AccountId: 011433970860
ContactId: 9b4179ae-e518-4a5f-b008-1b4e9a98a3bd
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 172710 ms
Total Talk Time (AGENT): 46246 ms
Total Talk Time (CUSTOMER): 72939 ms
Interruptions: 0
Overall Sentiment: AGENT=1.9, CUSTOMER=0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/26/9b4179ae-e518-4a5f-b008-1b4e9a98a3bd_20250226T15:23_UTC.wav
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[AGENT][NEUTRAL] APL, my name is [PII]. How can I assist you today?
[CUSTOMER][NEUTRAL] Hello, [PII]. Uh, this is [PII], uh, calling from provider's office.
[AGENT][POSITIVE] Good morning, [PII].
[CUSTOMER][NEUTRAL] Uh-huh, uh, I just need a timely filing limit for the, uh, member for the initial claim and then a pay claim.
[AGENT][POSITIVE] I'll be happy to assist with that information. May I have the policy number please?
[CUSTOMER][NEUTRAL] Yeah. It's uh 019.
[CUSTOMER][NEUTRAL] 12263 M. for Mama, L for Lima, and 8.
[AGENT][POSITIVE] OK, and if I can get a good call back number for you?
[CUSTOMER][NEUTRAL] Yeah, it's [PII] with the extension of [PII].
[AGENT][NEUTRAL] And what is the?
[AGENT][NEUTRAL] Patient's name and date of birth?
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Yeah, just a second.
[CUSTOMER][NEUTRAL] Uh, her name is uh [PII], and the date of birth is [PII].
[AGENT][NEUTRAL] Thank you for that information so I'm showing with this policy there is no timely filing.
[CUSTOMER][NEUTRAL] Mhm, OK.
[CUSTOMER][NEUTRAL] Uh, no time refiling limit for the appeal and then initial claim, right?
[AGENT][POSITIVE] Correct.
[CUSTOMER][NEUTRAL] Yes, just a second.
[CUSTOMER][NEUTRAL] OK. Uh, so you don't have any time refilling, uh, for any, any members? Like I just need the initial time refi.
[AGENT][NEUTRAL] No.
[AGENT][NEGATIVE] There's no timely filing.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, that's not fine. OK, just a second.
[CUSTOMER][NEUTRAL] Uh, OK, thank you for your patience and can I get the call reference number for this?
[AGENT][NEUTRAL] Reference is just my name [PII] last initial [PII], and the date and time of the call. Was there anything else I could assist with today?
[CUSTOMER][NEUTRAL] OK. Uh, before you winding up the call, I just need a clarification. Uh, as for the state guidelines, uh, how did you follow the timely filing limit?
[AGENT][NEUTRAL] We don't have timely filing. It's written in the policy, but we don't honor it. As long as they were active on the date of the service, we will process the claim.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][POSITIVE] OK, thank you so much.
[AGENT][NEUTRAL] So we don't penalize if the claim is late, whether it's a month late, 6 months, 2 years, 5 years, we're still gonna process the claim.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] OK.