Claims scrubbing
Denials caught before submission.
The cheapest denial is the one that never happens. A clean claim gets paid on the first pass. A flagged one comes back weeks later as lost time and lost revenue.
Altair checks every claim against each payer's policies before submission. When a claim comes back, one of our billers works it. The fix becomes a new pre-submission check, so the same mistake does not return.
How Altair scrubs your claims.
Altair checks every claim against the payer it is going to, not a generic policy set.
- 1
Validates the basics
Demographics, subscriber IDs, NPI, and required fields are checked and corrected before anything else.
- 2
Confirms eligibility and authorization
Verifies active coverage and any prior authorization required for the date of service.
- 3
Checks submitted codes and modifiers
Validates the submitted CPT, HCPCS, and ICD-10 codes against NCCI edits. Confirms modifiers like 25 and 59 match the payer's policies. Coding stays with your practice. Checking those codes against the payer is the scrub.
- 4
Applies each payer's policies
Beyond national edits, applies the billing policies of the payer the claim is going to.
- 5
Fixes, then submits
Flagged claims are corrected before submission, not after a denial comes back. One of our billers handles anything the AI cannot.
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.
95% clean-claim rate is the benchmark.
That is a market benchmark, not an Altair number. Every claim is checked against each payer's policies before it goes out. Denials worked on arrival, by our billers.
MGMA best-practice clean-claim target. Benchmarks vary by source and specialty.
Claims scrubbing, answered.
What is claims scrubbing software?
Claims scrubbing software reviews medical claims for errors before they are submitted to a payer, checking coding, modifiers, NCCI edits, demographics, and payer-specific policies, so problems are caught and fixed up front instead of coming back as denials.
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.
Does Altair scrub before or after submission?
Before. Issues are caught and fixed while the claim can still go out clean. When a denial slips through anyway, one of our billers works it and files the appeal.
Does Altair do our coding?
No, and that is the point. Coding stays with your practice. Altair checks the codes on the claim against each payer's policies, so a code that would be denied is caught first.
How is Altair different from a generic clearinghouse scrubber?
Generic clearinghouse scrubbers check claims against broad, static policies that are the same for every payer. Altair learns each payer and checks every claim against that payer's actual denial behavior. Every denial our billers work becomes a new pre-submission check.
Does scrubbing tie back to what we collect?
Yes. Altair gives you the forward view. You see what each payer will pay, not just what it already paid. Claims with low payment probability are flagged before they go out. Financial intelligence rolls those forecasts up across every claim.
Does it replace my clearinghouse?
No. Altair runs on the systems you already use, the EHR and the clearinghouse both. The payer-specific checks add to the edits already in place. Nothing gets ripped out.
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 the EHR and clearinghouse you already use. There is no rip-and-replace and no billing work for your front desk.