{
  "scenario_id": "eligibility_verification_basic",
  "description": "Basic eligibility verification call with clear Blue Cross identifiers.",
  "transcript": "Hi, this is Maya Thompson. I have an MRI next week and I want to confirm if it is covered.\nI have Blue Cross and my member ID is BCX-4439201. My date of birth is 02/14/1985.\nCan you tell me what my benefits look like and what I should do next?",
  "patient_metadata": {
    "patient_id": "PAT-1001"
  },
  "followup_qa": {
    "member ID": "BCX-4439201",
    "date of birth": "02/14/1985"
  },
  "expected": {
    "intent": "eligibility_verification",
    "required_entities": {
      "payer": "Blue Cross",
      "member_id": "BCX-4439201"
    },
    "required_tool_calls": [
      "insurance_eligibility_lookup"
    ],
    "required_resolution_elements": [
      "eligibility verified",
      "recommended next step"
    ],
    "expected_payer": "Blue Cross"
  },
  "gold": {
    "expected_next_step": "Confirm prior auth requirement for MRI and proceed with scheduling."
  }
}
