Everything Your Practice Needs to Run Itself

refract.ing installs on your OfficeMate server and deploys 53 autonomous AI skills that handle the operational work your staff shouldn't have to do manually. Here's exactly what each module does.

ERA Auto-Posting Engine

The ERA engine monitors your incoming Electronic Remittance Advice files in real-time. When a new ERA arrives from a payer, the engine parses every line item, matches it against the corresponding claim in OfficeMate, and verifies that the payment amount aligns with the expected reimbursement based on your fee schedule and contracted rates. If everything checks out, the payment posts automatically. If something looks off — an underpayment, an unexpected adjustment code, or a denial — the engine flags it for staff review instead of burying it in a pile of paperwork.

The system handles the complexity that makes manual ERA posting so tedious: split payments across multiple service lines, coordination of benefits between primary and secondary payers, contractual adjustments, and partial denials. It understands the difference between a write-off your contract requires and one that represents lost revenue. Every posted payment includes a full audit trail showing exactly what was matched, what was adjusted, and why.

Practices running the ERA engine typically save 2-3 hours per day that was previously spent on manual payment entry. It works with all major vision and medical payers including VSP, EyeMed, Medicare, Medicaid, and commercial insurance carriers. The time savings compound — your billing staff spends less time on data entry and more time on denial follow-ups and collections that actually recover revenue.

Insurance Verification Automation

Insurance verification runs before the patient arrives, not after. The system pulls eligibility and benefits data from the payer, checks both primary and secondary coverage, verifies copay and coinsurance amounts, and identifies coordination of benefits requirements. If a patient's coverage has lapsed or their plan changed since the last visit, your front desk knows before the patient walks in — not after the exam when collecting the correct amount becomes an awkward conversation.

Verification results sync back to the patient record in OfficeMate automatically. When your front desk opens a patient's chart at check-in, they see the verified benefit summary: copay amount, remaining allowance, authorization requirements, and any flags that need attention. No phone calls to payer hotlines, no logging into six different portals, no handwritten notes on sticky pads that get lost between the front desk and the billing department.

The system runs verification checks on a schedule tied to your appointment book. Patients scheduled for tomorrow get verified today. Patients who schedule same-day get verified immediately. If a verification fails — payer system down, invalid subscriber ID, terminated coverage — the system alerts your staff with the specific issue so they can resolve it before the patient arrives, not after you've already performed the exam.

Smart Patient Recalls

Smart Recalls analyzes your entire patient base to identify who is overdue for their annual exam, then segments them by how long they've been gone, their insurance status, and their visit history. A patient who's 13 months overdue with active VSP coverage gets a different message than someone who's 24 months overdue with no insurance on file. The system triggers multi-channel recall campaigns — SMS, email, and automated calls — with messaging tailored to each segment.

Unlike standalone recall platforms like Weave or Solutionreach, refract.ing recalls are driven by actual EMR data in real-time. Patients who have already scheduled an appointment are automatically excluded from recall campaigns. Patients who were seen at another location in your group are excluded. Patients who have been marked inactive or deceased are excluded. This eliminates the embarrassing and wasteful problem of recalling patients who don't need to be recalled.

Response rates with data-driven recalls are typically 3-5x higher than generic recall blasts because the messaging is relevant and the timing is right. The system also tracks recall outcomes — who scheduled, who didn't respond, who opted out — so you can measure the actual revenue generated by each recall campaign and adjust your approach over time. Every recall that converts to a booked appointment represents revenue your practice would have lost to attrition.

Collections Automation

The collections module identifies every outstanding patient balance in your system, categorizes them by age and amount, and initiates structured collection workflows that start gentle and escalate appropriately. A $25 copay balance from last week gets a friendly SMS reminder. A $500 balance from 90 days ago gets a formal email statement with payment options. Accounts that pass a configurable threshold get flagged for personal follow-up by your staff.

The system integrates with your existing merchant processor so patients can pay online directly from the SMS or email they receive. No phone calls to your office, no stamps, no checks to deposit. When a payment comes in, it posts to the patient's account in OfficeMate automatically. The collection workflow pauses for that patient and resumes only if there's still a remaining balance.

Practices typically recover $15,000-$25,000 in aged receivables within the first 90 days of running the collections module. Most of that money was already owed — it was just sitting in your AR aging report because nobody had time to chase it. The automation doesn't replace your staff's judgment for complex collection situations, but it handles the volume of routine balance reminders that would otherwise never get sent. See pricing for how the ROI works out for your practice size.

Real-Time Practice Dashboard

The dashboard pulls live operational metrics directly from your OfficeMate database: daily production, collections rate, no-show percentage, recall conversion rate, insurance payer mix, and AR aging. These numbers update in real-time as transactions post — no end-of-day report exports, no waiting for your staff to run the numbers, no spreadsheet reconciliation. You open a browser on any device on your network and see exactly where your practice stands right now.

The metrics are designed around the decisions practice owners actually make. Production versus collections tells you if you have a billing problem. No-show rate by day of week tells you where to overbook. Insurance mix shows you which payers are growing and which are shrinking. AR aging by bucket tells you where your collection efforts should focus. Each metric links to the underlying data so you can drill down when a number looks off.

The dashboard runs on your server — no data leaves your network for analytics purposes. It's accessible from any browser on your local network, including tablets and phones. There's no separate login, no SaaS subscription for analytics, and no delay between when a transaction happens and when it shows up in your numbers. What you see is what your OfficeMate database actually contains, interpreted through the lens of the questions you need answered to run your practice.

AI Skills Engine (53 Skills)

The AI Skills Engine is the core automation layer that powers everything else. Each skill is a specialized AI agent designed to handle one specific operational task autonomously. One skill parses EOBs. Another detects underpayments by comparing paid amounts against your contracted rates. Another generates patient communication drafts. Another monitors your appointment book for scheduling gaps. There are 53 of them, each focused on doing one thing well.

Skills run on your server, process your data locally, and never send patient information to external AI services. Every action a skill takes is logged with a timestamp, the data it processed, the decision it made, and the outcome. This audit trail means you can review exactly what the automation did, verify it made the right call, and adjust the skill's configuration if it didn't. Skills that make decisions about money — posting payments, flagging underpayments, initiating collections — always include a confidence score so your staff knows when to trust the automation and when to verify manually.

New skills are deployed via software updates — no reinstallation, no downtime, no reconfiguration. When a new skill becomes available, it activates on your next update cycle and starts working with your existing data immediately. The engine is designed to grow with your practice's needs. If you need a custom skill for a workflow specific to your practice, the platform supports it. Read more about our HIPAA compliance approach for how we handle PHI within the skills engine.

EMR Sync & Data Pipeline

The data pipeline maintains a real-time synchronized view of your OfficeMate database using the same SDK stored procedures that Eyefinity uses internally. This isn't a screen-scraper or a fragile integration built on undocumented endpoints — it uses the official OfficeMate SDK interface that was designed for exactly this kind of data access. Read-only by default, so there's zero risk of the sync corrupting your production data.

The pipeline handles patient demographics, appointments, claims, payments, insurance information, and clinical data. When a patient checks in, their record is available to the automation layer within seconds. When a payment posts, the dashboard updates. When an appointment is scheduled or cancelled, the recall engine knows immediately. Sync latency is under 30 seconds for most operations, and critical events like payment postings are captured in near-real-time.

The sync architecture is designed for reliability. If the connection to OfficeMate drops — server restart, network hiccup, maintenance window — the pipeline detects the gap and reconciles automatically when the connection restores. No manual intervention, no data loss, no "run the sync again" tickets. Your practice data stays consistent across every module in the platform without your staff needing to think about it.

Patient Communications

The communications module handles appointment confirmations, post-visit follow-ups, birthday messages, recall campaigns, and custom outreach — all driven by EMR data. The right message goes to the right patient at the right time because the system knows who's scheduled for tomorrow, who was seen last week, who's overdue, and who has a birthday coming up. No manual list exports, no copy-pasting phone numbers, no "did we already send that" confusion.

The module supports SMS, email, and automated voice calls. Messages are personalized with the patient's name, appointment details, provider name, and office location. Patients can confirm appointments by replying to a text. They can click a link in an email to pay a balance. They can call back from a voicemail at a number that routes to your office. Every outbound message is logged and tied to the patient record so your staff can see the full communication history at a glance.

All outbound communications are compliant with TCPA regulations for SMS and voice, and CAN-SPAM requirements for email. Patients can opt out of any channel at any time, and opt-outs are respected immediately across the entire platform. Before any PHI touches an outbound channel, we require a signed Business Associate Agreement — see our HIPAA compliance page for the full details on how patient data is protected throughout the communication pipeline.