Appeals
The appeal goes out before the deadline does.
Most denied claims are never appealed, even though the majority of appeals succeed. Deadlines pass, the work piles up, and earned revenue gets written off.
Altair is the AI billing team you never have to manage. Runs the whole cycle, eligibility to payment, on the systems you already use. Ranks denials by expected recovery. Drafts the payer-specific appeal with the documentation that payer wants, then files it before the window closes. Learns which arguments win for each payer and turns every overturn into prevention. When an appeal needs a person, one of our billers works it.
How Altair files the appeals.
Appeals stop being a backlog. They become a standing step in the cycle.
- 1
Identifies the denial reason
Altair reads the CARC and RARC on the remittance. Determines exactly why the claim was denied and whether it is worth appealing.
- 2
Finds the deadline
Looks up each payer's appeal window and prioritizes the time-sensitive, high-value denials first.
- 3
Pulls the documentation
Gathers the clinical records, the billed codes, and the payer's own policy language the appeal needs to win.
- 4
Drafts and files the appeal
Writes a payer-specific appeal that rebuts the exact denial reason. Files it through the payer's channel before the window closes.
- 5
Tracks to resolution
Follows the appeal through and learns which arguments win for each payer. When a level-two escalation needs a person, one of our billers works it.
Works with everything you already run.
Altair runs on top of every EHR, practice-management system, and clearinghouse on the market, including yours. No rip-and-replace, and no billing work for your front desk.
Runs the whole cycle: eligibility and benefits, prior authorization, medical necessity and documentation, payer-specific claim scrubbing, submission, claim tracking, remittance, denials, payer-specific appeals, financial forecasting and underpayment detection, patient statements and balances, and payment posting and reconciliation.
Nothing about your systems changes. What changes is who does the billing.
Over 80% of appealed denials are overturned.
In Medicare Advantage, more than eight in ten appealed prior-authorization denials are overturned, yet most denials are never appealed at all. Altair appeals them, before the deadline. There is no billing work for your front desk.
KFF analysis of Medicare Advantage prior-authorization data, 2024. Overturn and appeal rates vary by payer and program.
Appeals, answered.
How long is the window to appeal a denied claim?
It depends on the payer. Appeal windows commonly run from about 60 to 180 days from the denial. Medicare Advantage allows 60 days, and many commercial payers allow up to 180. Altair tracks each payer's deadline and files within it.
Does appealing actually work?
Often, yes. The majority of appealed denials are overturned, and in Medicare Advantage more than 80% of appealed prior-authorization denials are reversed. The problem is that most denials are never appealed. Altair appeals them.
What does Altair put in an appeal?
Altair rebuts the specific denial reason on the remittance and cites the payer's own policy. Attaches the clinical documentation that payer requires. Files through the payer's channel with proof of timely submission.
We do not have a billing team. Who actually does the work?
That is what Altair is built for. Altair works the claims. Our in-house billers handle the exceptions. There is no billing operation for you to staff or manage.
Is Altair HIPAA compliant?
Yes. Altair is HIPAA compliant. Review our security posture and controls in detail at our Trust Center.
How fast can we start?
Days. Altair connects to your existing EHR and clearinghouse, so there is no rip-and-replace and no billing work for your front desk.