How Alerts Reach Your Workflow
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When the autocoder finds something that needs human attention, it attaches an alert to the claim. Every alert carries a plain-language description, a type, a severity from 1 to 10, and a suggested reviewer role.
An alert is a classification, not an action. The autocoder does not hold, queue, or release claims. Your workflow does.
| Type | What it means |
|---|---|
| HARDSTOP | Something is missing or conflicting that would cause a payer rejection or denial. Resolve it before the claim is payer-ready. |
| COMPLIANCE | A regulatory or compliance concern. Route it to your compliance process. |
| FINANCIAL | A potential revenue impact: a possible missed charge, or a charge the documentation may not support. |
| INFORMATIONAL | Something noteworthy. No action is required. |
| OTHER | An internal system event, for example an external service failure. The automated check did not complete. |
Claim Maker turns alert types and severities into workflow actions. Your Claim Maker configuration decides which alerts hold coding, which route a claim to a review queue, and which pass through. Some gates also run before coding: document extraction and reconciliation can hold a case so the autocoder does not run until required information arrives.
Typical defaults: a HARDSTOP alert routes the claim to a reviewer before release, COMPLIANCE and FINANCIAL alerts flag the claim for the matching team, and INFORMATIONAL alerts are recorded with no action. Your administrators can change these routes.
Your integration receives every alert on the claim payload. Your implementation decides which alerts pause a claim, which reviewers see them, and when a claim is released. The type and severity fields exist to make those decisions easy to automate.
Read the alert reference for your specialty to learn each alert's trigger and the recommended reviewer action:
If an alert fires too often or not often enough for your workflow, your facility configuration can tune or suppress most alerts. See Tuning Review Alerts, and contact your Hank representative to change it.