AccountId: 011433970860
ContactId: a2492fc4-a34d-4bce-8e45-4e3054bcacf9
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 349339 ms
Total Talk Time (AGENT): 122700 ms
Total Talk Time (CUSTOMER): 126254 ms
Interruptions: 0
Overall Sentiment: AGENT=0.1, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/19/a2492fc4-a34d-4bce-8e45-4e3054bcacf9_20250219T20:22_UTC.wav
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[AGENT][NEUTRAL] Good afternoon. Thank you for calling APL. This is [PII]. May I help you?
[CUSTOMER][NEGATIVE] Hi [PII], my name is [PII], and I'm calling from Prisma Health. And please know that the call is being recorded for quality assurance. I'm calling to follow up on a previous call I made in December, and an EOB was supposed to be emailed to me and I hadn't received it.
[AGENT][NEUTRAL] OK, do you have a callback number I can get in case we get disconnected I can call you back?
[CUSTOMER][NEUTRAL] Yes, [PII].
[AGENT][NEUTRAL] And do you have the policy number?
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Is.
[CUSTOMER][NEUTRAL] 024.
[CUSTOMER][NEUTRAL] 65,490 for [PII].
[AGENT][POSITIVE] Thank you.
[AGENT][NEUTRAL] Hold on one moment, please.
[AGENT][NEUTRAL] OK, and what's her date of birth?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] Thank you, [PII]. And you were calling about an EOB somebody was supposed to email to you?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, I can help you with that. What date of service was it for?
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] OK, was it
[AGENT][NEUTRAL] For anesthesia or?
[CUSTOMER][NEUTRAL] And the total charge was 6,739.
[AGENT][NEUTRAL] What was the procedure code on that bill then?
[CUSTOMER][NEUTRAL] 48,150.
[AGENT][NEUTRAL] 48,150. And it was for 328-24.
[CUSTOMER][NEUTRAL] The total charge?
[AGENT][NEUTRAL] No, the date of service was [PII].
[CUSTOMER][NEUTRAL] Oh yeah, yes, that was the date of service.
[AGENT][NEUTRAL] OK, hold on just a moment, let me, I don't see that claim, so I don't know what they were gonna email you.
[CUSTOMER][NEUTRAL] She gave me the claim number. She said it was 3,472,230.
[AGENT][NEUTRAL] OK, let me look it up. Hold on one moment.
[CUSTOMER][NEUTRAL] And it was received on [PII].
[AGENT][NEUTRAL] And the procedure code on that bill was 48,150?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] Mm
[AGENT][NEUTRAL] OK, looks like she was giving you benefits, I mean, yeah, for anesthesia bill. I don't see a bill for 48,150. I see only one I see is the claim number she gave you, that was for procedure code 00794.
[CUSTOMER][NEUTRAL] What was the total charge on that?
[AGENT][NEUTRAL] See.
[AGENT][NEUTRAL] 5810.
[CUSTOMER][NEGATIVE] Yeah, that wasn't even submitted that must was submitted by the anesthesiologist.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Right, that's what I'm saying, and they didn't give you the correct information. I do not see a claim for 4851.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK, and that is the correct um member ID number, the 02465490?
[AGENT][NEUTRAL] It is for that data service.
[CUSTOMER][NEUTRAL] OK, um.
[CUSTOMER][NEUTRAL] Is it within timely to submit, resubmit?
[AGENT][NEGATIVE] We do not have timely filing.
[CUSTOMER][NEUTRAL] You don't have time, OK. And is the mailing address [PII]?
[AGENT][NEUTRAL] No, ma'am.
[AGENT][NEUTRAL] No, ma'am.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] What is that mailing address?
[AGENT][NEUTRAL] It is [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] OK, [PII].
[AGENT][NEUTRAL] Yes.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] And it's American public life.
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Or you can just put [PII].
[CUSTOMER][NEUTRAL] [PII] OK, so we'll get this sent back over to you guys again.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And I apologize for them giving you the wrong information, but that was on another claim.
[CUSTOMER][NEUTRAL] Right, I understand. And can I have the first initial of your last name and a reference number?
[AGENT][NEUTRAL] We do not have reference numbers. Um, my last initial is [PII]
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much, [PII]. You have a great day.
[AGENT][POSITIVE] Thank you, [PII], for calling APL. You have a good day as well.
[CUSTOMER][POSITIVE] Alrighty bye bye.
[AGENT][NEUTRAL] Bye bye.