A client wants to use insurance after your discovery call

If a client tells you during a discovery call that they would like to fund therapy with their private health insurance, nothing changes about the therapy itself. Only the payer changes, and we handle the checks with their insurer.

There are three things worth covering on the call, and one action on your side afterwards.

On the call

1. Check that you can be reimbursed

UK insurers reimburse HCPC-registered Clinical, Counselling and Educational Psychologists, and GMC-registered Psychiatrists. Your profile also needs insurance enabled. If insurance is not available with you, say so clearly on the call: the client can pay privately with you, or you can help them find a colleague who is insurance eligible.

2. Find out what they already know

Ask them to call their insurer and confirm three things:

• whether outpatient talking therapy is covered
• how many sessions a year they are allowed
• whether the insurer needs to pre-authorise the first session (if so, they should ask for the authorisation or claim reference on that call)

3. Watch the timing

Insurance needs at least 5 working days (Monday to Friday, excluding UK bank holidays) before the session, because we verify cover with the insurer in that window. If the time you agree on the call is sooner than that, insurance cannot cover it.

After the call: log the funding route

When you record the outcome of the discovery call, set the funding route to Insurance. It is a required field, and it is the one step that starts everything else:

• we email the client a short guide automatically, during business hours, explaining how to confirm their cover, book with insurance, and keep a card on file
• we do not need an email from you, and you do not need to ask the client to contact us

The client receives one email only, and never a second one about the same call.

If you agreed a time with them, tell the client to book it themselves and select insurance as the payment method. If they have already booked and paid for that session privately, they can switch it to insurance from their account instead.

Why you cannot create the insurance session for them

You can create appointments for clients from your dashboard, but an insurance appointment requires an active insurance authorisation on file. For a client using insurance for the first time there is no authorisation yet: it is created when the client completes the insurance setup in their own booking, with their policy details and a backup card.

If the client already has an active authorisation with you (a continuing client), you can create the appointment in the usual way and choose the insurance option in the dialog.

You can always create a self-funded appointment for a client who agrees to pay privately and has payment details saved.

What happens next

1. The client books and selects their provider, then adds their policy details and a card on file as a backup.
2. The session is held as Insurance Pending. The backup card is only used if a claim is declined, or for a shortfall or excess such as the client's own excess.
3. Our team verifies cover with the insurer within 5 working days and confirms or declines the claim, and we email the client the outcome.
4. Once confirmed, sessions continue on insurance until the authorisation runs out. We tell you in advance when a report or a renewal is needed.

Please do not

• Ask the client to email us their policy details. They must enter them in the booking flow, because that is what creates the claim.
• Chase us to obtain the details from the client.
• Assume a privately booked session can always be converted: switching to insurance also needs at least 5 working days before the session.
• Promise that a session will be covered before verification is complete.

Quick answers

What if the client is in a hurry? They can pay privately for the first session, or move it, and use insurance from the following one.

What if the client's insurer declines the claim? Their backup card is charged for that session at the self-funding rate, and we notify them.

What if the client is still undecided? Log the funding route as Insurance when insurance is the route they are leaning towards. The follow-up only goes out when insurance is the route on record, and never when you log self-funding.

What if they mention insurance after the call, not during it? Tell them how it works, and log the funding route on the call outcome if it is still open. Everything else runs automatically from there.