A 20 hours rehab and prehab coach VA is the point where admin support stops being partial and starts covering your practice end to end. You get everything from the smaller tiers - scheduling, client communication, referral management, exercise program delivery - plus social media and physician coordination. Twenty hours a week is where most growing practices land after realizing that ten or fifteen hours left too many tasks unfinished.
What Gets Done in 20 Hours
All prior scope carries forward. The additional hours open these systems:
Social media management. Your VA creates and schedules posts featuring recovery tips, exercise demos, patient success stories (with consent), and educational content about prehab benefits. Expect three to four posts per week across one or two platforms. They handle captions, basic graphics using templates, and community engagement - responding to comments and DMs.
Physician coordination. Your VA manages outbound communication with referring doctors. This includes sending progress summaries, coordinating on shared patients, scheduling case discussions, and maintaining a log of all physician touchpoints. This keeps your referral relationships active without you drafting emails between sessions.
Compliance documentation support. Your VA organizes files for insurance audits, maintains HIPAA-related records, tracks consent forms, and flags documentation gaps. They do not interpret regulations, but they make sure the paperwork is in order.
Patient outreach. Reactivation campaigns for clients who dropped off, birthday or milestone messages, and wellness check-ins for discharged patients. This is the kind of relationship maintenance that brings clients back and generates word-of-mouth referrals.
Expanded intake processing. With more bandwidth, your VA can handle a higher volume of new clients - verifying insurance, processing forms, sending welcome packets, and scheduling initial evaluations - without creating a bottleneck.
Sample Weekly Schedule
| Day | Hours | Tasks |
|---|---|---|
| Monday | 4 | Weekly scheduling review, insurance verifications, social media posts for the week, intake processing |
| Tuesday | 4 | Referral management, exercise program delivery, physician coordination emails, client messages |
| Wednesday | 4 | Progress note reminders, compliance documentation, midweek appointment management, social media engagement |
| Thursday | 4 | Patient outreach campaign, equipment tracking, reschedule requests, referral log updates |
| Friday | 4 | End-of-week reporting, confirm next week's schedule, physician follow-ups, social media check-in |
What Gets Cut
Even at twenty hours, a few things remain outside scope:
- High-volume social media. Three to four posts per week is manageable. Daily posting across multiple platforms, video editing, or running paid ad campaigns requires dedicated marketing hours.
- Full billing and claims management. Your VA supports insurance verification and documentation, but submitting claims, handling denials, and managing accounts receivable is a separate function.
- Multi-location coordination. If you operate from two or more clinics, the scheduling and communication complexity multiplies beyond what twenty hours can absorb.
When to Upgrade
Move to 30 or 40 hours when:
- You open a second location or add another practitioner and the admin workload doubles.
- Social media starts generating leads and you want to increase posting frequency or add video content.
- Insurance billing becomes a significant time drain and you need your VA to take on more of the claims process.
- Your client base exceeds 60 active patients and the volume of daily scheduling changes, messages, and follow-ups outpaces the current hours.
- You want your VA to handle community outreach - connecting with local gyms, sports teams, or senior centers for cross-referral opportunities.
Can my VA create exercise demo videos?
Your VA can coordinate video logistics - scheduling recordings, editing simple clips, and uploading to your platforms. They will not film or demonstrate exercises, but they handle everything around the content you create.
How does physician coordination work in practice?
Your VA sends templated progress updates after key milestones, follows up on referral status, and logs all communication. You review and approve clinical summaries before they go out. The VA handles the sending, tracking, and filing.
Will my VA manage my Google Business profile?
Yes, this falls under social media management. Your VA can update hours, respond to reviews, post updates, and add photos. Keeping your Google profile active also supports local SEO for your practice.
What compliance tasks can a VA realistically handle?
Organization, not interpretation. Your VA maintains files, tracks form expiration dates, flags missing signatures, and prepares documentation bundles for audits. Regulatory interpretation and policy decisions stay with you or your compliance officer.
Is 20 hours enough if I also run wellness workshops?
It depends on workshop frequency. Monthly workshops add scheduling, promotion, and follow-up tasks that fit within twenty hours. Weekly workshops create enough additional coordination that you should consider adding hours.
Starting smaller? The 15-hour scope covers referral basics. Scaling further? See the 30-hour scope for second-location ops. HBR research shows CEOs spend 72% of work time in meetings.