AccountId: 011433970860
ContactId: 5d2c2278-90b4-4082-be5e-2336d20ab1ff
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 285380 ms
Total Talk Time (AGENT): 84130 ms
Total Talk Time (CUSTOMER): 125476 ms
Interruptions: 1
Overall Sentiment: AGENT=1.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/5d2c2278-90b4-4082-be5e-2336d20ab1ff_20250211T17:39_UTC.wav
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[AGENT][POSITIVE] Good morning. Thank you for calling APL. This is. May I help you?
[CUSTOMER][NEUTRAL] Hi, my name is [PII]. I'm calling for the provider BHS.
[CUSTOMER][NEUTRAL] One moment please the system got stop.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, I'm calling for the provider BHS Physicians Network. Please note that this call will be monitored and recorded for quality and training purposes. I'm calling to get a piece of information that I missed in our last call.
[AGENT][NEUTRAL] OK, and I'm sorry, your name is?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] My name is [PII].
[CUSTOMER][NEUTRAL] And may I know your name?
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Sure, it's [PII] and Ms. [PII], you say you're calling to verify pre-cert information?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Um, actually, [PII], um,
[CUSTOMER][NEUTRAL] I'm, I, uh, I want the information like, um, the claim was not on file and I want to know the timely filing limit to submit the claim.
[AGENT][NEUTRAL] OK, uh, what is that policy number, please?
[CUSTOMER][NEUTRAL] One moment please, um, yes.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Um, the policy number is 01868764.
[AGENT][NEUTRAL] OK, thank you. And do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Mhm. And the callback number is [PII] and it's a direct line.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Yes. Patient's name is [PII] and the patient's date of birth is [PII].
[AGENT][NEUTRAL] OK, and what was the date of service that you called about previously?
[CUSTOMER][NEUTRAL] Sorry.
[CUSTOMER][NEUTRAL] Yes, the date of service is [PII] and the total bill amount is $40 even.
[AGENT][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] You said the total charge amount was $40?
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] OK, and what was the name of the provider's office you're calling about?
[CUSTOMER][NEUTRAL] It
[CUSTOMER][NEUTRAL] Um, it's BHS physician networks.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] One moment.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] I
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEGATIVE] I see a claim for $298 total for that data service and it processes office visits are not covered. And uh looks like.
[AGENT][NEUTRAL] Per the EOB received, the balance after primary was $40. So can you verify that what was the total charge amount or is that amount after primary process the claim?
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Yes, it's a uh primary process after the.
[CUSTOMER][NEUTRAL] I mean
[CUSTOMER][NEUTRAL] Amount after the primary process.
[AGENT][NEUTRAL] OK, I'm asking, what was the total charge amount because I'm seeing we have a claim for that provider for that data service, but it's in a different amount and it shows on the EOB $40 after primary process the claim.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, [PII], um, I think.
[CUSTOMER][NEGATIVE] I have given the wrong one.
[CUSTOMER][NEUTRAL] Um, [PII], um, I just want to know the timely filing limit if the claim is not on file. Could you please tell me that?
[AGENT][NEUTRAL] There is not a time limit uh for claim submission.
[CUSTOMER][NEUTRAL] So no claim no time limit for the claim submission.
[AGENT][POSITIVE] There is no time limit, correct.
[CUSTOMER][POSITIVE] OK. Yes. Thank you for the information, [PII].
[AGENT][POSITIVE] Mhm. You're welcome. Is there anything else I can assist you with today?
[CUSTOMER][NEUTRAL] Um,
[CUSTOMER][POSITIVE] No, thanks. Have a great day. Bye-bye.
[AGENT][POSITIVE] You're welcome. Thanks for calling APL. Bye.