<img height="1" width="1" style="display:none" src="https://www.facebook.com/tr?id=1742841602710293&amp;ev=PageView&amp;noscript=1">

Clinical Solutions Blog

How to Get Therapy Product Covered by Your Patient's Extended Health Insurance

Posted by Rick Lau on May 16, 2017 10:00:00 AM

Sell Therapy Product at your physiotherapy clinic.jpg

Updated: July 24, 2019

I recently attended Darryl Yardley’s training webinar on The Top 7 Reasons Why Clinicians Struggle To Sell Products and How To Fix It - if you click on that link you can watch the webinar instantly.

Look, I’ve been in the rehab business for a long time. I built a alot of physiotherapy and chiropractic clinics over the past decade. But, no matter how long you’re in business, there’s always something more to be learned.

For instance, even though I feel I know quite a lot about product sales, and I’ve been to several of Darryl’s webinars before, I had an amazing “ah ha” moment at Darryl’s most recent webinar.

The “ah ha” moment was the realization that physiotherapists and chiropractors are not taking advantage of getting therapy products reimbursed by their patient's extended health plans. This is a crazy realization because it costs you nothing and it costs them nothing!

Patients have a range of products available to them, all of which are covered by their health care plans. You just have to tell them about what they can get because they don’t know.

Of course you’re not just going to do it for the sake of doing it. But as a clinic owner or clinician, it’s in your best interest to offer “complete care.” Since patients see you once or twice per week, their complete care may include compression garments or knee braces to assist in their recovery. And you can take advantage of their insurance coverage to help them get what they need — now that’s superior care!

I want to share what I learned at Darryl's webinar because it can help you improve your business:

We'll cover:

  • Why you can charge more for products
  • Extended health benefits explained
  • 3 types of insurance coverages to pay for products you recommend to pattients 

Are you ready to make patients happier and watch your practice soar?

Of course you are, so let’s dive in so you can learn how to get the right coverage for your patients...

Overcome your internal objections

Before getting into what coverages to offer, I want you to have the right mindset for product sales.

One of the major obstacles we hear from clinic owners and clinicians is: “I can’t sell products at a premium price because the patient can get it down the road cheaper.”

Stop right there!

This is the exact mindset you need to change right now. Before you start to sell product or sell more product.


And here’s why:

#1: You are a trusted health advisor

You are the health professional and your patients have not come to see you as a financial advisor but as their trusted health advisor. They need help to overcome their pain or problem. And guess what?

They are not an expert. YOU ARE!

So advise them as you should.

#2: You provide exclusive fitting and modification services

If they go buy an inferior product from the pharmacy or big box store down the street, the people there are not going to help them choose the perfect product, take the time to fit it correctly, and ensure they are wearing it right so they get the best recovery.

This additional service is worth money. It’s highly valuable to the patients to achieve the best outcomes.

#3: You provide top quality products that will get the best results for patients

During recovery, some patients need product. And therefore, you are the one who should sell it to them. The last thing you want is your patient to go to the drug store chain and buy a crappy product (made in china) and end up saying you’re a pretty hopeless physiotherapist because your advice to wear a brace didn’t make things better but worse.  Or even worst, you don't recommend a brace (when they needed one) and their medical doctor tells them to get one.  

Not a good situation either way.

You want to guarantee patient satisfaction by providing them with the right product to suit their individual needs.

These 3 reasons mean you should mark up your products by 1.4 to 2x the cost. Simply because patients don’t just get the product, they get the EXPERTISE and SERVICE. That is valuable to the patient.

Change your mindset and accept this as a fact. You can be more expensive and you absolutely should be.


 TRAINING WEBINAR:  How to sell product to patients
Darrly Yardley will share his secrets on getting clinicians to sell product in their treatment plans.

CLICK HERE to watch it now


THREE Insurance Coverages You Need to Know

Most extended health benefits already cover paramedical services (i.e. physiotherapy, massage, chiropractic services etc). When patients attend your clinic you’ll know whether they are covered or not and from there, you can both take advantage of their coverage.

Here are some details on what most plans cover and the process required to get there...

1) Compression Coverage

Most extended health plans have compression coverage. And this is one little secret to selling more product right away.  

Patients can use this coverage for compression stockings and compression socks, which they may need for various injuries.  

Here’s the trick though: Your compression garment needs to be “Medical Grade Compression.”  This means it contains over 20 mmHg of pressure or tightness.  

What products are “Medical grade compression?”

Bauerfeind knee and ankle braces are a great example. They have medical grade compression (20-30 mmHG) so these will be covered by most people’s extended health care plans.

Here are some examples of braces we sell at CSC that will have compression coverage:

Knee Braces

Bauerfeind Genutrain Knee Brace

Bauerfeind Genutrain P3 Knee Brace

Bauerfeind Genutrain A3 Knee Brace

Bauerfeind Genutrain S Knee Brace

Ankle Braces

Bauerfeind Achillotrain Ankle Brace

Bauerfeind Malleotrain Ankle Brace

Bauerfeind Malleotrain S Ankle Brace

In most instances, you won’t need a doctors note for these to be covered (always get patient to call to check). As you, the physiotherapist or chiropractor, can write a note to get this covered by the insurance companies. The best course of action is to inform patients about their options and get them to check their plan before you proceed. ALWAYS get the patient to call to understand what is covered. Your front desk can help them place this call on the first visit.  

2) Medical Equipment Coverage

For medical equipment, most of the time patients are 100% covered with no limits and non deductibles (always get patient to call to check). But, these medical supplies are covered only when medically necessary and ordered by a doctor.

If the patient gets a doctor’s note, they can get:

  • TENS machines (make sure its CSA approved)
  • Custom knee braces
  • Knee braces that have metal or rigid plastic in the brace
Like I said, patient’s will need to get a doctor’s note in most instances.  

Here’s the process to do it:

Step 1 Call patient’s insurance company

Find out the specific coverage and requirements. Knee braces are grouped in the category of 'medical equipment/devices' and most insurers will typically pay 100% with no deductibles.

Step 2 Get a doctors note

Most insurance companies require you to get a doctor’s note if you want your medical equipment covered. Most plans typically require the following on their doctor’s note:

  • Diagnosis necessitating the knee brace
  • Anticipated duration the brace will be required
  • Description of what activities the knee brace will be primarily worn for (daily living, sports, etc.)
  • Verification if this is an initial purchase, otherwise reason for replacement
  • Type of knee brace required
  • Purchase price of the knee brace

To make it easier for patient’s it is best to call the insurance company to verify the requirements of the doctor’s note.

Step 3: Submit for Reimbursement

Submit the claim form with the proof of purchase (receipts) AND doctors note in order to get reimbursed.

3) Orthotics Coverage

Patients orthotics are usually covered.

In general the coverage is: 100% covered, non deductible, maximum $400 for every 3 years.

Coverage includes custom-made orthotic inserts for shoes when prescribed by a doctor, podiatrist, physiotherapist or chiropodist.

If you can charge $450 and it costs you $125, that’s a pretty good margin and will help lift your revenue. I even know clinics who are earning more than 20% of their revenue in orthotics alone. Most patients do need them.

Here is a process you can use to get more patients purchasing orthotics.

Anytime a patient calls and books an appointment or comes in with lower extremity problems, they also get a gait scan booked. This can also work for hip problems or even lower back issues - these are all things that can be affected by a patient’s gait.

For the clinics I work with, we call this a "Movement Imbalance Scan” and book this scan on the first day.  

Once they have their scan, you can explain how orthotics help rebalance their gait, which helps relieve their problems and hasten their recovery.

You’ll find that a percentage of people will be happy to purchase the orthotics. And the good news is, you don’t need everybody to buy orthotics, all you need is 1 out of 5 people who do a scan to buy.    

About Darryl Yardley

Darryl happens to be an expert on product sales because he’s got such an incredible background, he’s:

  • A physical therapist and a clinical consultant 
  • He runs the operations for a network of 14 clinics in the greater Toronto area
  • He is a professor at Western University, University of Toronto, McMaster University, where he teaches physiotherapist business and entrepreneurship
  • He has all the credentials such as CAMPT and has written tons of publications
  • He is the chair of the Private Practice Division at the Canadian Physiotherapy Association
  • He has hired and mentored over 50 new physiotherapist grads

To upscale your product sales, watch his webinar replay:

New Call-to-action

Topics: Product Sales

Subscribe to Clinical Solutions Blog

New Call-to-action

Most Popular