Minimize claim denials and increase cash collections with insurance verification that has the most up-to-date information—so you can proactively make patient payment arrangements and have a streamlined payer workflow. Get the best coverage detection and find hidden coverage for self-pay patients with proprietary intelligence based on more than 15 years of healthcare data—delivering a hit rate that confirms 2.8x more coverage than the competition. Waystar gives you actionable results in minutes, routinely uncovering 5-15% more billable insurance coverage for self-pay and charity patients. We’ll help you identify all the revenue you’re owed, from every patient and payer.
Recover millions from charge capture leakage and errors
Never leave revenue on the table no matter how high your claims volume. Detect undercoded claims and ensure all DRGs accurately reflect the work performed. Deploying data science and predictive analytics, Waystar’s DRG Anomaly Detector automatically reviews each claim, flagging any undercoding issues; then our auditors scrutinize flagged claims to assess if revenue is compromised. Our proprietary data normalization offers benchmarking so you can always make data-driven decisions.
Work claims smarter—get paid faster and more fully
With a 98.5% first-pass clean claims rate, Waystar automates an end-to-end claims workflow for faster, more complete reimbursement. Our powerful claims scrubbing and plain English messages tell you how to fix issues before claims go to payers. Waystar integrates with your PM system, HIS or EHR so you can work in your preferred system, with features such as on-the-fly editing and the ability to automatically split remits among many providers. Claims Monitoring offers early insight, automatically checks claim status and allows you to work by exception.
Expedite and automate revenue recovery
Intervene on the front end, identify root causes and avoid denied claims with Waystar. Our machine-learning algorithms predict denials with 5x the accuracy of spot checking, and we aggregate predictions for further prevention. Automate the prediction of revenue leakage—and automate sending workable denials to your assigned workgroups, too. Staff checks eligibility with one click, reworks and resubmits the denied claim, saving up to 50 minutes per denial. Our customized dashboards by workgroup and individual keep staff focused on getting the best results.
Optimize reimbursement and negotiation
Enjoy unprecedented visibility into payer performance. Manage all contracts and terms through a centralized repository, and complete contract loading and modeling in real time. Model what-if scenarios—assess payer contract performance and KPIs at the facility and enterprise level—and immediately see expected net patient revenue impact vs. your baseline. Identify underpayments, uncover root causes, streamline appeals and improve your payer negotiation position by exploring the strengths and weaknesses of contracts.
Patient Financial Experience
Increase patient satisfaction and payment revenue
Maximize revenue with a proactive, automated patient payment workflow. Foster a positive financial patient experience and collect payments earlier. Provide financial transparency with cost estimates as you take time-of-service payments, arrange for post-adjudication payments and set up payment plans for outstanding balances. Leverage Waystar’s consumer-friendly features that reduce your cost to collect while boosting patient loyalty.