Complete patient demographics first. The Add a new policy or payer button does not appear until the patient’s last name, first name, date of birth, gender, and treating therapist have been entered. If demographics are incomplete, StrataEMR displays a red alert with a Fix It button — click it to go directly to the demographics form.
Navigate to the Policies Page
Navigate to Policies: Patient Menu Bar > Patient Info > PoliciesSelect a Payer Type
Click Add a new policy or payer. A dropdown appears listing the available 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 sole 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 |
Understand the Self-Pay Case Indicator
StrataEMR surfaces the case’s current billing rate type in three places — on the case header, on the Policies page, and inside the Add Policy form. Together they help all staff understand what type of case they are working in before making changes. Case header badge: A badge at the top of every case displays whether it is currently billed at self-pay or insurance rates. This is visible to all users at all times, not just when adding a policy.
“To switch this case to self-pay, we recommend creating a new case without an insurance policy present. To create a new case, click here.”
Fill In the Policy Details
After selecting the payer type, complete the policy form. Required fields vary by payer type, but all medical policies require a subscriber ID and policy start and end dates. For Medicare Advantage (Medicare Replacement Plan) policies, 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 Supplement plans are different. Enter Medicare Supplement plans as Medical (Secondary), not as a replacement plan. Because Medicare Advantage cards look like standard commercial insurance cards, they are easy to misidentify — confirm with the patient or look for a Medicare contract or plan name on the card when in doubt.
| 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 |