For Independent optometry and eyecare practices with an optical shop
Find vision plan claims that were rejected or never paid
Vision plan claims are small and many, so a rejected one or a short payment often just sits. Over a year, unworked claims and uncollected patient overages turn into real money nobody remembers to chase.
What it can cost you
Example: 25 unworked claims a month x $110 average = $2,750 a month left uncollected.An illustration, not a promise. Your Opportunity Scan puts a real number on it.
What the system checks overnight
- Lists claims with no payment after the time you expect each plan to pay.
- Flags rejected claims that have not been resubmitted.
- Compares payments received to the expected allowable for each plan.
- Checks for patient overage amounts that were never collected at dispense.
- Shows open claims by plan and by age.
Where it reads from
- Eyefinity
- RevolutionEHR
- Crystal PM
- Compulink
- OfficeMate
Plan remittance reports from vision plan portals, read as data only.
What happens when it fires
The billing person works the list in order. The system drafts the list with each claim's status and the step to take.
Autonomy level: Suggest only. The brief tells you what changed and what to do. Nothing happens without you.
What we guarantee
Every claim past its expected pay date is on the work list by the next business morning. We agree on the metric before the Sprint starts and measure it over the first 20 business days after go-live. If we miss it, you get half your Sprint fee back. Dollar savings are tracked in your monthly saves log, reported rather than promised.
Questions
Does it submit or fix claims?
No. It shows which claims need attention and why. Your billing person submits and corrects them.
What patient details does it use?
Claim status, amounts, dates, and plan. It does not use exam findings or diagnoses, and patient details stay out of the AI.
Do I need new software for this?
No. The system reads from the tools you already use, with read-only access by default. A guardrail layer controls exactly which data the AI can see.
What does it cost?
A 3-week Sprint is $6,000 fixed and includes the morning brief plus one automation tied to an agreed metric. Ongoing support is $1,500 a month, or $500 a month to keep it running without new automations. If the agreed metric is missed over the first 20 business days after go-live, half the Sprint fee is refunded.
How is this different from a dashboard app or a free AI kit?
A dashboard app shows numbers when you go look. A free AI kit gives you the parts, and you do the setup, the upkeep, and the checking. Here the alarms are built for your kind of business, they watch outside data like market rates and rule changes alongside yours, and on Run or Keep-Running, the person who built them keeps them working and logs what they caught.
More alarms for independent optometry practices
Seven more things worth watching.
- Optical capture dropsTrack optometry capture rate by doctor, day, and location, and see when exam patients leave without an eyewear or contact lens order.
- Recall gapsSpot optometry patients past their recall date with no appointment, by doctor and location, and get a call list your front desk can work.
- Lab remakes and late jobsTrack optical jobs past their promised date and remakes by lab, optician, and reason, so you fix the pattern and call patients before they call you.
- Contact lens orders missedFind optometry contact lens patients with a fitted lens and no supply order, and track lens orders lost to online sellers, by doctor and week.
- Aging frame inventoryTrack optical frames by days on the board, brand, and price point, and see slow movers that tie up cash and wall space.
- Exam no-showsTrack optometry no-shows and same-day cancels by doctor, day, and appointment type, and find repeat patients before their next booking.
- Lens and frame cost increasesCompare lab and frame vendor invoice costs to your optical retail prices and flag lenses and frames where your margin has quietly shrunk.
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