Bracket

AI Insurance Verification

Real-Time Benefit Extraction, Eligibility Checks, and Smart Plan Matching—Built for Orthodontics

Insurance is one of the most time-consuming and error-prone parts of running an orthodontic practice. Policies are often ambiguous, benefits vary widely, and verification requires multiple phone calls, portal logins, and repeated cross-checks. Even then, it’s easy for key details to slip through the cracks—leading to incorrect estimates, patient frustration, delays in claims, and lost revenue.

Bracket OS replaces this outdated process with AI Insurance Verification, a system designed specifically for orthodontics and fully integrated into the Bracket OS PMS. With real-time benefit extraction, automated eligibility checks, and intelligent plan matching, practices no longer need to chase down benefit details or guess whether a policy covers treatment.

AI handles the complexity.
Your team focuses on care.

Real-Time Benefit Extraction: Clear Answers Without the Chase

The foundation of AI Insurance Verification is automated benefit extraction. Instead of calling payers, logging into portals, or searching through dense PDFs, Bracket OS instantly reads, interprets, and structures insurance benefits the moment they’re provided.

How It Works

Using advanced AI document understanding, Bracket OS extracts benefit details from:

  • Insurance cards
  • Electronic eligibility responses
  • Benefit breakdown PDFs
  • Payer portals
  • Patient-submitted documentation
  • Digital ID cards
  • Historical claims patterns

The system recognizes and structures orthodontic-specific details, including:

  • Lifetime orthodontic maximums
  • Remaining benefits
  • Covered vs. uncovered procedures
  • Waiting periods
  • Age limits for ortho benefits
  • Percentage coverage for treatment
  • Coordination of benefits
  • In-network vs. out-of-network differences
  • Plan frequency limitations

All data is cleaned, standardized, and applied directly to the patient’s record.

Why It Matters

No more deciphering complex insurance language.
No more time wasted on phone calls.
No more errors from manual interpretation.

Your team gets instant, clear, structured benefit information—organized exactly the way orthodontists need it.

Automated Eligibility Checks: Always Up-to-Date and Always Accurate

Eligibility changes. Plans renew. Benefits get used elsewhere. Families forget to notify you when coverage changes. Eligibility verification is not a one-time event—it’s a constant challenge.

Bracket OS automates the entire eligibility workflow with AI-driven checks that run in the background and alert your team when something changes.

AI Checks Eligibility Automatically:

  • Before consults
  • At the start of a new month
  • Before treatment starts
  • Prior to claim submission
  • When a patient reports insurance updates
  • When appointment types suggest clinical changes affecting coverage

The system validates:

  • Active vs. inactive status
  • Plan start and end dates
  • Patient relationship accuracy
  • Whether benefits are available for orthodontics
  • Group and policy number matching
  • Deductible impact when applicable

Alerts When Something Changes

If a patient loses coverage, switches employers, or moves to a new payer, Bracket OS immediately notifies your team so:

  • Financial arrangements can be updated
  • Claims can be stopped or adjusted
  • The patient is contacted proactively

Result

No surprises.
No last-minute scrambling.
No unpaid claims due to lapsed eligibility.

Smart Plan Matching: AI Finds the Right Plan Automatically

One of the hardest parts of insurance verification is simply figuring out which plan a patient has. Many carriers have dozens of variations. Employers may use slightly different plan names. Patients often don’t know the exact policy.

Bracket OS solves this with AI Plan Matching, a feature that identifies the most likely insurance plan based on limited information and automatically fills in the missing details.

How Plan Matching Works

The AI compares the patient’s information against:

  • Known employer plans
  • Payer databases
  • Historical policies
  • Plan patterns for specific groups
  • Coverage structures
  • ID card design and formatting
  • Patient zip code and employer location
  • Benefit behavior from past claims

It then selects the most probable plan and fills in:

  • Deductibles
  • Maximums
  • Coverage percentages
  • Waiting periods
  • Coordination rules
  • Orthodontic age limits

If multiple options are possible, the AI highlights them and recommends which details your team should request to confirm the match.

Practical Impact

Administrative teams no longer need to guess which plan is correct.
Bracket OS eliminates the uncertainty, increases accuracy, and drastically reduces the time spent gathering missing insurance information.

Seamless Integration Into the Financial Workflow

What sets Bracket OS apart is how tightly AI Insurance Verification is integrated with the rest of your PMS. Benefit extraction, plan matching, and eligibility checks don’t sit in a separate tool—they flow directly into your financial workflows.

The system automatically updates:

  • Patient contracts
  • Insurance estimates
  • Expected reimbursement timelines
  • Claim submission rules
  • Ledger forecasts
  • AR projections
  • Autopay scheduling
  • Payment plan creation
  • Financial presentations during consults

When benefits change, the system recalculates automatically and surfaces the impact.

You get accurate information in real time—without the burden of manual verification.

Better Consults, Faster Starts, and Clearer Expectations

Insurance uncertainty slows down case acceptance. When families don’t understand their benefits, financial conversations become stressful, and recommended treatment can feel unpredictable.

Bracket OS removes this friction by giving patients accurate, immediate, and transparent information during consults.

Your Treatment Coordinators Can Now Present:

  • Exact expected insurance contribution
  • Lifetime maximum remaining
  • Real-time eligibility status
  • Out-of-pocket estimates with precision
  • The best payment options
  • Upfront impact vs. monthly impact

This transparency builds trust and leads to faster case starts.

No waiting days for verification.

No calling the family back.

No uncertainty.

Consults become confident, clear, and efficient.

Proactive Intelligence: Insurance That Thinks Ahead

Because Bracket OS uses AI and a unified data graph, the insurance engine stays proactive—not reactive.

The system automatically detects:

  • When lifetime maximums are nearly met
  • When patients approach age-out deadlines
  • When secondary insurance could improve reimbursement
  • When claims mismatch predicted payments
  • When a payer’s processing timeline changes
  • When an employer’s plan renews with new rules

Each insight is delivered to the right team member automatically.

Your practice stays ahead of potential issues rather than chasing them.

Designed for Mac and iPad: Insurance on the Go

Bracket OS is native to Mac and built to move with clinicians and coordinators using iPad.

On Mac:

  • Detailed verification dashboards
  • Instant benefit extraction
  • Deep financial analysis
  • Full administrative workflows

On iPad:

  • Quick plan overview
  • Eligibility status
  • Benefit summaries
  • Consult-ready financial breakdowns

Your team can verify insurance anywhere—chairside, consult room, front desk, or on the go.

Conclusion: The Future of Orthodontic Insurance Is Automated, Accurate, and Effortless

Insurance should support treatment—not complicate it.
Bracket OS transforms verification from a time-consuming administrative burden into a fast, intelligent, automated process that delivers reliable clarity to your team and confidence to your patients.

With real-time benefit extraction, automated eligibility checks, and smart plan matching, Bracket OS brings true AI-powered financial precision to orthodontic practices.

You get fewer errors.
You get faster starts.
You get better reimbursements.
You get complete peace of mind.

Bracket OS isn’t just a PMS.
It’s the intelligent backbone of the orthodontic financial workflow.