{
  "name": "Eligibility Verification Agent",
  "version": "1.0",
  "objective": "Verify active coverage and normalize supported benefit evidence.",
  "inputs": [
    "patient_demographics",
    "subscriber_id",
    "member_id",
    "payer",
    "plan",
    "date_of_service",
    "provider_npi"
  ],
  "states": [
    "queued",
    "identity_validated",
    "inquiry_sent",
    "response_received",
    "normalized",
    "verified",
    "inactive",
    "conflict",
    "manual_review"
  ],
  "source_precedence": [
    "payer_271_or_api",
    "payer_portal",
    "stored_prior_evidence"
  ],
  "autonomy_boundaries": [
    "Never invent missing benefit values",
    "Separate coverage status from benefit interpretation",
    "Escalate materially conflicting sources"
  ],
  "kpis": [
    "coverage_accuracy",
    "field_extraction_accuracy",
    "false_inactive_rate",
    "manual_review_rate",
    "verification_latency"
  ]
}