Phys Med grows from 2,500 to 3,000+ visits a month by filling last-minute cancellations automatically
Phys Med Physical Therapy Clinics, a 30-year-old outpatient practice in Fresno, California on WebPT, brought in Penciled to automate scheduling, confirmations, and cancellation-fee collection—lifting monthly visits from 2,500 to more than 3,000 and doing the work of two front-office staff without adding headcount.
Overview
Phys Med Physical Therapy Clinics, an outpatient orthopedic practice that has served Fresno and the San Joaquin Valley for more than 30 years, was rebuilding after a period of downsizing and needed to grow without hiring more front-office staff. Penciled now schedules and confirms appointments directly with patients over text, fills therapist schedules after last-minute cancellations, and collects cancellation fees—taking Phys Med from roughly 2,500 patient visits a month to more than 3,000, a 20% increase, while doing the work of two front-office employees.
High-impact features
- Automatic scheduling and appointment confirmations with patients over SMS, straight into WebPT
- Therapist schedules refilled automatically after last-minute cancellations
- Cancellation fees charged and collected without front-desk phone calls
- A front office refocused on insurance verification, authorizations, and treatment plans
About the team
Phys Med Physical Therapy Clinics is an outpatient orthopedic practice based in Fresno, California, that has provided rehabilitation services to the San Joaquin Valley for over three decades. It's owned by Blasenko Simunovic, a physical therapist who began his career in the mid-1980s, and run day-to-day by Chief Operations Officer Pedro Santana. The practice sees thousands of patient visits every month with a bilingual front office serving a large Spanish-speaking community.
When Penciled came into the picture, Blasenko's priority was steadying the business and getting it growing again.
"Our objective was to keep Phys Med running forward—safe, strong, and looking ahead to more growth. Our strategy was to stabilize the company financially after the downsizing and re-establish our growth. Our relationship with Penciled is an important step forward in that process."
Core problem
For Pedro, the operational picture came down to three things: missed appointments, front-office workload, and scheduling.
"Before Penciled, the objectives that mattered most were addressing missed appointments and cancellations, front-office tasks and efficiencies, and patient scheduling."
The existing answer to all three was the same one most practices reach for: more people making more phone calls.
"Our strategy was hiring more front-office staff to assist with the day-to-day—more phone calls."
Software hadn't been much help. Asked how he thought about its role in the organization before Penciled, Pedro's answer was one word: insufficient. Blasenko's experience with technology vendors had been similarly uninspiring.
"Software was not a pleasant experience from the beginning, but we learned to deal with it and move forward. What I was looking for was AI involvement—and, for me, a more personalized relationship, more customized to our needs."
Why they chose Penciled
Pedro had already been thinking about AI for scheduling and patient communication when he initiated the conversation with Penciled. What kept him talking was a specific question.
"I was curious to know how the AI system automatically schedules and confirms patient appointments."
After the demo, the decision came down to two things: the automation itself, and how little it would disrupt the way the clinic already ran.
"The automation of patient scheduling. What made us sign up was how simple it was to integrate the system with our current operations. It allowed us to update and improve our daily tasks and duties to become more efficient."
Blasenko, by his own account, knew nothing about Penciled before the first meeting. What won him over wasn't the technology—it was the people.
"The most important thing was your positive and personalized approach to the whole training process with our staff—the more humanized relationship, dealing in person with you both and resolving problems on-site. You made me feel that I was dealing with the right people, with your desire to make things work well and your hard work—which for me is a basic thing."
Product
Penciled integrates directly with WebPT. When a cancellation or opening appears on a therapist's schedule, Penciled's AI contacts patients over SMS, answers their questions in a natural back-and-forth, and books them straight into the slot. The same assistant confirms upcoming appointments, handles reschedules and cancellations over text, and applies the clinic's cancellation policy—so fees get collected without a phone call.
Through a front-office dashboard, the team can monitor cancellations as they're being filled in real time, see which patients were contacted and which accepted each slot, and read—or manually step into—any individual text conversation to override the AI when needed. Patients reply to the assistant and schedule appointments without any portals, logins, or extra steps.
Phys Med went a step further than most practices in introducing the assistant to patients: framed posters at the front desk—printed in both English and Spanish—explain how to book, reschedule, and get reminders from their phone.
The early days
The first problems Penciled took on were the ones that had been costing the clinic the most.
"Penciled immediately solved our high cancellation rate and missed appointments—and collecting cancellation fees."
"What seemed most promising was being able to charge and collect the cancellation fees, and that it automatically fills the therapist's schedule after a cancellation."
Rollout was hands-on. The Penciled team trained the front office in person, on-site at the clinic.
Automating scheduling also surfaced a process gap upstream: appointments were sometimes being booked before insurance verification and authorizations were complete. Rather than a limitation of the software, the team treated it as a reason to tighten their own workflow.
"Insurance verifications and authorizations need to be completed before scheduling. Often, we didn't have this process completed before scheduling appointments. Now, this has been a priority."
For Blasenko, the early gaps were small—and the main adjustment was on the patient side.
"Some of the gaps were minimal, and while growing with the system we are all learning positive things. Some of our patients were a little confused and overwhelmed with the amount of texting—in my opinion, a normal learning process."
The moment Pedro knew it was working came when he watched appointments land in WebPT on their own.
"I felt Penciled was worth it after I saw how the system was automatically scheduling appointments through WebPT."
Results
From 2,500 to 3,000+ visits a month
The headline number is volume. By filling last-minute cancellations that used to go empty, Phys Med is seeing roughly 20% more patient visits.
"A 20% increase in patient scheduling—filling in last-minute cancellations—equates to seeing more patients. We're currently seeing more than 3,000 patients per month with Penciled. Before Penciled, we were seeing 2,500 patients per month."
The work of two front-office employees
Asked whether the money could have gone somewhere better, Pedro measured Penciled against the alternative he'd been pursuing before: more hires.
"No. I believe Penciled effectively does the tasks of two front-office personnel. It saves money on extra salaries. The system is able to communicate and confirm appointments directly with patients."
Faster confirmations over text
Confirmations that used to mean a phone call—and often a voicemail—now happen over SMS, with patients responding faster.
"Definitely worth it. Penciled has allowed us to follow up with patients' care more effectively. We are able to get a quicker response or confirmation from patients over text than calling on the phone. It's a time saving—fewer phone calls to confirm appointments."
A front office with new priorities
With scheduling and confirmations automated, the team reorganized around the work that only people can do.
"We implemented and established new priorities that are critical, such as insurance verification, authorization, and treatment plans."
"In a few words, I have been very impressed, since we have resolved important weaknesses we had inside our organization. It was the right financial decision for us, and we are looking forward to making it better."
Discussion
Filling the gaps in WebPT
Penciled layered on top of Phys Med's existing EMR and closed gaps the clinic had been managing by hand—particularly around authorizations.
"There were gaps Penciled was able to fill: monitoring the number of visits per insurance authorization, and making sure insurance was verified before scheduling appointments."
Pedro's wish list for what comes next is a single, integrated system—billing, scheduling, insurance verification, authorization, and payment processing in one place. Asked whether he'd consider transitioning if Penciled built its own EMR, his answer was yes, as long as billing is integrated. Blasenko was even more direct: "You are giving us a new possibility, and we are looking forward to a change."
A partner, not a vendor
Both leaders came back to the same theme: what sets Penciled apart is the relationship.
"Penciled is able to customize and make the necessary changes that best fit our operations. What matters most in choosing an AI technology partner is having a strong business relationship—and being able to speak to someone to resolve issues is important."
"What I admire most about Penciled's philosophy of work is the strong desire to provide the best product with a personalized and friendly approach—more humanized and realistic. Your customer approach is genuine and makes us feel that we are with the right group. You are an exceptional group of professionals."
Where the industry is heading
Pedro sees AI taking the repetitive, manual work off the front office—and consistency with patients as the real prize.
"The industry is heading toward using more AI to reduce the extensive manual work in the front office. AI is the new way of generating more patients for PT practices. It helps eliminate human error or oversight. Most importantly, it helps keep consistent communication with patients."
Advice for other practices
Blasenko's advice is about expectations: the payoff is real, but it takes some investment from staff and patients alike.
"It is part of the process for our staff and patients. It requires some extra time now, training patients and staff, but we will reach an optimal operation with time—and Penciled's consistent support is a crucial tool to reach that level."
And asked who Penciled is an ideal fit for, Pedro cast a wide net: any healthcare organization.
Conclusion
Phys Med shows how an established practice can grow again without growing its front office. By layering Penciled on top of WebPT, the clinic turned last-minute cancellations into filled visits, moved confirmations and cancellation fees to text, and freed its team to focus on verification, authorizations, and treatment plans—taking monthly volume from 2,500 visits to more than 3,000.
"Highly recommend Penciled. Shawn and Justin are great to work with—very understanding and knowledgeable about how AI impacts our business. It has been very positive, especially being able to schedule more patients in a timely manner."
"It has been very much worth it, and I'm looking forward to making this relationship even stronger. Please continue doing the same forever, because that is what will make your business grow fast."
