MedExPRO....Are You Actually Referral and Reimbursement-Ready? Complete the Checklist

Hello MedExPRO,

Let me ask you a direct question.

Do you believe your practice is referral-ready?

Do you believe you are reimbursement-ready?

Most Medical Exercise Professionals think they are.

You manage complex clients.
You understand pathology.
You care deeply about safety.
You communicate professionally.

But here is the uncomfortable truth:

Good intentions and strong exercise knowledge do not make a practice referral-ready or reimbursement-ready.

Systems do.

Why This Matters (And Why Most Don’t Realize They’re Not Ready)

Most MedExPROs fear three things:

1. Approaching physicians and being dismissed
2. Talking about reimbursement and saying the wrong thing
3. Accidentally stepping outside scope

So what do they do?

They avoid the conversation.
They hope referrals will “just happen.”
They tell clients, “You can try to submit this,” without structured documentation.

And they quietly wonder why medical professionals don’t consistently refer.

That is not a competence problem.

It is a systems problem.

We’ve developed a professional self-assessment tool:

The Referral-Ready & Reimbursement-Ready Checklist for MedExPROs

This checklist is not marketing fluff.

It is a standards audit.

Here is what I want you to do:

1. Read every section slowly.
2. Check each box only if you can confidently say:
   “Yes, this exists in my practice right now.”
3. Be objective.

Do not check a box because you could do it.

Check it only if it is installed and operational.

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The more boxes you can confidently check, the stronger your professional foundation already is. Each box represents a structural element of a true medical exercise practice. This is not about perfection — it is about identifying where your systems are solid and where they need reinforcement.

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PART I — REFERRAL-READY

1. Medical Referral Requirements (Non-Negotiable)

Ask yourself:

☐ Practice requires a written referral from a licensed physician
☐ Referral specifies Medical Exercise Training or Functional Conditioning
☐ Referral includes a medical diagnosis
☐ Referral includes an ICD-10 code
☐ Referral confirms discharge or transition from formal medical treatment

If any of these are missing, the referral is incomplete—not “close enough.”

This is where most MedExPROs realize they are assuming readiness instead of proving it.

2. Referral Intake Systems

Now examine your intake process:

☐ Standardized referral intake form exists
☐ Diagnosis and ICD-10 code are documented in the client record
☐ Functional limitations are identified relative to the diagnosis
☐ Scope of practice is clearly defined and documented
☐ Client is transitioned from “patient” (medical care) to “client” (exercise services)

If this is not structured, your referral process depends on memory—not systems.

3. Assessment & Programming Alignment

Now look at your assessments and programming:

☐ Assessment is framed around functional capacity, not fitness goals
☐ Exercise selection aligns with diagnosed condition and limitations
☐ Progressions are defensible and documented
☐ Language avoids diagnosis, treatment, or therapy terminology

This is where fitness businesses reveal themselves.

Medical exercise practices document defensibility.

4. Provider Communication Systems

Finally, evaluate your communication structure:

☐ Initial intake summary prepared for referring provider
☐ Progress reports scheduled at defined intervals
☐ Documentation uses medical-appropriate, functional language
☐ Communication is consistent, professional, and expected

If physicians don’t clearly understand what you do, that is not their fault.

It is a communication system gap.

PART II — REIMBURSEMENT-READY

Now let’s move to the part most MedExPROs avoid.

Reimbursement.

1. Reimbursement Clarity (Scope Protection)

Ask yourself honestly:

☐ Practice does not bill insurance
☐ Clients are clearly informed they are responsible for submission
☐ No guarantees of reimbursement are made
☐ Role as a Medical Exercise Professional is clearly explained

If this conversation feels uncomfortable, your scope is not fully defined.

2. Documentation Standards

Review your session documentation:

☐ Each session log includes:

• Date
• Duration
• Service and exercise description
• Functional focus tied to diagnosis or functional limitations

☐ Language aligns with the original medical referral
☐ Progress is tracked objectively (capacity, tolerance, function)

If documentation is vague, reimbursement conversations become fragile.

3. Client-Ready Reimbursement Packet

Evaluate what you provide clients:

☐ Session summaries prepared in client-friendly format
☐ Progress reports available upon request
☐ Clear service description provided for insurance submission
☐ Documentation is consistent, legible, and professional

Professional systems create calm reimbursement discussions.

4. Professional Confidence

Finally, assess yourself:

☐ MedExPRO can clearly explain the reimbursement support role
☐ MedExPRO can confidently answer client questions
☐ No fear of overstepping scope
☐ No avoidance of reimbursement conversations

If fear still exists, the system is incomplete.

Final Self-Assessment

☐ I am referral-ready
☐ I am reimbursement-ready
☐ My systems—not my personality—carry my practice

Why This Checklist Is So Important

If you cannot check every box, your practice is still operating like fitness.

Fitness relies on:

• Personality
• Motivation
• Energy
• Sales conversations

A medical exercise practice relies on:

• Written referrals
• Documented diagnoses
• ICD-10 clarity
• Defined scope
• Structured communication
• Defensible documentation
• Measurable functional outcomes

That is the difference between:

“Trainer who works with special populations”

and

“Medical Exercise Professional integrated into the continuum of care.”

And If You Discover Gaps?

Good.

That awareness is power.

Because the exact gaps you uncover are the reason the MES Enterprise Cohort exists.

Inside the Cohort, we:

• Install referral systems step-by-step
• Clarify scope and reimbursement conversations
• Build documentation protocols
• Develop provider communication templates
• Transition your mindset from business operator to practice owner
• Remove fear through structure

We don’t hope for readiness.

We engineer it.

The next MES Enterprise Cohort begins February 28th.

Complete the checklist first.

Then ask yourself:

Am I truly referral-ready?
Am I truly reimbursement-ready?
Or am I assuming I am?

If you are ready to move from assumption to certainty—join us.

This is where capable MedExPROs become confident practice owners.

Let’s build it the right way.