. I'm sorry.
[CUSTOMER][NEUTRAL] What, what is the
[CUSTOMER][NEUTRAL] Part one and what yeah, what is the claim, the claim number?
[AGENT][NEUTRAL] Yes, that is 353 2.
[AGENT][NEUTRAL] 301.
[CUSTOMER][NEUTRAL] OK, sure, um, hm, well, what we can always do is, uh, I'll, I can put in a request for the, uh, you know, to check that at the.
[CUSTOMER][NEUTRAL] He signed it, um, so that's always.
[AGENT][NEUTRAL] Oh OK that's smart. I wasn't sure what we were able to do in that kind of situation.
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Oh, yeah, it's, it's kind of strange. Um, so let's see what we have here.
[CUSTOMER][NEUTRAL] OK. Uh.
[CUSTOMER][NEUTRAL] Whatever is fine and, and uh pain in spine hospital.
[AGENT][NEUTRAL] Yes, yes, and she did verify that's the name of their practice um and the address that the check was sent to, um, that's what she stated.
[CUSTOMER][NEUTRAL] OK, yeah. That's, no, that, that shouldn't be a problem. Um.
[CUSTOMER][POSITIVE] So what I can do is I can, I can talk to her and I can, I can tell you what.
[CUSTOMER][POSITIVE] Oh goodness.
[AGENT][POSITIVE] I know, I'm sorry.
[CUSTOMER][NEUTRAL] OK, so the, no, no, uh, so what is the check number again? What is the?
[AGENT][NEUTRAL] That was 2014625.
[CUSTOMER][POSITIVE] 65, great. No, that's great. So what I can do is I'll just go ahead and, and talk to her and uh we can figure it out.
[AGENT][NEUTRAL] Yes.
[AGENT][POSITIVE] OK, I sure appreciate your help thank you. Ar[PII] you ready for her now?
[CUSTOMER][NEUTRAL] Uh, sir, what, what is her name? What is her name, by the way?
[AGENT][POSITIVE] Oh [PII] [PII], yes, yes, thank you. Are you ready for her now?
[CUSTOMER][POSITIVE] [PII], OK, great. Thank you.
[CUSTOMER][POSITIVE] Yes, uh-huh, thank you.
[AGENT][POSITIVE] Alright, I sure appreciate your help thanks bye bye.
[CUSTOMER][POSITIVE] Thank you.