A great new hire, and a pile of refused claims
You take on a new physio. They are excellent, the diary fills quickly, and reception book them freely, including insured patients. Weeks later, claims for their sessions start coming back refused. The insurer has no record of them as a recognised practitioner at your clinic, or the application is still pending.
Now the clinic must decide whether to write off the sessions, bill the patients, or move them to another physio mid-treatment. None of those are good options, and all of them could have been avoided with a warning at booking.
Why this slips through
Insurers typically require each physiotherapist to be registered or recognised with them, and the process and timescale differ by insurer. The clinic submits applications, waits, and may receive confirmation by email at an unpredictable point.
Meanwhile, the clinic system knows the physio exists and has a diary. It does not know which insurers they can treat under. Reception cannot see it either. The information lives in the practice manager's inbox, and only they know that the new starter should not see a particular insurer's patients yet.
Associates and part-time physios make the picture more complicated. A physio might be recognised by an insurer at another clinic where they also work, but not yet at yours, and they may not realise the distinction matters. Reception reasonably assume that an experienced clinician can see anyone.
The same problem appears when a physio changes clinic, qualifies for a new grade, or when an insurer updates its requirements.
What unrecognised sessions cost
| Problem | Effect |
|---|---|
| Sessions with an unrecognised physio | Claims refused |
| Patient moved mid-treatment | Disrupted care and an unhappy patient |
| Billing the patient instead | Complaints and possible write-off |
| Pending applications forgotten | Physios left unable to see insured patients for longer than needed |
| Knowledge held by one person | Mistakes when they are away |
How we guard insured bookings
- A registration matrix lists every clinician against every insurer you work with, showing recognised, pending or not applied, with dates.
- Pending applications have follow-up reminders, so they are chased rather than forgotten.
- When an insured patient is booked, the booking tool checks the matrix and warns if the chosen physio is not recognised by that insurer, suggesting a recognised colleague.
- Online booking for insured patients only offers physios recognised by the patient's insurer.
- New starters get an onboarding checklist that includes each insurer's registration, so nothing is missed.
- Changes are logged, so you can see when a physio became recognised by each insurer.
Registration requirements are set by each insurer. We track the status you record and apply it at booking; we do not decide eligibility.
For reception and new starters
Reception can book confidently, knowing the system will warn them. New physios start seeing self-pay patients straight away and insured patients as each registration comes through. The practice manager can see which applications are outstanding and chase them. Refused claims for this reason become rare.
It also helps with planning. When you know which physios can see which insurers' patients, you can see where the gaps are, for example too few clinicians recognised by the insurer most of your patients use, and prioritise registrations or recruitment accordingly.
And when an insurer asks for a list of your registered clinicians, or a physio asks which insurers they can now see, the answer is on one screen rather than in a chain of old emails.
Could this be costing you?
- Claims have been refused because a physio was not registered
- Insurer registrations are tracked in one person's inbox
- Online booking offers insured patients any physio
- New starters' registrations are not on an onboarding checklist
- Nobody knows how long applications have been pending