{
  "scenario_id": "billing_coverage_clarification",
  "description": "Patient received an unexpected imaging bill and wants coverage clarification.",
  "transcript": "Hey, this is Luis Romero. I got a bill after an ultrasound on 2026-02-08 and I thought it was covered.\nMy insurance is Cigna and my member ID is CG-291001.\nCan someone explain what happened and what I should do now?",
  "patient_metadata": {
    "patient_id": "PAT-1004"
  },
  "followup_qa": {
    "date of service": "2026-02-08",
    "payer": "Cigna"
  },
  "expected": {
    "intent": "billing_coverage_clarification",
    "required_entities": {
      "payer": "Cigna",
      "member_id": "CG-291001"
    },
    "required_tool_calls": [
      "insurance_eligibility_lookup"
    ],
    "required_resolution_elements": [
      "billing coverage review",
      "recommended next step"
    ],
    "expected_payer": "Cigna"
  },
  "gold": {
    "expected_next_step": "Route to billing review with EOB and service date context."
  }
}
