Denial management
Denials are where the money leaks.
Most denials are preventable, and most appealed denials get overturned. Rework by hand is slow and costly, so denials go untouched and the revenue is 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. Prevents the denials it can, works and appeals the rest on arrival, and learns each payer's policies along the way. When a claim comes back, one of our billers works it.
How Altair works your denials.
Altair runs the full denial lifecycle: prevent, work, appeal. No billing work for your front desk.
- 1
Prevents what it can
Scrubs every claim against the payer's policies before submission. Flags missing authorizations, codes that conflict with policy, and eligibility gaps.
- 2
Reads every remittance
Ingests each 835. Classifies every denial by its CARC and RARC, payer, dollar value, and whether it is correctable or appealable.
- 3
Denials worked on arrival
Corrects and resubmits fixable denials right away. No worklist, and no queue on anyone's desk.
- 4
Drafts payer-specific appeals
For denials that are wrong, writes the appeal from how that payer behaves and the documentation that payer requires, then files it before the deadline. One of our billers works anything the appeal cannot carry.
- 5
Learns every payer
Every worked denial teaches Altair a new edge case for your payers, so the same denial does not repeat.
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.
Most denials are preventable.
Most appealed denials get overturned, yet a large share are never worked at all. Altair prevents what it can and works the rest on arrival. Our in-house billers handle the exceptions. Altair gives you the forward view: what each denial is worth and the likelihood of recovery. You see what each payer will pay, not just what it already paid.
Industry analyses: Change Healthcare Denials Index, KFF, Premier. Rates vary by payer and setting.
Denial management, answered.
What is denial management?
Denial management is the process of preventing, working, and appealing payer claim denials so earned revenue is not written off. It covers catching errors before submission, correcting and resubmitting denied claims, and appealing the denials that are wrong.
What are the most common denial codes?
Common ones include CO-16 (missing or invalid information), CO-97 (bundled service), CO-50 (not medically necessary), CO-45 (above the contracted rate), and CO-197 (prior authorization absent). Altair reads the CARC and RARC on every remittance and works each one.
How is Altair different from my clearinghouse?
A generic clearinghouse scrubber checks claims against broad, static policies that are the same for every payer. Altair checks each claim against the specific payer's policies, works denials on arrival, and drafts payer-specific appeals, learning each payer over time.
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.