{
  "scenario_id": "prior_auth_confusion_ct",
  "description": "Caller is confused about whether CT angiogram needs prior auth and what intake should do.",
  "transcript": "This is Victor Chen. I was told to schedule a CT angiogram, but another office said prior authorization is missing.\nMy insurance is UnitedHealthcare and I think my ID is UHC-771032.\nI need to know if I can move forward or if you need more information.",
  "patient_metadata": {
    "patient_id": "PAT-1002"
  },
  "followup_qa": {
    "date of birth": "09/03/1990",
    "procedure or visit type": "CT angiogram",
    "payer": "UnitedHealthcare",
    "member ID": "UHC-771032"
  },
  "expected": {
    "intent": "prior_auth_confusion",
    "required_entities": {
      "payer": "UnitedHealthcare",
      "member_id": "UHC-771032"
    },
    "required_tool_calls": [
      "insurance_eligibility_lookup"
    ],
    "required_resolution_elements": [
      "prior authorization",
      "recommended next step"
    ],
    "expected_payer": "UnitedHealthcare"
  },
  "gold": {
    "expected_next_step": "Route to utilization review with CT angiogram authorization packet."
  }
}
