Denial management
Denials are wherethe money leaks.
Most denials are preventable, and most of the ones you appeal get overturned. But reworking each one by hand is slow and costly, so many are never touched and the revenue is written off.
Altair prevents the denials it can, then works and appeals the rest the moment they land. It learns each payer's policies and behavior and turns every worked denial into a proactive check that stops the next one, on top of the systems you already run.
How Altair works your denials.
Altair runs the full denial lifecycle, prevent, work, and appeal, autonomously.
- 1
Prevents what it can
Before you submit, Altair scrubs every claim against the payer's policies and flags missing authorizations, coding conflicts, and eligibility gaps.
- 2
Reads every remittance
Altair ingests each 835 and classifies every denial by its CARC and RARC, payer, dollar value, and whether it is correctable or appealable.
- 3
Works denials the moment they land
It corrects and resubmits fixable denials right away, with no worklist queue, and routes the rest with the documentation needed to resolve them.
- 4
Drafts payer-specific appeals
For denials that are wrong, Altair writes the appeal using how that payer behaves and the clinical documentation it requires, then files it before the deadline.
- 5
Learns every payer
Every worked denial teaches Altair a new edge case for your payers, so the same mistake does not happen twice.
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, no new software, no exceptions.
Runs the whole cycle: eligibility and benefits, prior authorization, medical necessity and documentation, payer-specific claim scrubbing, submission, claim tracking, remittance, autonomous denials, payer-specific appeals, and CFO-grade financial forecasting and underpayment detection.
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 end to end. It also forecasts what each denial is worth and your probability of recovery, so finance sees expected collections, not surprises.
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 you recover the revenue you have earned. 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 clearinghouse forwards claims and runs broad, generic edits. Altair checks each claim against the specific payer's policies, works denials autonomously the moment they land, and drafts payer-specific appeals, learning each payer over time.
Will this replace my billers?
No. Altair takes the repetitive denial and appeal work off your billers, not their jobs. Your team reviews and approves, and spends its time on the exceptions that actually need a person.
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 new software for your team to run.