Example 06: Medical Services Reservation

This is an example of a Medical Services Reservation request and response between a payer and a primary care physician. The example will show how a physician can reserve a medical service for a patient from a payer and the example will also show the response from the payer.

Joe Smith is a subscriber to ABC Payer. Dr. James Gardner is expecting to perform a service on Joe Smith in the near future and is required to reserve this service with the payer. The procedure code is 99212 and the unit count being reserved is 1.

ABC Payer accepts the medical reservation request and responds.