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One of the most preventable sources of claim denials is incorrect policy information — a subscriber ID entered wrong, a name that doesn’t match the payer’s records, or an inactive policy that slipped through. Automatic Policy Validation catches these issues the moment a policy is entered or updated, before a single claim is sent. When you add or update a subscriber or payer number on a patient’s policy, Mako AI runs a validation check in the background. Results return in about 10 seconds. If anything doesn’t match what the payer has on file, an error appears directly on the policy.
Access: Automatic Policy Validation is enabled for all customers and runs automatically — no setup or activation is required. All staff can view policy validation errors and correct them via the patient’s Policies page.

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How Automatic Policy Validation Works

Mako checks the subscriber and payer information against payer records the moment it is entered or changed. It looks for exact matches on key identifiers — subscriber ID, name, and date of birth. If anything doesn’t match, an error appears on the policy using the same interface as Authorization Holds. When a Policy Validation error is active, StrataEMR blocks documentation completion and claim creation for that patient until the error is resolved.
Note: Automatic Policy Validation is separate from benefit verification. Benefit verification confirms coverage details — copay, deductible, visit limits, and authorization requirements. Policy Validation confirms that the policy itself is accurate: that the subscriber ID and identifying information match what the payer has on file. Both must be complete before claims can move forward.

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When Validation Runs

Validation triggers automatically when:
  • A subscriber number is entered on a new policy
  • A payer is selected or updated on an existing policy
  • A subscriber number is edited on an existing policy Policies already on file are not re-validated unless they are opened and saved with a change.

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Identifying a Policy Validation Error

Policy Validation errors appear on the patient’s Policies page and look similar to Authorization Hold errors. You can confirm an error is from Automatic Policy Validation because the message begins with:
This policy was validated on [date] and returned the following error(s):
If the error message does not begin with this phrase, it is not a Policy Validation error — it may be a separate billing or configuration issue that needs a different resolution path. Common validation errors include:
  • Invalid/Missing Subscriber ID — The subscriber number doesn’t match payer records
  • Name Mismatch — The patient’s first or last name doesn’t exactly match what the payer has on file
  • Birth Date Mismatch — The date of birth on the policy doesn’t match payer records
  • Inactive Policy — The payer indicates the policy is no longer active
  • Subscriber Not Found — No matching record was found for the subscriber information entered

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Resolving a Policy Validation Error

  1. Review the error message on the patient’s policy to identify what didn’t match.
  2. Verify the correct information — check the patient’s insurance card, call the payer, or use your eligibility tool.
  3. Update the policy details in StrataEMR to match what the payer has on file.
  4. Re-save the policy. Saving automatically re-runs the validation.
  5. If the error clears, documentation completion and claim creation can proceed.
Note: If the validation result appears incorrect after you’ve confirmed the information is right, contact StrataPT Support and include the patient ID and the exact error text. Do not attempt to manually clear the error — re-saving the policy after making a correction is the only supported resolution path.

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Common Scenarios

Nicknames and legal name differences Mako looks for an exact name match with the payer. If a patient goes by “Kate” but the insurance card reads “Katherine,” the validation returns a name mismatch error. Update the name in StrataEMR to match the insurance card exactly, then use the Preferred Nickname field for the name the patient goes by day to day. Transitioning to StrataEMR at go-live When your practice imports existing patient data into StrataEMR, Mako runs validation on all imported policies. Some errors may appear on existing patients immediately after go-live — these represent real data discrepancies that should be resolved before submitting claims. Reviewing and cleaning up patient policy data before your import date reduces the number of errors you’ll encounter on day one.