Does the script replace our verification record?

No. It is a question guide. Record the answers, source, and outstanding questions in your clinic's approved record or the companion worksheet.

Can we use it for PT, OT, and speech therapy?

Yes. Ask about each planned discipline and confirm whether visit limits or authorization rules are shared or separate.

What if the representative cannot confirm an answer?

Record it as unresolved. Ask which department or source can answer it, request a reference, and assign a follow-up before the visit.

Does a reference number guarantee payment?

No. It helps document the call. It does not replace plan terms, required authorization, or claim adjudication.

Resource library

Free payer-call script

Therapy Benefits Verification Phone Script

Know what to ask when a payer response leaves questions open. Use this practical script to confirm therapy benefits, patient responsibility, visit limits, and referral or authorization requirements for an upcoming visit.

Printable PDF script

Why this resource

Ask beyond “Is the coverage active?”

A benefits call is more useful when staff know which questions to resolve before hanging up. The script follows a practical sequence: confirm the service and date, ask about therapy-specific benefits, clarify the financial details, and document anything the representative cannot answer.

Use it alongside the eligibility verification worksheet or your clinic's existing record. The script supplies the questions; your approved record holds the answers.

What's included

An opening that sets the context.

State the therapy discipline, planned service, treating provider and location, and date of service before asking for benefits.

Prompts for the details that affect the visit.

Ask about network status, copay or coinsurance, deductibles, shared limits, referrals, and authorization thresholds.

A read-back and follow-up close.

Confirm what you heard, capture a reference number, and give unanswered questions a next step.

How to use it

01
Prepare the clinic's approved verification record and the planned service details.
02
Use the relevant prompts. Clarify uncertain answers instead of filling the gap with an assumption.
03
Read back the key details and record the source, date, reference, and unresolved items in the approved record.

Who it helps

Who it's for

Staff learning to make therapy benefits calls.
Experienced teams handling incomplete or conflicting payer responses.
Clinic managers standardizing a payer-call workflow across locations.