AccountId: 011433970860
ContactId: d1c7039d-37ca-427a-83fd-5e87cf370f56
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 219259 ms
Total Talk Time (AGENT): 67060 ms
Total Talk Time (CUSTOMER): 105279 ms
Interruptions: 2
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/05/29/d1c7039d-37ca-427a-83fd-5e87cf370f56_20250529T18:20_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling American Public Life. This is [PII]. How may I assist you?
[CUSTOMER][NEUTRAL] Hi, [PII]. This is [PII] from Genesis Care [PII] [PII]. I'm calling concerning a claim.
[AGENT][NEUTRAL] OK, may I please have a callback number?
[CUSTOMER][NEUTRAL] [PII]
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And may I have the policy number?
[CUSTOMER][NEUTRAL] It is 01960211, M as in Mary, L as in love, number 8.
[AGENT][NEUTRAL] And may I have the patient's name and date of birth?
[CUSTOMER][NEUTRAL] Patient's name is [PII]. Date of birth is [PII].
[AGENT][POSITIVE] And thank you so much [PII] for verifying the policy. You're calling in for status of a claim.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, may I have the date of service and total bill?
[CUSTOMER][NEUTRAL] Um, it is 41625. Total bill is $1,118.19.
[AGENT][NEUTRAL] $1,118.19.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] OK, let me check that for you.
[AGENT][NEUTRAL] And this claim is for [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] I'm not seeing a claim on file for that data service.
[CUSTOMER][NEUTRAL] OK. Um, not sure if I'm calling the right number then cause I have an EOB in my hand. I have an EUB number.
[AGENT][NEUTRAL] May I have that claim number?
[CUSTOMER][NEUTRAL] I have a document number.
[AGENT][NEUTRAL] Is there a claim number listed?
[CUSTOMER][NEUTRAL] Which one, the EOB or the document number?
[AGENT][NEUTRAL] It should be a claim number that's listed on the EOB.
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][NEUTRAL] I don't see a claim number.
[CUSTOMER][NEUTRAL] Document number, ID number, UOB number. Yeah, I don't see a claim.
[AGENT][NEUTRAL] Mm because yeah our EOBs will have a claim number.
[CUSTOMER][NEUTRAL] Why is there not a claim number on this?
[CUSTOMER][NEUTRAL] Mm
[CUSTOMER][NEUTRAL] No claim number on here.
[CUSTOMER][NEUTRAL] Is this your member or can you check to see if this is your member? Maybe we have the wrong phone number.
[AGENT][NEUTRAL] She is one of our members of our supplemental.
[AGENT][NEUTRAL] Policy, but we're not her primary insurance.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] No, I know this is a secondary claim.
[AGENT][NEUTRAL] Yes, we don't have it.
[CUSTOMER][NEUTRAL] I just need an explanation of the EOB.
[AGENT][NEUTRAL] What is it saying that it's denying for?
[CUSTOMER][NEUTRAL] Why is there not a claim number on here?
[CUSTOMER][NEUTRAL] It's not, I don't know if it's denied or not, it said what was paid to us.
[CUSTOMER][NEGATIVE] And um also it's telling us what's the patient's responsibility, but it doesn't, it's not adding up. That's why I need to figure out which, how much I need to charge her.
[AGENT][NEUTRAL] What is the amount that is showing that it was paid, how much was paid to you?
[CUSTOMER][NEUTRAL] Um, it says benefits paid $449.17.
[AGENT][NEGATIVE] Because I don't even see a claim for that.
[CUSTOMER][NEUTRAL] And it said patient responsibility is $445.38.
[AGENT][NEUTRAL] No, that couldn't be one of our claims because we don't say have a patient's responsibility like that.
[CUSTOMER][NEUTRAL] And this is coming from.
[AGENT][NEGATIVE] We would never have that.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Well, let me call this number on here. All right. Thank you.
[AGENT][POSITIVE] You're welcome. Is there anything else that I can assist you with today, [PII]?
[CUSTOMER][POSITIVE] No, that was it. Thank you.
[AGENT][POSITIVE] Thank you so much for calling