Opalforce — Growing Practices. Digitally.

Insurance AI

Benefits gathered before the visit.

Insurance AI gathers a patient's benefits before the visit so your team can review the estimate.

See how it worksTalk to us

How it works

  1. 1Visit details confirmed

    Patient, subscriber, plan and visit date are checked.

  2. 2Benefits gathered

    Each benefit fact is recorded with where it came from.

  3. 3Gaps flagged

    Check point

    Anything missing or unclear is marked unknown. Unknown benefits are never turned into an estimate.

  4. 4Team reviews

    Your team reviews

    Your team checks the summary before anything is shared with the patient.

Example

Coverage is active but the frequency limit isn't listed. It shows that as unknown, not as covered.

What your team receives

  • A benefits summary with sources
  • A list of unknowns to call about
  • An estimate only where the facts support one

Limits and setup

Active coverage is not a promise of payment.

This page explains the workflow. It runs for your practice only after we assess, connect and test your practice systems.

How connections workPlan setup

Questions about Insurance AI

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

How practice connections work
Is active coverage a payment guarantee?
No. The payer decides after the claim. The estimate is for your team to review.
What happens when a fact is missing?
It shows as unknown. It is never counted as zero.
Does this replace your insurance verification service?
No. It supports it. See our Insurance Verification page for the service.

Works well with

Plan Insurance AI for your practice.

Talk to us