AccountId: 011433970860
ContactId: 23e99b77-3c21-4393-9eae-91921b829656
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 475279 ms
Total Talk Time (AGENT): 103212 ms
Total Talk Time (CUSTOMER): 144006 ms
Interruptions: 0
Overall Sentiment: AGENT=-0.1, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/06/23/23e99b77-3c21-4393-9eae-91921b829656_20250623T14:54_UTC.wav
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[AGENT][NEUTRAL] Thank you for calling APL. This is [PII]. How can I help you?
[AGENT][NEUTRAL] Hello.
[CUSTOMER][NEUTRAL] Hi, this is [PII]. I'm uh, yes, this is [PII] and last thing to mention is OK yeah OK.
[CUSTOMER][NEUTRAL] Do you need the
[AGENT][NEUTRAL] OK, I'm sorry, did you say [PII]?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] OK, and you were calling for?
[CUSTOMER][NEUTRAL] I'm calling for regarding client status.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] I'm sorry, you're muffled. I can't hear what you're saying.
[CUSTOMER][NEUTRAL] Cli status?
[AGENT][NEUTRAL] Same status? OK. Do you have a good callback number, [PII]?
[CUSTOMER][NEUTRAL] Yes, the callback numbers.
[CUSTOMER][NEUTRAL] [PII]
[AGENT][NEUTRAL] And the policy number for the patient?
[CUSTOMER][NEUTRAL] Yes, the policy number is.
[CUSTOMER][NEUTRAL] 022421.
[CUSTOMER][NEUTRAL] 72
[CUSTOMER][NEUTRAL] M as in Mike, L as in Lima, 8.
[AGENT][NEUTRAL] And patient name and date of birth?
[CUSTOMER][NEUTRAL] Yes, the member's name is [PII], and date of birth is [PII].
[AGENT][NEUTRAL] D of service and bill charges.
[CUSTOMER][NEUTRAL] The date of services [PII]. I'm sorry, [PII].
[CUSTOMER][NEUTRAL] The total charge amount is $213.20.
[AGENT][NEUTRAL] OK, give me one moment.
[CUSTOMER][NEUTRAL] Bye.
[AGENT][NEUTRAL] OK, it looks like the claim was received on 10-16-2024. Pro 10-21, [PII].
[AGENT][NEUTRAL] Um,
[AGENT][NEUTRAL] Services were rendered after coverage was terminated.
[AGENT][NEUTRAL] Policy terminated [PII].
[CUSTOMER][NEUTRAL] Although it dwindles uh coverage as effective.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And terminate.
[AGENT][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] Is that the same date?
[AGENT][NEUTRAL] No, [PII] and [PII].
[CUSTOMER][NEUTRAL] Bye.
[CUSTOMER][NEUTRAL] May I know the claim number?
[AGENT][NEUTRAL] Claim number 351-9650.
[CUSTOMER][NEUTRAL] 351-9650 right.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Nodu proper now.
[AGENT][NEGATIVE] It was billed after the policy terminated.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] The date of service was [PII], the policy terminated [PII].
[CUSTOMER][NEUTRAL] Right
[CUSTOMER][NEUTRAL] Could you please come up to me?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Could you please say that again?
[AGENT][NEUTRAL] The date of service you provided me was [PII]. The policy terminated [PII].
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Is there any other active insurance for the member?
[AGENT][NEUTRAL] No.
[CUSTOMER][NEUTRAL] May I know the time of time?
[AGENT][NEUTRAL] The timely filing limit?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEGATIVE] No we are billed after the to terminate right.
[AGENT][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] So what is the time?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] So that uh what is it what is it your time is limit.
[AGENT][NEUTRAL] The appeal timely filing?
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] 180 days after process date.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Can I bill it to the patient uh remaining amount?
[AGENT][NEUTRAL] I'm sorry?
[CUSTOMER][NEUTRAL] Is it possible?
[CUSTOMER][NEUTRAL] Is it possible to bill the amount remaining amount the policy was terminated after we were billed client, right?
[AGENT][NEUTRAL] Yeah, we can't determine patient responsibility.
[CUSTOMER][NEUTRAL] So is it possible
[CUSTOMER][NEUTRAL] Shall I bill it to the patient, the patient responsibility.
[AGENT][NEUTRAL] We can't instruct or determine patient responsibility because this is a supplemental policy.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] So
[CUSTOMER][NEUTRAL] Got it.
[CUSTOMER][NEGATIVE] And we have we have got the denial here. The only filing was expired.
[CUSTOMER][NEUTRAL] [PII].
[AGENT][NEUTRAL] I'm sorry, are you asking a question? I'm sorry.
[CUSTOMER][NEUTRAL] Yes, sir, we will, uh, received the claim.
[CUSTOMER][NEGATIVE] Uh, that is denied as timely final limit was expired.
[AGENT][NEUTRAL] What claim number is that?
[CUSTOMER][NEUTRAL] That is
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Mhm
[CUSTOMER][NEUTRAL] Sorry, there is no, there is not an actual client.
[CUSTOMER][NEUTRAL] Alright, uh, thank you for assisting. And may I know the call reference number to wind up this call?
[AGENT][NEUTRAL] It's my name is [PII] in today's date.
[CUSTOMER][NEUTRAL] Could you please spell it out?
[AGENT][NEUTRAL] [PII], [PII].
[CUSTOMER][NEUTRAL] Last name to your initial [PII].
[AGENT][NEUTRAL] [PII].
[CUSTOMER][POSITIVE] Thank you so much for that.
[CUSTOMER][POSITIVE] All right. Thanks very much for your assistance today. Have a nice day. Bye for now.
[AGENT][POSITIVE] Thanks for calling APL. You too. Bye bye.