Physiotherapy Claim AI Blueprint — WSIB, MVA & EHB for Ontario Clinics
Ontario physiotherapy clinics deal with the most complex insurance billing of any allied health profession — WSIB Treatment Extension Requests, MVA OCF-18 packages, Extended Health Benefit claims, all at the same time.This DIY blueprint gives you three complete Make.com + Claude API modules that automate all three payer types. Set it up in your own Make.com account in under 2 hours. Your patient data stays with you. MODULE A — WSIB Treatment Extension RequestsAI drafts your TER letters in under 5 minutes. Tracks approval status, sends follow-up reminders at Day 14, and drafts appeal letters on every denial — automatically. MODULE B — MVA / OCF-18 PackagesDocument completeness checklist catches missing items before submission. AI generates the treatment rationale section. Tracks each claim per insurer (Intact, Aviva, TD, Economical). 40% of OCF-18 resubmissions are caused by missing documents — this system prevents that. MODULE C — Extended Health BenefitsTrack every claim across Sun Life, Manulife, Canada Life, Blue Cross, and Desjardins. Auto-follow-up at Day 15. Denial appeal letters generated instantly from the denial reason code. WHAT'S INCLUDED:- All 3 complete Make.com workflow blueprints (copy and deploy)- 3 exact Claude API system prompts (WSIB, MVA, EHB) — ready to paste- Google Sheets claim tracker setup — 3 tabs with conditional formatting guide- Step-by-step setup guide (under 2 hours)- 8-step automated workflow explained- Phase 2 expansion ideas (weekly revenue report, SMS reminders, OCF-18 expiry tracking)- Done-For-You setup available at $497 TOTAL RUNNING COST: $14–$31 CAD/monthOne prevented WSIB rejection rework ($45–$90) pays for 1–3 months of this system.Works for: solo physiotherapists, small physio clinics (2–5 therapists), clinic admin staff, and clinic owners wanting to recover unpaid denied claims.NOTE: Your patient data stays in YOUR Google and Make.com accounts. This blueprint does not involve artefac.digital storing, processing, or accessing your clinic's patient information. physiotherapy, WSIB, MVA, OCF-18, Ontario, extended health benefits, AI automation, Make.com, Claude API, clinic billing, prior authorization
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