Guides
A day in a physical therapy business, written as procedures
Physical therapy SOP checklist for daily operations: the opening, per-visit, closing and weekly checks a front desk and a therapist sign, and who owns each one.
What to take away
- A daily SOP for a clinic is four short listsbefore the first patient, at every visit, after the last patient, and once a week. Each item has one owner.
- The lists exist so the practice runs the same way on the day the owner is out as on the day they are in.
- Nothing here states a rule. Where an item depends on the state physical therapy board or a payer, the item says so and the answer is in the compliance file.
- Print it, tick it, keep the ticked copies. An SOP that lives in a drive nobody opens is not an SOP.
Before the first patient
Owner: front desk, unless stated.
- Today's schedule printed or exported, in case the system goes down.
- Eligibility re-checked for every insured patient on today's list, with the patient share noted beside each name.
- Every visit checked against its authorization by date and count; any visit outside one flagged to the therapist before the patient arrives.
- Any assistant column checked against the supervision the state board requires, using the wording in the compliance file; any gap moved, not treated.
- Waitlist opened and current, so a same-day cancellation can be filled at once.
- Rooms and equipment checked and the treatment areas clear. Owner: the first clinician in.
- Referrals and portal messages from overnight logged with date and source, and the patients called before the first slot if possible.
At every visit
Owner: front desk for the first three, the clinician for the rest.
- Patient identity and today's visit confirmed against the schedule.
- Patient share collected at check-in, receipt given.
- Any change to the patient's insurance or contact details recorded now.
- Visit delivered by the person and in the slot type the schedule shows; any substitution recorded and, where supervision applies, confirmed within the board's terms.
- Note written in the documentation block the template provides, that day. What a payer expects in the note is the payer's standard; for Medicare, the CMS compliance tips for physical therapists in private practice describe what reviewers find missing.
- Next visit confirmed with the patient before they leave, or the whole plan booked if this was the evaluation.
- Any complaint, incident or near miss recorded and passed to the person who owns it.
After the last patient
- Every note for today complete and signed. Ownereach clinician for their own; the front desk checks the count.
- Claims for today's visits ready to go with the notes behind them. Owner: biller. Coding follows the payer's rules, with Medicare's on the CMS therapy services page.
- Today's cancellations and no-shows recorded by reason, and the policy applied as written.
- Tomorrow's schedule reviewed for gaps, and the waitlist worked to fill them.
- Any authorization ending within the stated number of visits flagged for extension or re-certification.
- Cash and card totals reconciled to the schedule. Ownerfront desk, checked by the owner or manager.
- Rooms reset, supplies noted for reorder.
Once a week
- Referral-to-evaluation days, per referral source, from the log. Any referrer whose patients waited longer than the practice's stated target gets a call.
- Planned visits delivered against visits booked, per therapist.
- A sample of notes read against the payer's standard by a clinician who did not write them.
- Denials reviewed by reason, and the one that repeats fixed at source.
- Waitlist purged of anyone placed or unresponsive.
- License, certification and re-credentialing calendar checked for anything due in the next month.
- The week's ticked daily lists filed, because the IRS guidance on which records to keep expects a business to be able to show what it did to earn its income, and the daily lists are that trail in this trade.
Who signs what
| List | Ticked by | Checked by |
|---|---|---|
| Before the first patient | Front desk | Owner or manager, weekly sample |
| At every visit | Front desk and clinician | Weekly note sample |
| After the last patient | Front desk, clinicians, biller | Owner or manager, daily count |
| Once a week | Owner or manager | Quarterly review of the trend |
Where the lists come from
The daily lists are the operations and workflow guide cut into a day. Booking and waitlist items are the rules in how to schedule physical therapy appointments without delays.
Supervision and authorization items point at answers in the compliance file that the licensing and compliance guide describes. The person ticking each item learned it in their first week, what the hiring and training guide is for.
Common questions
Is this too much for a small practice?
Each list takes minutes. What takes hours is the denied claim, the lapsed authorization or the unfilled gap that the list would have caught.
Should the therapist tick items or just the front desk?
The clinician ticks the note and the next-visit items. Nobody else can confirm those, and a note count checked by the front desk is not the same as a note written.
What if an item cannot be done that day?
Write why beside it. A blank tick box is a gap nobody can explain later; a written reason is a decision.
