Claims and denials

From approved codes to paid claims.

CMS-1500Assembled for you
NCCIChecked before sending
ApprovedBy your team first

Althais assembles the claim, checks it before it leaves, sends it electronically once your team approves it, and follows it to payment, including the denials.

One platform

Claims & Insurance is one part of the whole.

Every tool shares the same patients, notes and claims. No handoffs between vendors.

01 · Assemble

Everything in one claim, ready to review.

The visit, provider, payer, member ID, codes and charge are pulled together for you. Open the claim to see exactly what will be sent.

CMS-1500 assembled · Claim check on every claim
A claim detail with the claim check, codes and estimated charge
02 · Queues

Every claim, in the queue it belongs in.

Claims sort themselves into work queues, from waiting for sign-off to paid, so the team always knows what needs them next.

Before submission to after adjudication · Bulk submit
The Althais claims screen with work queues and every claim this month
03 · Track

Followed from submission to payment.

Collections, the claims pipeline and denial rate sit on one screen, with tasks for anything that needs a person.

Pipeline and collections · Tasks for the team
The Althais overview with today's schedule, tasks, collections and the claims pipeline
04 · Denials

Denials come back with an appeal drafted.

Denied claims land in their own queues with the reason, the amount and the appeal deadline. Althais drafts the appeal letter for you to edit and send.

Appeal letters drafted · Deadlines tracked
The Althais denials screen with a denied sample claim and a drafted appeal letter
Interactive demo · real checks

Try Claims.
Open one. Fix one. Appeal one.

The Althais claims queue with sample claims. Filter it, open any claim, run the pre-submission check on the real Althais rules engine, fix a held claim and draft an appeal for a denied one.

app.althais.com/revenue/claimsDemo · sample data
Claims
Every claim across the practice: coding, submission, and payer status in one place.
All Claims
ClaimCPTPayerStatusAmount
Sample claims for fictional patients. The pre-submission check calls the real Althais NCCI and code-format rules.Next: ask Althea about a claim →