AccountId: 011433970860
ContactId: 75ebc480-1010-4b79-96fc-b65755832914
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 352559 ms
Total Talk Time (AGENT): 76225 ms
Total Talk Time (CUSTOMER): 150600 ms
Interruptions: 0
Overall Sentiment: AGENT=0, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/19/75ebc480-1010-4b79-96fc-b65755832914_20250619T13:51_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] calling with Lexington Medical Center, and I am calling on a uh old claim that I'm trying to find out if the primary EOB was ever received in the claim process.
[AGENT][NEUTRAL] OK, I can help you with claim status, [PII]. Do you have a good callback number?
[CUSTOMER][NEUTRAL] I do [PII].
[AGENT][NEUTRAL] Thank you. And what's that policy number for the patient?
[CUSTOMER][NEUTRAL] Policy I have is 019.
[CUSTOMER][NEUTRAL] 91,600
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] [PII]. Date of birth, I have [PII].
[AGENT][NEUTRAL] And what was that data service and bill charges?
[CUSTOMER][NEUTRAL] Uh, data service was [PII]. Total bill was $6,312.01 for the facility claim.
[AGENT][NEUTRAL] OK. Let me see.
[CUSTOMER][NEUTRAL] OK
[AGENT][NEGATIVE] Yeah, it does not look like we ever received the primary EOB.
[CUSTOMER][NEUTRAL] OK, um, because it looks like in my system that it was they were last sent out for this one and the facility claim on 43-24 and it looks like the facility claim process. I mean there was no payment made, however, I'm showing that you know something had to be received for that so.
[AGENT][NEUTRAL] Um, let's see
[AGENT][NEUTRAL] Yeah, we, we received the claim on 325-24. It processed 326-24, but it just had the UV.
[AGENT][NEUTRAL] We didn't receive a primary EOB.
[CUSTOMER][NEUTRAL] For the, which one now for the facility?
[AGENT][NEUTRAL] The facility.
[CUSTOMER][NEUTRAL] I but
[CUSTOMER][NEUTRAL] OK, but again, like I said, the other one for the 1,5003 for the um.
[CUSTOMER][NEGATIVE] I can't talk to them I'm sorry for the um pre fee claim it processed like I said, it didn't pay anything, but now it says that that was done um with the check check date in [PII] stating that it applied 38379 to the patient deductible. So obviously something had to be received and if they were mailed together then they both should have been received at the same time.
[AGENT][NEUTRAL] Make sure it isn't attached to the other claim for some reason, um 2732.
[CUSTOMER][NEUTRAL] I'm trying to see if there's actually.
[CUSTOMER][NEGATIVE] Two EOBs are just one because sometimes there's stuff split, sometimes it's not. So my system is just running a little slow here.
[AGENT][NEUTRAL] Yeah, we just have on the claim for
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] No.
[AGENT][NEUTRAL] 1503, it just has the explanation of benefits attached to for that charges, and then
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] For the other one, it just has the UBO 4, so I don't see nothing else is attached.
[AGENT][NEUTRAL] Is there any way to actually?
[CUSTOMER][NEUTRAL] Hm. And that's the one that was received in.
[CUSTOMER][NEUTRAL] That was the ones that were received in [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Hm, OK, and I'm sorry, you said I could fax the EOB over?
[AGENT][NEUTRAL] Yes, um, our fax number is [PII].
[AGENT][NEUTRAL] 3659423.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] OK, and does that go to just attention claims?
[AGENT][NEUTRAL] That goes straight to our claims department.
[CUSTOMER][NEUTRAL] OK. And then once that information's been received, what's that normal turnaround time?
[AGENT][NEUTRAL] It takes about 7 business days.
[CUSTOMER][NEUTRAL] OK, 7 business days.
[CUSTOMER][NEUTRAL] All right. And is there gonna be a reference number for the call today?
[AGENT][NEUTRAL] Uh, reference number is my name, [PII]. First initial to last name is [PII], and today's date. And is there anything else I can help with today?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] No, ma'am, that's all I have. I appreciate all your help.
[AGENT][POSITIVE] OK, thank you for calling [PII]. I hope you have a great day.
[CUSTOMER][NEUTRAL] You too bye bye.