Opalforce — Growing Practices. Digitally.

Claims & Revenue AI

Claims built from what was documented.

Prepares claims from what was documented, then tracks them.

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Checks a claim has everything it needs, then tracks it until it's paid.

1

Tick the missing items, like X-ray images and staff approval.

2

Once it says Ready, add status updates from the bottom row.

3

Leave one item unticked and see the claim stay on hold.

What to look for

A claim only moves forward when each step has its own proof.

Sample workspace · fictional data. No live calendar, payer, messages, payments or chart are connected. Results stay in this browser tab and clear when you reset or leave.

Documented in the visit note
Sample status events received

Not ready: 1 item missing

Missing

  • • X-ray images not attached for D0274

Status, each step needs its own evidence

  1. prepared
  2. submitted
  3. accepted
  4. adjudicated
  5. paid
  6. reconciled

Nothing is sent to a payer here. Codes come only from what was documented.

What it does

  • Uses only documented services
  • Flags exact missing evidence
  • Waits for staff approval
  • Tracks each status step separately

How it works

  1. 1Gathers documented services and evidence
  2. 2Checks it and waits for staff approval
  3. 3Submits and tracks status
  4. 4Matches payments back to the claim

Uses

  • • Signed visit note
  • • Attachments like x-rays
  • • Subscriber details
  • • Payer status events

Produces

  • • A missing-items list or a packet for review
  • • A clear status timeline

Practice setup

  • • Assess your clearinghouse and system access
  • • Set approval rules
  • • Test one claim from note to posting

Your team decides

Never invents codes or procedures.

Questions about Claims & Revenue AI

Live use depends on a connection we assess and test for your practice systems.

How practice connections work
Can it add codes?
No. It never invents codes or procedures.
Is submitted the same as paid?
No. Submitted, accepted, decided, paid and posted are separate steps.
Does this page contact a payer?
No. Status events here are samples you switch on.

Works well with

Plan Claims & Revenue AI for your practice.

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