Claims & Denials

Claim Status, Denial Retrieval, and Appeals Automation

Pull claim status, retrieve denial detail, and file appeals through the payer portals where that work actually lives. The follow-up half of the revenue cycle, the part the EDI rails don’t carry, run as a browser agent instead of a queue of portal logins.

Go-live in as little as 30 minBrowser agentCustomer portal login

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How Asteroid runs this workflow

The follow-up loop, worked on the payer's clock

A claim lands in the follow-up queue, Asteroid pulls its status and denial detail off the payer portal, assembles the appeal from the documentation your team provides, and files it. The argument for overturning a denial is never the agent's to make, so that judgment stops with your staff.

Clearinghouse-style payer portals

How it actually runs

  1. 01Sign in to the clearinghouse-style payer portal with your credentials, stored in an agent profile.
  2. 02Look up the claim and capture its status with the portal’s exact wording, the detail behind the status code your EDI feed already gave you.
  3. 03For a denied claim, retrieve the denial reason and remittance detail as one structured record instead of a screen someone transcribes.
  4. 04Where the portal supports appeal submission, assemble the appeal from the documentation provided and file it. Provided data only; nothing is invented to complete a form.
  5. 05A claim the portal can’t find, a member mismatch, or anything the portal disputes routes to a person with the portal’s wording attached.

The appeal argument itself stays human, deliberately: the agent retrieves, assembles, and files, but it never invents the clinical or contractual case for overturning a denial.

A claim or follow-up item enters the work queue

  1. Updated record in your claim queue

    The portal's status, the structured denial detail, the appeal confirmation, and the deadline position write back to your claim queue, claim by claim.

Appeal decision or ambiguous denial: The denial record and the portal's wording return to your team; a person decides whether to fight and supplies the argument, once, and the filing proceeds.

Denials age on the payer’s clock, not your staffing plan

Denial follow-up is the queue that loses to everything else, because it’s the most manual work in the revenue cycle: portal by portal, claim by claim, screen by screen. But appeal windows and filing deadlines run on the payer’s calendar whether or not anyone opened the queue this week, and a denial that ages out stops being a denial and becomes a write-off. Running status sweeps and denial retrieval as agents means the queue is worked on schedule, and what reaches your staff is the decision-shaped part: which denials to fight and with what argument.

At scale

What runs today

These claims agents are in the catalogue pipeline; the same portal discipline runs today one step upstream in the prior authorization submission workflows, reference numbers and statuses captured on every run. At queue scale, status sweeps run nightly across the payer mix and appeals file as fast as your team approves the argument; the queue layer above this loop is denial management, the economics are in the medical billing automation deep-dive, and if the denial queue is the current pain, scoping a build against your payer mix is the fastest path. Category view: the claims and denials workflow library.

Questions

Frequently asked questions

The loop is configured to your payer mix and follow-up SOP: which clearinghouse-style payer portals to work, how status sweeps are scheduled - nightly across the payer mix at queue scale - what the structured denial record must carry, and which documentation your team supplies for appeals. Your team keeps the part that is genuinely theirs: deciding which denials to fight and with what argument; appeals file as fast as your team approves. The agent takes the logins, lookups, and transcription. Scoping a build against your payer mix sets the configuration.

Disclaimer

Third-party names, including government agencies and registries, are used only to identify systems commonly involved in healthcare operations workflows. Asteroid is not affiliated with, endorsed by, sponsored by, or certified by those third parties unless expressly stated. Workflow availability depends on customer authorization, account permissions, configuration, and applicable system terms.