Benefit verification is the process of confirming a patient’s insurance coverage details before treating — copay, coinsurance, deductible, visit limits, authorization requirements, and PCP referral status. Accurate benefit details allow StrataEMR to calculate the correct recommended collection amount and prevent claim denials.Documentation Index
Fetch the complete documentation index at: https://docs.stratapt.com/llms.txt
Use this file to discover all available pages before exploring further.
Access: All staff can view and enter benefit information.
Accessing the Benefits Section
The Benefits section is accessed from Patient Menu Bar > Patient Info > Policies, then clicking the Benefits button on the relevant policy.Medicare vs. Commercial Payers
Medicare benefits are verified automatically. When a Medicare policy is saved, StrataEMR pulls current benefit usage and coverage information directly — no manual entry is required. The Medicare tracker updates automatically throughout the year as the benefit is used. All other payers require manual benefit entry. Commercial insurance, Medicaid, workers comp, and other payer types do not have an automatic verification connection. Your team must call the insurance, obtain the benefit details, and enter them into the Benefits screen.Entering Benefits for Commercial Payers
From the patient’s Policies page, click the Benefits button on the relevant policy to open the benefit verification screen. Enter the details obtained from the insurance:- Copay — Fixed dollar amount per visit (if applicable)
- Co-insurance — Patient’s percentage responsibility (if applicable)
- Deductible — Annual deductible amount and how much has been met
- Out-of-Pocket Maximum — Annual cap and amount met
- Visit Limit — Total visits allowed and how many have been used
- Authorization Required — Yes/No, and from which visit authorization becomes required
- PCP Referral Required — Yes/No, and whether it has been obtained
- In/Out of Network — Confirm the provider’s participation status with this plan
Recommended Amount to Collect: After saving benefit details, StrataEMR automatically calculates the recommended collection amount per visit based on the copay, coinsurance, or deductible status entered. This value drives collection tasks for each appointment.
Benefit Verification Tasks
When adding a new policy, you can opt to create a Benefit Verification Required task by checking the Create Benefit Verification Task checkbox next to the Save Policy button. This places a task on the dashboard under Billing Tasks, alerting your team that benefits still need to be obtained for the new policy. This task workflow is optional — StrataPT encourages the use of this task if benefits are not verified at the time the policy is entered, but does not require it. Use the task feature if your practice wants a structured reminder system for tracking which patients still need benefit verification.Benefit Verification Completed Tasks
Once StrataPT completes a Medicare benefit verification on your behalf, a Benefit Verification Completed task appears on the dashboard. These tasks do not clear automatically — a staff member must review the entered benefits and manually mark the task complete.Clearing completed tasks keeps your dashboard clean. Benefit Verification Completed tasks remain on the dashboard until manually cleared. After reviewing the benefits, click the task to mark it complete.