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When you open a patient’s visit or case, StrataEMR may display a suggested dollar amount to collect from the patient at the time of service. This is the StrataPT Recommended Amount — an estimate calculated from the patient’s verified insurance benefits, including their copay, co-insurance rate, and remaining deductible. The collection suggestion is a guide, not a guarantee. It reflects what StrataEMR expects the patient will owe based on benefit information on file. The actual amount may differ once the claim is adjudicated and the insurer responds.

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How StrataEMR Calculates the Suggestion

StrataEMR uses the following information to calculate the suggested amount:
  • Copay: A flat amount defined on the patient’s policy, collected every visit.
  • Co-insurance: A percentage of the allowed amount the patient owes, typically after the deductible is met.
  • Deductible remaining: The amount the patient still owes toward their annual deductible before co-insurance kicks in.
If a patient has a $0 copay but a 20% co-insurance with an unmet deductible, StrataEMR will suggest collecting toward the deductible rather than $0. This is working as expected.
Note: Benefit information is pulled from the verification data on file. If benefits were not verified or are outdated, the collection suggestion may be inaccurate. See Insurance Verification to update benefit details.

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Why the Suggestion May Look Wrong

There are several common reasons the suggested amount may not match your expectation: The patient has a secondary insurance. When a patient has a Medicaid secondary or another plan that covers the patient’s share, the suggestion may still show an amount owed. In most cases, you should not collect from a patient with Medicaid as secondary — the secondary plan covers it. The deductible reset at the start of the year. In January, deductibles reset. If benefit information has not been re-verified for the new plan year, StrataEMR may show a lower suggestion than is actually owed. The copay and co-insurance are both present. For some plans, copay applies at each visit and co-insurance applies separately to specific services. StrataEMR reflects both if present in the benefit data. The patient has a non-standard arrangement. If you have a financial arrangement in place with a patient — such as a reduced rate or deferred payment — the system may still show the standard calculated amount unless a financial arrangement has been recorded. If you want to stop StrataEMR from prompting collection for a specific patient, you can override the suggestion at the case level.
  1. Open the patient’s case in StrataEMR.
  2. Navigate to the Policies screen of the Patient Info section of the case.
  3. Locate the Your Preferred Amount box.
  4. Enter $0 or another amount you would prefer to collect.
  5. Save your changes.
Note: Overriding the recommended amount does not affect the patient’s balance or any claims. It only removes the prompt from appearing in tasks and visit workflows. The patient may still have a balance due — disabling the suggestion does not clear or write off any amount.
Warning: If you are turning off the recommended amount because a secondary plan (such as Medicaid) covers the patient’s responsibility, discuss this with your StrataPT Billing or Customer Success team. Do not turn off the suggestion as a workaround for an unresolved insurance setup issue.

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Practice-Wide Collection Suggestion Settings

Practice-wide collection suggestion behavior — including whether the suggestion appears, how it behaves for specific payer types, and default thresholds — is configured by StrataPT on your behalf. If you need to adjust how the collection suggestion works across your entire practice, contact StrataPT Support or your account manager.