The Policies page is where all payer information for a patient is entered and managed. Every date of service requires an active policy covering that date before a clinical document can be completed and charges submitted. This includes commercial insurance, Medicare, Medicaid, workers comp, liability, attorney cases, self-pay, and financial arrangements. Navigate to the Policies page from within a patient’s case: Patient Menu Bar > Patient Info > Policies.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 the Policies page.
Adding a Policy
Click Add a new policy or payer and select from the following payer types. The type you select determines how StrataEMR handles billing behind the scenes — it controls claim submission format, billing order, and how patient responsibility is calculated.| Payer Type | When to Use |
|---|---|
| Medical (Primary) | The patient’s main commercial or government insurance |
| Medical (Secondary) | A second insurance that pays after the primary |
| Medical (Tertiary) | A third insurance that pays after secondary |
| Worker’s Comp | Work-related injury billed to an employer’s workers comp carrier |
| Liability / Auto | Auto accident or general liability claim |
| Attorney | Attorney billing where the attorney is the primary responsible party |
| Attorney (After Medical/Liability) | Attorney billing that should only be billed after other insurances are exhausted first (visible after a primary policy has been added) |
| Self-Pay | Patient pays directly with a flat rate or per-charge fee schedule |
| Financial Arrangement | A negotiated reduced rate applied after all other policies have processed |
Policy Types in Detail
Medical Policies
Standard commercial and government insurance — Blue Cross Blue Shield, Aetna, UnitedHealthcare, Medicare, Medicaid, and others. Enter the subscriber ID, policy start and end dates, and upload the insurance card. Policy start and end dates matter for charge submission. If a patient’s policy has a start date of June 1 and you need to complete documentation for a May date of service, StrataEMR will not allow document completion until a valid policy covering that date is present. Correct the start date or add an appropriate policy to cover the gap. If a patient has multiple active policies, the order they appear on the Policies page determines billing priority. StrataEMR bills them in order — primary first, then secondary, then tertiary. Contact your account manager through the Messaging area if the policy order needs to be changed; do not attempt to reorder policies manually.Medicare Policies: Replacement Plans and Dual Eligible
Two Medicare-specific configurations come up frequently when loading policies, and they’re easy to confuse. Using the wrong setup affects how StrataEMR routes and formats the claim.Medicare Replacement Plan (Medicare Advantage)
Medicare Replacement Plan (Medicare Advantage)
If a patient’s insurance is a Medicare Advantage plan, enter the policy as Medical (Primary). When the New Policy form opens, locate the Is this a Medicare Replacement Plan? field and select Yes. This tells StrataEMR to bill the Advantage plan directly and formats the claim accordingly. Medicare Advantage plans can also be referred to as Advantage plans — Medicare Supplement plans are different and should be entered as Medical (Secondary), not flagged as a replacement plan. Because Medicare Advantage cards look like standard commercial insurance cards, they’re easy to misidentify — when in doubt, confirm with the patient or look for a Medicare contract or plan name on the card.
Dual Eligible (Medicare + Medicaid)
Dual Eligible (Medicare + Medicaid)
Dual eligible patients have both Medicare and Medicaid coverage, processed by the same payer.Enter the policy as Medical (Primary) and navigate to the Benefits tab. Set the Dual Eligible Plan field to Yes. StrataEMR will automatically generate the Medicaid secondary — do not manually add a second policy.If the Medicare payer does not process the Medicaid portion, enter the primary policy as Medical (Primary) and set Is this a Medicare Replacement Plan? to Yes. Then load the Medicaid processor separately as Medical (Secondary).
Quick reference
Quick reference
| Scenario | Policy Setup |
|---|---|
| Patient has a Medicare Advantage plan | Medical (Primary) → set Is this a Medicare Replacement Plan? to Yes |
| Patient is dual eligible; payer processes both Medicare and Medicaid | Medical (Primary) → set Dual Eligible Plan to Yes on Benefits tab; system auto-generates secondary |
| Patient is dual eligible; Medicare payer does not process Medicaid | Medical (Primary) → set Is this a Medicare Replacement Plan? to Yes; load Medicaid processor as Medical (Secondary) |
| Patient has traditional Medicare only | Medical (Primary), no additional fields needed |
Workers Comp
Workers comp cases require a date of injury in addition to standard policy fields. Workers comp notes also typically require time in/out on each visit. Confirm your state and payer requirements with your account manager when setting up a new workers comp case.Liability / Auto
Used for auto accident and general liability cases. Claims are sent with clinical documentation automatically. In many liability cases, a patient will also have a commercial backup policy to cover treatment if liability benefits are exhausted — add this as Medical (Primary Backup).Attorney
Use Attorney when the attorney is the sole responsible party. Use Attorney (After Medical/Liability) when the attorney should only be billed after other payers have processed first. For example, a patient with Allstate auto insurance and a BCBS commercial backup who also has an attorney would be entered as:- Liability / Auto — Allstate
- Medical (Primary Backup) — BCBS
- Attorney (After Medical/Liability) — Attorney name
Self-Pay
Self-pay can be configured with a flat rate per visit or a rate per billing charge. The amount to collect displays automatically on collection tasks based on the rate entered. Self-pay is appropriate for patients with no insurance or for private-pay wellness services.Self-Pay is not the same as Financial Arrangement. Self-pay is used when the patient has no insurance and is paying the full rate. Financial Arrangement is used when an insured patient has a negotiated reduced rate applied after their insurance processes. Do not use Self-Pay as a workaround for cash-pay patients who have insurance — this will affect how claims are submitted.
Financial Arrangement
A financial arrangement is a negotiated rate that gets applied to the patient’s balance after all other policies have processed. It is not billed directly — it caps how much the patient owes out of pocket on dates of service covered by the arrangement. Common use cases include:- Patients with high deductibles or high co-insurance who have financial hardship
- Patients where the practice has agreed to a flat rate regardless of insurance outcome
- Cases where the practice wants to ensure a patient is never billed more than a set amount