Health member appeals denied MRI claim after urgent back pain referral
Speech Summary
Daniel Mercer spoke with Green Valley Health member services agent Mina to verify his identity and discuss an MRI claim (diagnosis code M54.5) and denied Gabapentin 300 mg prescription for nerve pain related to a workplace back injury. He requested the appeal form be sent to daniel.mercer82@protonmail.com and 4827 Willow Creek Drive, Apt 5B, Columbus, Ohio 43215.
Speakers
| Speaker | Emotion pattern | Speaking time | Language |
|---|---|---|---|
|
Customer Service Representative
The speaker introduces themselves as Mina from Green Valley Health
member services, verifies the caller's identity and details, and
accesses and discusses specific account, claim, and medical
information on file.
Inferred, 100%
|
Tired,
Amused,
Confused,
Neutral,
Calm,
Affectionate
|
76% | English, American accent |
|
Customer
The speaker provides personal verification details, describes
issues with an MRI claim and denied prescription, and requests
appeal forms and related actions, clearly acting as the caller
seeking assistance.
Inferred, 100%
|
Calm,
Neutral,
Amused,
Excited,
Tired,
Concerned,
Confused
|
24% | English, American accent |
Topics & Sentiment
| Speaker | Topics |
|---|---|
| Customer Service Representative |
Customer service -0.10
Delivery delays -0.10
Refund policy -0.10
|
| Customer |
Customer service -0.95
Delivery delays -0.95
Refund policy -0.95
|
Behaviors
| Speaker | Behavior | Model reasoning | Confidence |
|---|---|---|---|
| Customer Service Representative | Issue Not Resolved |
The representative continues verification and account review, but
does not provide a concrete follow-up commitment, ownership
handoff, or confirmed resolution for the caller's issue.
|
75% |
| Not detected | |||
| Complaints |
The available representative lines are procedural and calm,
without dissatisfaction, accusation, or negative evaluation that
would indicate a complaint from the speaker.
|
100% | |
| Coercion Manipulation |
The representative asks for confirmation and shares account
context without threats, pressure, repeated demands, or attempts
to steer the caller against their stated interest.
|
100% | |
| Issue Resolved |
The transcript excerpt does not show a closure cue such as issue
completion, customer acceptance, or a clear next step that would
establish resolution.
|
95% | |
| Inappropriate Speech |
The representative uses professional, factual language throughout
the sampled lines, limited to identity verification and account
information.
|
100% | |
| Customer | Complaints |
The customer raises an unresolved claims and medication issue,
giving corrected contact details while continuing to seek action
from the support specialist.
|
86% |
| Issue Not Resolved |
The customer describes an unresolved claim and denied
prescription, then continues supplying corrected information
without receiving confirmation that either issue has been closed.
|
82% | |
| Coercion Manipulation |
The customer applies pressure by linking corrected contact and
employer details to the denied care issue, keeping the
representative focused on the appeal path.
|
71% | |
| Not detected | |||
| Issue Resolved |
The customer continues describing the issue and requested contact
updates, with no acceptance cue or statement that the claim or
medication concern has been resolved.
|
97% | |
| Inappropriate Speech |
The customer confirms identity and provides updated contact and
employer information without slurs, insults, or abusive phrasing.
|
98% | |
Transcript
Thank you for calling Green Valley Health member services. This is Mina speaking on a recorded line. Can I confirm I'm speaking with Daniel Mercer, born July 18, 1982, and living at 4827 Willow Creek Drive, Apt 5B, Columbus, Ohio 43215?
Yes, this is Daniel Andrew Mercer. The last four of my Social Security number are 4421, and my member ID is GVH-88394127.
Thank you, Mr. Mercer. For verification, can you confirm the phone number and email we have on file: 614-555-0198, and daniel.mercer82@protonmail.com?
Yes, that's right, although my new callback number is 380-555-4412, and my employer is Harrison Industrial Company at 2150 Fisher Road, Columbus, Ohio.
I see your plan is under policy number PPO-77-194402, and the primary care physician listed is Dr. Elena Ruiz at Buckeye Family Clinic, 903 East Main Street, Columbus, Ohio 43205.
Raw JSON
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General Statistics
- Uploaded
- Ilya Sinelnikov
- Date Uploaded
- 15 Apr 2026, 09:12
- Status
- Completed
- Speakers
- 2
- Languages
- en
- Deepfake analyzed
- 17 / 19 utterances
- Avg deepfake score
- 0.6368
- Max deepfake score
- 0.9810
Audio
- File Name
- AIAgentFrustration.mp3
- File Size
- 1.87 MB
- File Type
- audio/mpeg
- Audio Duration
- 1m 37.3s
Request
- HTTP
- 200 OK
- Endpoint
- /api/velma-2-stt-batch
- Response Size
- 5.8 KB
Performance
- Processing Time
- 2.66s
- Processing Factor
- 36.6x real-time