If your clinic treats motor-vehicle or workers’ compensation patients, you know the routine. A patient is ready to start or continue treatment, but the approval has not come through. Someone emails the adjuster. Someone else updates a spreadsheet. A week later, nobody is sure who followed up last. Clinic admin teams have told us this waiting and chasing eats their time and delays care. This guide explains how to automate the follow-up without new clinical software and without pretending to integrate with insurers.
A quick note on scope: we describe insurer workflows in general terms. Each insurer’s forms, timelines and rules change, and your team knows the current requirements best.
Why is insurer follow-up so time-consuming?
Several things combine:
- Each insurer works differently. Motor-vehicle cases in BC (for example, ICBC-funded care) look nothing like workers’ compensation cases with WorkSafeBC, WSIB in Ontario or WCB Alberta.
- Many people are involved. Adjusters, case managers, employers, referring physicians, your clinicians and the patient.
- Tracking is scattered. Spreadsheets, inboxes, sticky notes and memory.
- Follow-up depends on one person. When they are away, cases stall.
- Patients call to ask. Each status call takes front desk time.
None of this is clinical work, but it directly affects when patients get care.
What can be automated, and what should stay manual?
| Task | Automate? |
|---|---|
| Keeping a list of every pending approval with due dates | Yes |
| Sending scheduled follow-up emails to adjusters and case managers | Yes, with your templates |
| Reminding clinicians when a progress report is due | Yes |
| Updating patients on their approval status | Yes, with consent |
| Weekly summary of stuck cases for the director | Yes |
| Completing and submitting insurer forms | No, admin stays in control |
| Writing clinical reports | No, clinicians write them |
| Invoicing and billing | No, we are not a billing service |
The goal is to remove the remembering and chasing, not to take decisions away from your team.
How do you set it up?
Step 1: Map your current process
For each insurer you work with, write down what happens from referral to approval: which form, who sends it, who receives it, typical wait, and what triggers a follow-up. This is usually one session with your admin lead.
Step 2: Put every pending case in one tracker
Each case gets a record: patient, insurer, case type, what is pending, who it is waiting on, date sent and next follow-up date. This can live in a simple shared tool, your CRM or a purpose-built tracker. The point is one source of truth.
Step 3: Schedule follow-ups
For each case type, set a follow-up rhythm. For example, a polite check-in to the adjuster if no response in five business days, and a second follow-up and alert to admin after ten. Templates are written with your team and reviewed by them.
Step 4: Remind your own team
Many delays are internal: a progress report not yet written, a signature missing. Automated reminders to the right clinician or admin, with the due date, cut these delays.
Step 5: Keep patients informed
With consent, send patients short updates: “We’ve sent your request to your insurer and will let you know when we hear back.” This reduces anxious calls to your front desk. Commercial messages require consent under CASL, and personal health information should be kept to the minimum.
Step 6: Review weekly
The clinic director gets a short weekly list: cases waiting longest, cases at risk of delaying care, and follow-ups sent. Problems become visible before patients complain.
What about privacy?
Canadian clinics handle personal health information under PIPEDA and provincial laws, such as BC and Alberta PIPA and Ontario PHIPA. In practice, that means collecting only what is needed, limiting who can see it, keeping messages to insurers within proper channels, and getting consent for commercial texts and emails under CASL. Ask any vendor where data is stored. We are confirming our Canadian data-hosting option [CONFIRM: Canadian data-hosting option].
Does this help with patient drop-off?
Yes. A patient waiting weeks for an approval may give up on treatment. Faster approvals and clear updates keep patients engaged. When a funded patient does drop off, a structured follow-up helps; see how to stop losing rehab patients mid-treatment.
What mistakes should clinics avoid?
A few common traps slow clinics down. The first is automating a messy process before mapping it; if nobody agrees who sends which form, automation just sends the confusion faster. The second is chasing too often. Adjusters and case managers handle many files, and a polite, predictable rhythm gets better results than daily emails. The third is leaving clinicians out. Many delays come from progress reports, so clinicians need reminders they will actually see. The last is forgetting the patient. A short update when an approval is sent, and again when it is approved, prevents worried calls and keeps patients committed to their care.
Does the same approach work in the US?
It does. US personal-injury and auto-accident practices, and practices dealing with workers’ comp or prior authorizations, face the same tracking and chasing problem. Our insurer follow-up service covers both countries.
Where should a clinic start?
Start by counting: how many approvals are pending right now, and how many are past their expected date? If you cannot answer quickly, the tracker alone will help. If the number is large, automation pays off fast.
Learn more on our Canada hub or see how we work with physiotherapy and rehab clinics.