The $10M Framework for Cash PT Objection Handling

Client Acquisition & Retention, Operations & Efficiency, Sales & Patient Conversion

What to Say When Patients Say No: The $10M Objection Handling Framework for Cash-Based Physical Therapy Practices

Introduction

Over $40 million has been generated using a single objection-handling framework. Not by a sales team. By physical therapists — in cash-based practices, one patient conversation at a time.

That’s the combined result Dr. Ben Baggy has seen across his own cash practice ($10M over seven years) and the clients he coaches through Clinical Marketer ($30M+ and counting). And the framework behind those numbers isn’t complicated — but most cash PTs are doing the opposite of what it teaches.

If you’ve ever lost a patient at the point of conversion — someone who was nodding along, genuinely interested, and then disappeared behind “let me check my insurance” or “I need to think about it” — this is the post you’ve been waiting for.

We’re breaking down the Triple A Framework: the exact structure Dr. Baggy uses and teaches to handle every major objection without ever coming across as pushy, salesy, or desperate.

Why Cash PT Owners Keep Losing Patients at the Point of Conversion

Here’s the uncomfortable truth: most failed conversions aren’t about price, insurance, or timing. They’re about how the conversation was handled.

The two most common mistakes Dr. Baggy sees cash PT owners make:

Turning the conversation combative. When a patient raises an objection and the PT immediately pushes back, it feels like a battle. The patient gets defensive, trust erodes, and the conversation ends badly — even if the PT “wins” the argument.

Jumping straight to the discount. Slashing your rate or offering a downsell before you’ve addressed the real objection doesn’t solve anything. If the perceived value isn’t there, even a steep discount won’t close the gap.

The core problem: Patients aren’t refusing to say yes. They’re waiting for a reason to. Most cash PTs never give them one.

Introducing the Triple A Framework for Patient Objection Handling

The Triple A Framework is built on three steps: Acknowledge, Associate, and Ask. It works for every objection you’ll face in a cash-based practice — cost, insurance, time, a hesitant spouse, or the patient who converts and then calls back to cancel.

The sequence matters. Skip a step and the whole thing falls apart.

Step 1: Acknowledge — Make Them Feel Heard Before You Say Anything Else

Every objection deserves genuine acknowledgment before you attempt to reframe it. Not a perfunctory “I hear you” — actual empathy that shows the patient their concern is valid and understandable.

This step also includes normalization: letting the patient know that others just like them — with the same insurance, the same hesitation, the same budget — have been in this exact spot. Nobody wants to feel like they’re doing something unusual or risky. When they understand that other patients have navigated this and come out the other side, the objection immediately carries less weight.

Good news: this step comes naturally to most PTs. You’re already trained to listen and empathize. The mistake is moving on too quickly.

Step 2: Associate — Use Storytelling to Shift Their Frame of Reference

This is where most cash PT owners stall. After acknowledging the objection, they don’t know what to say next — so they either over-explain, argue, or give up.

The answer is storytelling. Specifically: share a story about a past patient who had the exact same concern. Walk through what they were worried about, how they thought about it, what they decided to do — and what happened as a result.

You’re not telling the patient what to think. You’re letting someone else’s experience open up a new way of seeing the situation. That’s the difference between feeling helpful and feeling salesy.

Pro tip: The most powerful stories feature a patient who had the same objection, went a different route, struggled — then came back and got results. That contrast is what shifts perspective.

Step 3: Ask — Close With Confidence and Give Them Something to Say Yes To

This is the step most people skip entirely — and it’s the most important one. After you’ve acknowledged and reframed, the patient needs a clear, confident next step. Not an open-ended “so what do you think?” — a specific question they can answer yes to.

The goal is to help the patient arrive at the right conclusion themselves. You’re facilitating, not pushing. But facilitating still requires a clear ask at the end.

The Insurance Objection: A Full Triple A Walkthrough

The most common objection in cash-based physical therapy practices is some version of this:

“This sounds great — I just need to check my insurance first.”

Here’s how the Triple A Framework plays out:

Acknowledge: “That makes total sense. Insurance costs a lot — it’s natural to want to use it. In fact, every single patient we work with has insurance. I’d want to check mine too.”

Note the normalization: “every patient we work with has insurance.” This tells the patient they’re not an outlier. Others just like them have been here and found a path forward.

Diagnose Before You Associate:

Before jumping into the story, ask one clarifying question:

“Can I ask — is it because of the investment, or is it more the principle of wanting to use what you’re already paying for?”

This matters more than it seems. A patient who can easily afford out-of-pocket care but objects on principle needs a very different conversation than one who is genuinely stretched financially. Knowing which path you’re on determines everything that follows.

Associate:

“I had a patient not too long ago who felt the same way. They decided to go to a traditional clinic that took their insurance — totally reasonable. But three months later they were still in pain, doing cookie-cutter exercises, feeling like they were spinning their wheels. They came back to us. Within six weeks, the pain they’d had with running was essentially gone. They finished their half marathon. That’s not magic — it’s what happens when we can spend real one-on-one time building a plan around your body instead of following what an insurance company’s checklist says.”

Ask:

“If a clinic accepted your insurance but didn’t actually get you the results you wanted, would it still feel worth it?”

Pause. Let them answer. Then close:

“Based on what you’ve shared, it sounds like results are what matter most to you — and that’s exactly what we focus on. If we can get you there, would you be opposed to getting your next few sessions booked so we can start working toward that together?”

The mindset shift that lands: “The most expensive option is the one that doesn’t work.” Help patients understand that perceived savings on an ineffective solution aren’t savings at all.

When to Use Downsells in Your Cash PT Practice (and When Not To)

Downsells are a legitimate tool — but only after the Triple A Framework has been fully worked through. Used too early, they undercut your value. Used at the right moment, they bridge the gap for patients who are genuinely on the fence.

Two downsell options that work well in cash-based PT:

A single discounted evaluation. Offer a reduced rate (for example, $99 instead of $249) to get the patient in the door with no obligation to continue. Frame it as giving them the information they need to make the best decision for themselves — whether that’s with you or not. The non-committal framing removes the biggest perceived barrier.

A money-back guarantee. For patients you’re confident you can help, offer to refund the session if they don’t find it valuable. Every time you reduce perceived risk, you increase the likelihood of a yes. This shouldn’t be used indiscriminately — but for the right patient, it closes the gap completely.

Key rule: If a patient won’t say yes to a single discounted session with a money-back guarantee, they were never going to commit to a full package. Downsells reveal intent — they don’t create it.

This Framework Handles Every Cash PT Objection — Not Just Insurance

The scripting changes for each objection. The structure never does. The Triple A Framework applies to:

Cost objections — “This is more than I expected to spend.”
Think-about-it stalls — “Can I get back to you?”
Spouse objections — “I need to check with my partner first.”
Post-conversion cancellations — The patient calls back to back out after signing up.

Each of these has its own scripting nuances — which is exactly why Dr. Baggy built out a full playbook rather than leaving practitioners to improvise in the moment.

Frequently Asked Questions About Patient Objection Handling in Cash PT

How do I handle patients who say they need to check their insurance?

Start by acknowledging the concern genuinely, then identify whether the hesitation is about cost or principle. From there, share a story about a past patient in the same situation, and close by asking whether results or coverage matter more to them. This reframes the conversation around outcomes rather than logistics.

Is it okay to offer a discount to close a patient in a cash-based practice?

Only after you’ve fully addressed the real objection. Jumping to a discount prematurely signals low confidence in your own value, and it often doesn’t work because the patient’s hesitation isn’t actually about price. Use a discounted session or money-back guarantee as a final bridge — not a first response.

What’s the most common objection in cash-based physical therapy?

Insurance is the top objection in most cash PT practices, followed closely by cost. Both respond well to the Triple A Framework — the key is diagnosing which underlying concern is actually driving the hesitation before you attempt to address it.

How do I close a patient without feeling salesy?

The Triple A Framework is designed to avoid exactly that feeling. By acknowledging concerns, sharing relatable stories, and asking questions rather than making statements, you’re guiding the patient to their own conclusion rather than pushing them toward yours. The result feels like a helpful conversation — not a sales pitch.

Watch and Listen to the Full Video

For a deeper dive into a cash physical therapists’ journeys, make sure to listen to the full video: What to Say When Patients Say No: The $10M Framework for Handling Any Objection.

About Author:

Jordan Mather got started in the entrepreneurship game at 18 with a medical software startup that revolutionized the physical therapy patient experience. As CEO for 5 years, Jordan participated in top Startup Accelerator Programs, collaborated with a major Wisconsin hospital, raised over $250K in funding, and earned a spot on Wisconsin’s ‘Top 25 Entrepreneurs Under 25’ list.

Although the company eventually failed, it provided Jordan with invaluable learning experiences. He became passionate about designing world-class patient experiences and building efficient marketing & sales funnels for cash physical therapists. Utilizing this expertise, Jordan became the CMO of a well-known physical therapy media company, and consulted for and built marketing funnels for some of the top physical therapy business coaches.

Eventually growing tired of the typical agency and consulting grind, Jordan, alongside Max Zirbel, founded Clinical Marketer. They infused it with the hands-on support and mentorship that they benefited from in their initial venture. The company was a success from the start, aiding clinics in scaling to 6 and 7 figures in revenue. During its first launch, Jordan and his team met Dr. Ben Bagge, whom they later partnered with after helping him grow his business from $200K/year to over $1M/year in three years.

Now, Jordan is focused on empowering clients in the cash physical therapy space, sharing his accumulated skills, processes, and hiring strategies to help them increase their revenue and impact without proportionally increasing their workload.