Prior authorization
Prior auth,without the hours a week.
Prior authorization is one of the heaviest administrative burdens in medicine, and a missing or expired authorization is one of the most common, and most preventable, denials.
Altair confirms what each payer requires and maps the authorization to its criteria before submission, so claims do not come back as authorization absent. It learns each payer and turns that into prevention, on top of the systems you already run.
Every authorization Altair clears is revenue that posts on the first pass instead of aging in a denial worklist, and its financial intelligence layer puts 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 first
It confirms active coverage and network status, the prerequisite to a valid authorization, separate from the authorization itself.
- 3
Maps to payer criteria
Altair gathers the clinical documentation the payer's policy requires and maps the request to its medical-necessity criteria.
- 4
Submits and tracks
It submits through the payer's channel and tracks the decision against the payer's timeline, following up before it 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, 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.
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 you get approval before a service, drug, or device is delivered, as a condition of coverage. Approval confirms the payer considers it medically necessary, but it is not a guarantee of payment, which still depends on eligibility and a correct claim.
How does Altair reduce the prior-auth burden?
Altair checks whether each service needs authorization, gathers the documentation the payer's policy requires, maps the request to its criteria, submits it, and tracks the decision, so your team is not living on payer portals and 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.
Will this replace my billers?
No. Altair takes the repetitive authorization 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.