Most of your patients’ commercial payers can be checked directly in Availity, no phone call required. StrataPT recommends that every customer has an Availity account (generally set up during onboarding), so this option is available to your team. This guide walks front desk and billing staff through pulling up a patient’s benefit details for a commercial payer. Medicare benefits still verify automatically in StrataEMR and don’t need this process.
Before You Begin
- You need an active Availity login. Check with your practice admin if you don’t have credentials.
- Have your practice’s NPI and Tax ID on hand.
- Have the patient’s insurance card: Member ID and Date of Birth. If you don’t have the Member ID yet, you can search by the patient’s first and last name instead.
Note: Availity coverage varies by payer. Most major commercial payers (Aetna, Blue Cross, and others) support eligibility and benefits lookups. Not every payer a patient carries will be available.
Verify a Patient’s Benefits
- Log in to Availity.
- Select Patient Registration from your home page.
- Choose the patient’s payer from the payer list.
- Enter your practice’s NPI and Tax ID.
- Enter the patient’s information: Member ID and Date of Birth (or First Name and Last Name if you don’t have the Member ID yet).
- Select Submit.
Once the request loads, the patient’s benefit summary appears, including their remaining deductible and other cost-sharing details. Use the In Network / Out of Network toggle at the top to see benefits under each, and the dropdown menu to confirm physical therapy is covered.
Tip: You can print this results page and upload it to the patient’s Documents in StrataEMR, the same way many practices already keep a record of phone verifications.
Note: Availity doesn’t send this information into StrataEMR automatically. Enter what you find into the patient’s benefit record in StrataEMR (Patient Menu Bar > Patient Info > Policies > Benefits) so your billing team has it on file.
Save Time on Repeat Lookups
If you check benefits often, star Patient Registration as a favorite so it appears on your Availity home page for quick access.
[SCREENSHOT: Favoriting Patient Registration on the Availity home page]
Availity also keeps a recent patient history, so switching between patients you’ve already looked up doesn’t require re-entering their information each time.
Checking Authorizations and Referrals
Tip: Availity isn’t just for benefits. The same portal lets you check whether a payer requires prior authorization or a referral, and submit an authorization or referral request using the same patient and policy information. Look for Authorizations & Referrals in the Availity menu. If a policy requires either, see Patient Benefit Verification for what to do with that information once you have it. 
