{
  "scenario_id": "messy_ambiguous_knee_case",
  "description": "Messy real-world call with ambiguous details requiring follow-up, retrieval, and multiple tool invocations.",
  "transcript": "Hi, this is Jordan Lee. I had a knee surgery consult and maybe some imaging planned, then I got mixed messages about auth.\nI also saw a bill and I am not sure if this is Blue something PPO or what.\nMy phone is 555-0134 and I think the referral might be REF-90171.\nCan you figure out what I need to do next?",
  "patient_metadata": {
    "patient_id": "PAT-1006"
  },
  "followup_qa": {
    "insurance payer": "Blue Cross",
    "member ID": "BCX-9017710",
    "date of birth": "04/17/1992",
    "procedure or visit type": "knee surgery consult",
    "referral ID": "REF-90171"
  },
  "expected": {
    "intent": "prior_auth_confusion",
    "required_entities": {
      "payer": "Blue Cross",
      "member_id": "BCX-9017710"
    },
    "required_tool_calls": [
      "insurance_eligibility_lookup",
      "appointment_referral_status_lookup"
    ],
    "required_resolution_elements": [
      "prior authorization",
      "recommended next step"
    ],
    "expected_payer": "Blue Cross"
  },
  "gold": {
    "expected_next_step": "Route to auth queue and share referral pending status with patient."
  }
}
