Playbook, physiotherapy clinic
Insurance questions before a first physiotherapy appointment
This is asked before booking rather than after treatment, which makes it the most valuable question in the trade to get right. It is also three separate questions that visitors ask using a single phrase.
Why this is not the general answer
The handling pattern for insurance and coverage holds across every trade. What follows is the part that does not.
- The question is asked before booking rather than after treatment, so a good answer saves an appointment slot instead of unpicking a refund.
- Being registered with an insurer, being able to invoice one directly, and a particular policy paying out are three separate things, and visitors use one phrase for all of them.
- Most insurers require an authorisation code that the patient obtains themselves before the first session, and the clinic cannot get it for them, so naming that step is the most useful thing the assistant does all day.
- Insurers reimburse against specific service descriptions and session limits, so paraphrasing what a session includes can cost the patient a rejected claim that becomes the clinic's problem.
How it arrives
- do you take my insurer
- are you registered with them
- do i need an authorisation code
- will my insurance cover sports massage
- do you invoice the insurer directly
- how many sessions will my policy pay for
What has to be indexed for this to work
| The insurers you are registered with | The list as it stands, with any that you are registered with but do not invoice directly marked as such. The distinction matters and patients cannot infer it. |
|---|---|
| The exact service descriptions on your invoices | The wording you actually bill under. Let the assistant quote it rather than paraphrase, because the paraphrase is what gets a claim rejected. |
| What the clinic needs before a first insured session | The authorisation code, the policy number, any referral requirement. This is the checklist that stops a first appointment being wasted. |
| Your self pay prices | So that somebody whose policy will not cover a treatment still has a route rather than a dead end. |
The reply
We are registered with the insurers listed on our fees page and we invoice most of them directly [1]. Before your first appointment your insurer will usually give you an authorisation code, and we need that code and your policy number when you book [2]. How many sessions your policy covers, and whether a particular treatment is included, is set by the insurer, so please check that part with them directly.
It separates the three things the visitor has merged into one question, then names the authorisation code, which is the step that derails first appointments more than anything else. The coverage question is refused by naming exactly who does know, so it reads as accurate rather than as a brush off.
Where it stops
The trigger. The visitor asks whether a specific claim will be paid, or asks the clinic to word an invoice so that it will be.
I cannot say what your insurer will pay, and invoice wording has to come from the clinic rather than from me. Leave your name and an email and the team will go through it with you.
It stops answering before it guesses, says who will pick it up, and asks for the one thing that makes a reply possible. Nothing about it reads as a dead end.
Never say this here
Out of bounds
- Never say a treatment will be reimbursed.
- Never name an insurer you are not registered with as one you accept.
- Never describe a session in different words from the ones on your invoices.
- Never suggest how a patient should describe their problem to an insurer.
Questions
- Why is the authorisation code worth leading with?
- Because a patient who arrives without one has either wasted the slot or created an invoicing problem. Saying it before booking is worth more than saying it correctly afterwards.
- Should we list insurers we are not registered with?
- Only to say plainly that you are not, and to give the self pay price. A visitor who gets a clear no still has a decision to make, and half of them make it in your favour.
- Can it answer session limit questions?
- It can say that limits exist and are set by the insurer. It must not state a number, because the limit belongs to the policy and not to the clinic.
Keep reading
- Everything for a physiotherapy clinicSession prices, referral rules and what to wear are safe to automate. Exercise advice and injury assessment are not.
- Handling insurance and coverage in generalWhether something is covered turns on the policy wording, so the assistant explains process and never adjudicates. Claims have to reach a person fast.
- Quoting a physiotherapy session price without predicting a recoverySomebody asking what a physio session costs is really asking what getting better costs. Answering both honestly.
- Answering the practical questions before a first physio sessionClothing, scan reports, chaperones and whether treatment happens on day one. The practical half of a physio first visit.
- Moving a physiotherapy appointment, and what a late notice costsA physio appointment is booked one to one time, so a late cancellation costs the hour. Explaining the charge well.
Try it on your own material
Upload a document or point it at your site, paste one line of HTML, then ask it something only your business could answer.