What if a patient calls to book PT but doesn't have a physician referral and their insurance requires one?

For Physical Therapy Clinics

This depends on your state's direct access laws and your clinic's specific insurance contracts, and it's a scenario worth configuring explicitly rather than leaving to a generic booking flow. Many states allow some form of direct access to PT without a physician referral, but insurance plans frequently have their own referral or physician order requirements independent of state law, meaning a patient can legally walk in without a referral in some states but still have their insurance deny the claim without one. Voksha can be configured to ask the intake question directly (do you have a physician referral, and if not, is one required by your insurance) and route the caller accordingly: if a referral isn't required either by state law or the patient's specific plan, book the initial evaluation as normal; if it is required and the patient doesn't have one yet, the appropriate response is usually to explain that a physician order will be needed before or shortly after the first visit and either help the patient understand next steps to get one, or book a conditional evaluation pending referral submission depending on how your clinic handles this administratively. Getting this configuration right matters because booking a patient without a required referral, only for the visit to be denied by insurance later, creates a billing headache and an unhappy patient who assumed their insurance would cover the visit. Clinics operating across multiple states with different direct access rules should configure this logic per location rather than using a single blanket script, since the correct answer genuinely differs by state and by payer.