Prior authorization
Prior auth, without the hours a week.
Prior authorization is one of the heaviest administrative burdens in medicine. A missing or expired authorization is one of the most common denials, and one of the most preventable.
Altair is the AI billing team you never have to manage. Runs the whole cycle, eligibility to payment, on the systems you already use. Confirms what each payer requires and maps the request to its criteria, so claims do not deny for authorization absent. When a claim comes back, one of our billers works it.
Every authorization Altair clears is revenue that posts on the first pass instead of aging in a denial worklist. Financial forecasting and per-payer transparency put a dollar figure on each prevented denial.
How Altair handles prior auth.
Altair confirms what each payer requires and maps the request to its criteria before submission.
- 1
Checks if auth is required
For each planned service, drug, or device, Altair checks the patient's plan to see whether prior authorization is needed.
- 2
Verifies eligibility and coverage
Confirms active coverage and network status, the prerequisite to a valid authorization, separate from the authorization itself.
- 3
Maps to payer criteria
Gathers the clinical documentation the payer's policy requires and maps the request to its medical-necessity criteria.
- 4
Submits and tracks
Submits through the payer's channel and tracks the decision against the payer's timeline, following up before the request lapses.
- 5
Links auth to the claim
The approved authorization is attached to the claim at billing time, so it does not deny for authorization absent or exceeded.
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.
About 13 hours a week lost to prior auth.
Physicians and their staff spend roughly 13 hours a week on prior authorization, completing around 39 requests per physician. Altair maps each one to the payer's criteria before submission.
AMA 2024 Prior Authorization Physician Survey. Self-reported averages; vary by specialty and practice.
Prior authorization, answered.
What is prior authorization?
Prior authorization is a payer's requirement that a service, drug, or device be approved before delivery, as a condition of coverage. Approval confirms the payer considers it medically necessary. It is not a guarantee of payment. Payment still depends on eligibility and a correct claim.
How does Altair reduce the prior-auth burden?
Altair checks whether each service needs authorization and gathers the documentation the payer's policy requires. Maps the request to the payer's criteria, submits it, and tracks the decision. No one at your front desk sits on payer portals or phone lines.
Is prior authorization the same as eligibility?
No. Eligibility confirms the patient has active coverage. Prior authorization is a separate approval that a specific service is covered. Altair handles both, eligibility first, then authorization.
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.