AccountId: 011433970860
ContactId: f7a72a3b-f34f-40c5-bcf1-2426f84670a1
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 269869 ms
Total Talk Time (AGENT): 59162 ms
Total Talk Time (CUSTOMER): 51438 ms
Interruptions: 0
Overall Sentiment: AGENT=0.6, CUSTOMER=0.3
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2024/12/31/f7a72a3b-f34f-40c5-bcf1-2426f84670a1_20241231T17:22_UTC.wav
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[AGENT][NEUTRAL] Calling APL, my name is [PII]. How may I assist you today?
[CUSTOMER][NEUTRAL] Hey [PII], this is [PII] on the care team. How are you?
[AGENT][POSITIVE] I'm good how are you?
[CUSTOMER][POSITIVE] I'm doing good. Can you look at this claim with me?
[AGENT][NEUTRAL] Sure.
[CUSTOMER][NEUTRAL] Um, it's policy number 2073603.
[AGENT][NEUTRAL] OK. For which part?
[CUSTOMER][NEUTRAL] It's um part one.
[CUSTOMER][NEUTRAL] And it's claim 3388926.
[CUSTOMER][NEGATIVE] So we paid out on the claim, but the check was voided and then they resubmitted and it was denied as a duplicate.
[CUSTOMER][NEUTRAL] I'm not, what should I do to get the claim the payment to them?
[AGENT][NEUTRAL] OK, so let's see.
[AGENT][NEUTRAL] 537.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Wait, where do you see where it was voided?
[CUSTOMER][NEUTRAL] Uh, I looked the check number up in ouch, O U T C H.
[AGENT][NEUTRAL] That's odd because they didn't void it in the system.
[AGENT][NEUTRAL] They didn't void the check in the system. That's crazy.
[CUSTOMER][NEUTRAL] But
[CUSTOMER][NEUTRAL] What you mean?
[AGENT][NEUTRAL] Meaning they didn't go in under the claim they voided it in the accounting system but they didn't go in on the claim and void it.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Oh, so that's why I was denied as a duplicate cause it's like.
[AGENT][NEUTRAL] Right, because when she looked at it she was like we already paid this because they, they have to go in under the claim and void it out under the claim and then issue. So, uh, give me a second, I'll send some screenshots to [PII].
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] And ask her to look into that.
[AGENT][NEUTRAL] And who's calling the provider or the insured?
[CUSTOMER][NEUTRAL] Um, the provider.
[AGENT][NEUTRAL] OK, I've emailed [PII] with the screenshots asking her to take a look at that.
[CUSTOMER][NEUTRAL] OK, so just let them know it's being reprocessed.
[AGENT][NEUTRAL] Let the provider know to allow us um 7 to 10 business days for an updated EOB.
[CUSTOMER][POSITIVE] OK, I'll just tell her. OK, thank you so much.
[AGENT][POSITIVE] Alright thank you you have a good day.
[CUSTOMER][NEUTRAL] You too bye bye.