Waystar

What Waystar does

Waystar Holding Corp. (Nasdaq: WAY) is a U.S.-headquartered, publicly traded healthcare technology company that provides a cloud-native, single-database revenue cycle management (RCM) platform serving over 30,000 clients and 1M+ providers across the United States. The platform spans six integrated modules — Financial Clearance, Clinical Integrity + Revenue Capture, Claim Management, Payment Management, Denial Recovery, and Analytics + Reporting — and is powered by Waystar AltitudeAI, a proprietary AI layer combining Agentic AI, Generative AI, and Predictive AI capabilities trained on over 7.5 billion annual healthcare payment transactions covering approximately 60% of the U.S. patient population. The platform also operates one of the largest SaaS-based clearinghouses in the U.S. with 5,000+ payer connections and processes $200B+ in provider payments annually.

The company's business model is a hybrid of subscription-based SaaS (over 90% recurring revenue) with transaction-based clearinghouse fees and contingency-based recovery services (e.g., Transfer DRG). Distribution is enterprise-led: direct field sales to health systems and hospitals, inside sales to physician/specialty practices, an EHR/PM-integrated partner channel, and embedded distribution through integrations with Epic, MEDITECH, Cerner, and other major healthcare IT systems. Q1 2026 subscription revenue grew 38% year-over-year to $172M, and Q1 2026 total revenue reached $313.9M (22% YoY growth) at a 43% adjusted EBITDA margin. The company has pursued aggressive inorganic growth, completing the $1.25B Iodine Software acquisition in 2025 to extend into mid-cycle clinical documentation, the $450M+ Patientco acquisition in 2021 for patient payments, and prior acquisitions of eSolutions, HealthPay24, Recondo, Digitize.AI, and Connance to assemble the unified platform.

Waystar was formed from the 2017 merger of Navicure and ZirMed (with operational lineage to 2010), was taken public on Nasdaq in 2024, and is led by CEO Matt Hawkins. Pre-IPO sponsors EQT, Bain Capital, and CPP Investments have been active sellers post-listing, contributing to a 43-55%+ year-to-date stock decline that has created a divergence between business fundamentals and share price. The company generated $1.099B in FY2025 revenue (16% YoY) and guides FY2026 revenue to $1.274–$1.294B. The Board authorized a $200M stock repurchase plan in May 2026 to signal capital return discipline.

Name

Waystar

Legal name

Waystar Holding Corp.

Website

https://waystar.com

Company type

Public

Founded year

2010

Operating status

Operating

Headcount range

1,001–5,000 employees

Short description

Waystar Holding Corp. (Nasdaq: WAY) is a U.S.-based, publicly traded healthcare technology company that provides a cloud-native, AI-powered revenue cycle management platform to 30,000+ clients and 1M+ providers, processing 7.5 billion annual healthcare payment transactions covering 60% of U.S. patients.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management Software

NAICS

Computer Systems Design and Related Services (54151), Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)

SIC

Services-Prepackaged Software (7372), Services-Computer Programming, Data Processing, Etc. (7370)

akta.pro primary industry

RPM Reimbursement, Billing & Program Operations Platforms (HLACAFAN)

akta.pro secondary industries

Data Aggregation, Interoperability & APIs for RPM (FHIR/IoMT Gateways) (HLACAFAO), Chronic Care & Remote Patient Monitoring (RPM) Platforms (HLALABAF)

Keywords

• Revenue cycle management
• Healthcare payment software
• Claims management software
• Eligibility verification solutions
• Denial management software

Headquarters

HQ city

Louisville

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Software

Cost components

Technology or R&D, Personnel, Infrastructure, Marketing or Sales, Operations

Revenue model

1. SaaS Subscription Revenue: Recurring subscription revenue from cloud-based software platform. SaaS subscription model generates over 90% recurring revenue. Q1 2026 subscription revenue grew 38% year-over-year to $172 million, described as the company's primary recurring revenue engine.
2. Transaction-Based Revenue: Transaction-based fees tied to claim processing, electronic remittance advice (835), eligibility checks, and other payment processing transactions through Waystar's clearinghouse. Total Q1 2026 revenue of $313.9 million was 22% year-over-year growth, driven by AI-powered platform adoption and transaction volume across 7.5 billion annual healthcare transactions.
3. Professional/Contingency Services (Transfer DRG, Charge Integrity): Contingency-based pricing for services such as Transfer DRG (TDRG) recovery and Charge Integrity audits, where Waystar recovers revenue on behalf of providers and earns a percentage of recovered funds. U.S.-based auditing team validates suspected missing charges and coding variances.

Pricing tiers

Go-to-market motion4 records

Distribution channels4 records

Marketing channels12 records

Core offering

Waystar provides a single-database, cloud-based healthcare revenue cycle management (RCM) platform that unifies eligibility verification, claims management, denials prevention and recovery, clinical documentation, payer remittance, patient payments, and analytics across the full revenue cycle. The platform is delivered as a SaaS subscription, augmented by transaction-based clearinghouse services and contingency-based recovery offerings such as Transfer DRG, and is embedded within all major EHR/PM systems including Epic, MEDITECH, and Cerner.

Product overview

Waystar offers a unified, single-database cloud-based healthcare revenue cycle management (RCM) platform consisting of six core solution suites: Financial Clearance (with sub-products like Eligibility Verification, Patient Estimation, Coverage Detection, Charity Screening, Authorization, Referral Status, Registration QA, Advanced Propensity to Pay, and Price Transparency), Clinical Integrity + Revenue Capture (including Clinical Documentation Integrity, Charge Integrity, DRG Anomaly Detection, and Transfer DRG), Claim Management (Claim Manager, Claim Monitoring, Claim Attachments, Medicare Management), Payment Management (Payer Reimbursement Suite with Remit Manager, Remit + Deposit Management, EOB Conversion + Payer Lockbox, Patient Payments, Agency Manager), Denial Recovery (Denial + Appeal Management, Recoupment Manager), and Analytics + Reporting (Analytics, Medicare Analytics, Quality + Compliance Reporting). These platform modules are all powered by Waystar AltitudeAI, the company's proprietary AI suite integrating Agentic AI, Generative AI, and Predictive AI capabilities, which is augmented by an expanded collaboration with Google Cloud's Gemini models. The platform serves over 30,000 clients including more than 1 million providers, processes over 7.5 billion healthcare payment transactions annually representing approximately 60% of U.S. patients, and supports 5,000+ commercial and Medicaid/Medicare payer connections. Notable acquired and integrated products include Iodine Software (clinical AI, acquired 2025 for $1.25B), Patientco (patient payments, acquired 2021 for $450M+), and eSolutions (Medicare analytics).

Differentiator

Problem solved

Functional benefit

Brands

• Waystar AltitudeAI: AI-powered automation platform referenced across Waystar's product suite (e.g., AltitudeAI agents)
• Waystar Innovation Lab

Products and services

• Waystar AltitudeAI Waystar's proprietary AI suite powered by Google Cloud Gemini models that automates work, prioritizes tasks, and eliminates errors across the end-to-end healthcare payment platform. Includes Agentic AI for autonomous workflows, Generative AI for content creation (e.g., appeal letters), and Predictive AI for forecasting outcomes. Has prevented over $15.5 billion in denied claims and reduced denial appeal processing time by 90%.
• Financial Clearance Suite of front-end solutions including Eligibility Verification, Patient Estimation, Coverage Detection, Charity Screening, Authorization, Referral Status, Registration QA, Advanced Propensity to Pay, and Price Transparency.
• Eligibility Verification Automates insurance eligibility verification with intelligent alerts that flag plan exclusions and coverage gaps before claims are submitted. Includes MBI Lookup, Auto Coverage Detection, and customizable alerts; 55% reduction in eligibility-related denials and 35% reduction in dollars denied.
• Patient Estimation HFMA Peer Reviewed patient payment estimator that uses enriched benefit data to generate highly accurate patient liability estimates with 87% estimate accuracy.
• Advanced Propensity to Pay Uses predictive analytics to intelligently stratify patient accounts based on collection risk and expected cash value; achieved $11M+ annual collection improvements at Atrium Health.
• Price Transparency Self-service tool that generates comprehensive coverage estimates in real-time by assessing charge master data, contract rates, and RPA-enhanced eligibility benefits to meet the CMS shoppable services mandate.
• Clinical Integrity + Revenue Capture Suite for finding missing charges and capturing revenue, including Utilization Management, Clinical Documentation Integrity, Prebill Anomaly Detection, Charge Integrity, DRG Anomaly Detection, and Transfer DRG, combining clinical and financial intelligence on a single end-to-end platform.
• Clinical Documentation Integrity (CDI) AI-powered CDI software powered by AltitudeAI that helps capture the complete patient story for stronger revenue capture, including Interact mobile query tool with QueryAgent for drafting post-discharge queries and DRG/GMLOS predictions.
• Charge Integrity Automatically identifies incorrect and under-coded claims as well as missing charges using predictive analytics, machine learning algorithms, and a U.S.-based expert auditing team.
• DRG Anomaly Detection Combines advanced tech, a large data set, and 100% onshore certified coders/clinicians to systematically review DRG assignments, with comprehensive reporting by Major Diagnostic Category, service line, or medical versus surgical.
• Transfer DRG (TDRG) Identifies TDRG underpayments and adjusts claims on behalf of providers as an approved CMS Network Services Vendor with direct Common Working File access, on contingency-based pricing.
• Claim Management Award-winning claim management suite helping prevent rejections and denials, automate claim monitoring, and streamline attachments, including Claim Manager with 2.5M claim edits and 98.5%+ first-pass clean claim rate.
• Claim Monitoring Automated claim status checking solution with Remit Forecast engine that predicts the right time to status a claim and intelligently drives follow-up across 600+ payers.
• Claim Attachments Electronic claim attachments solution that automatically matches claims to right attachments across hundreds of commercial and government payers, supporting PDF/TIFF files with batch processing.
• Medicare Management Medicare claim management with high-speed DDE/FISS connection that automates workflows, achieves Medicare compliance, and provides comprehensive Medicare reporting with automated NOA/NOE entry to FISS.
• Payment Management Suite for managing healthcare payments including Payer Reimbursement Suite (Remit Manager, Remit Deposit Management, Payer Lockbox, EOB Conversion), Patient Reimbursement, Patient Payments, and Agency Manager, processing $200B+ in provider payments annually.
• Payer Reimbursement Suite (Remit Manager) Healthcare-specific remittance solution offering one platform for all payer payments, auto-matching and posting payer payments with analytics, enrollments, and search.
• Remit + Deposit Management Automatically matches remits and posts payer payments with 95% average match rate when reconciling ERAs and EFT deposits, identifying missing or inaccurate deposits and remits.
• EOB Conversion + Payer Lockbox HIPAA-compliant digital lockbox solution that digitizes deposits by imaging and indexing all correspondence, checks, statement stubs, and ERAs, converting paper remittance advice into electronic 835 remittances and checks into ACH transactions.
• Agency Manager Healthcare vendor management system providing insight into collection agency performance with scorecards, invoice verification technology to ensure commission accuracy, and reconciliation tools.
• Denial Recovery Denial prevention and recovery suite powered by AltitudeAI that helps manage, appeal, and prioritize medical billing denials, including AI-powered prioritization and automated appeal generation.
• Recoupment Manager (Silent Denials AI) Industry's first AI-powered solution to detect and recover the $40B+ in provider revenue lost annually through payer recoupments and 'silent denials,' built on the Waystar AltitudeAI platform.
• Analytics + Reporting Suite of analytics solutions including Analytics (60+ pre-built reports, 12 dashboards), Medicare Analytics, and Quality + Compliance Reporting, providing 24/7 analytics with daily data refreshes and competitive benchmarking.
• Waystar Analytics Healthcare data analytics with 60+ pre-built RCM reports, 12 dashboards, 24/7 access with daily data refreshes, automated alerts, shareable reports, and competitive benchmarking.
• Medicare Analytics Medicare data analytics providing direct access to Medicare's system for on-demand reporting, actionable claim status with proprietary FISS Reason Code Classification, worklists, and trending reports.
• Quality + Compliance Reporting Healthcare quality and compliance software enabling CMS-mandated reporting via OASIS, MDS, HIS and PBJ file transfer with validation, automating manual processes and consolidating Medicare vendors.
• Waystar Claim Intelligence (AI-powered) AI-powered Claim Intelligence platform that improved first-pass claim acceptance rates from 89% to 96% across commercial implementations.

Quantifiable outcome

• $15.5B in denied claims prevented in less than one year
• +18 more outcomes

Named customers49 records

Segments10 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

Yes

API docs

API detail

Core technology

AI maturity

App detail

Integration15 records

AI capability11 records

Feature10 records

Partnerships

Nine partnerships are on record, tiered core, flagship and minor.

• Cooperative Exchange / HL7 Da Vinci ProjectcoreStrategic or Co-development Partner · 17 April 2026Waystar is one of twelve clearinghouse companies (alongside Availity, Experian Health, Optum, TriZetto Provider Solutions) participating in the Da Vinci Trebuchet Clearinghouse-to-Clearinghouse Prior Authorization Pilot Cohort. The pilot validates hybrid HL7 FHIR and X12 EDI workflows, develops a reference architecture for CH-to-CH routing and endpoint discovery, and identifies policy and technical barriers to interoperability. Aimed at reducing administrative burden for providers and payers.
• Google Cloud (Alphabet)flagshipTechnology or Integration · 5 March 2026Expanded collaboration integrating Google Cloud's Gemini large language models and hyperscale infrastructure into Waystar's AltitudeAI platform to advance the industry's first autonomous revenue cycle. Builds on prior collaboration since early 2024. Combines Waystar's proprietary financial and clinical data spanning over 1 million providers with Google Cloud's advanced AI models. Use cases include prior authorization, coverage identification, and denial prevention. The system has reportedly prevented over $15 billion in denied claims within a year while reducing denial appeal time by 90%.
• Iodine SoftwareflagshipStrategic or Co-development Partner · 23 July 2025Waystar acquired Iodine Software for $1.25 billion from shareholders led by Advent International. The deal combines Iodine's clinical AI capabilities into Waystar's healthcare software platform, enhancing automation and expanding market reach by over 15%. Iodine Software's AI-driven clinical intelligence is integrated with Waystar's financial data, expanding mid-cycle capabilities for clinical intelligence and denial prevention. Transaction closed by year-end 2025 with Iodine Software shareholders led by Advent International selling.
• PatientcoflagshipStrategic or Co-development Partner · 15 July 2021Waystar announced a definitive agreement to acquire Patientco, a provider of patient payments technology, in a move to transform healthcare payments and enhance the patient financial experience. Deal valued at over $450 million. The combined company aims to improve payment process transparency, increase collection rates, and reduce administrative costs by integrating Patientco's platform with Waystar's existing solutions.
• eSolutionsflagshipStrategic or Co-development Partner · 1 January 2020Waystar agreed to acquire eSolutions, a leader in revenue cycle technology with Medicare-specific solutions. After the transaction closed, Waystar became the first technology to unite commercial and governmental payers onto a single payments platform. The acquisition elevated Waystar's Medicare offerings with new Same or Similar and Same or Similar Batch functionality, enabling fully automated HCPCS code verification across all Medicare jurisdictions. Particularly valuable for DME suppliers.
• Epic (EHR Integration Partner)coreTechnology or IntegrationWaystar technology is powered by one of the industry's largest unified clearinghouses and integrates quickly and seamlessly with all major EHR systems including Epic. The 'Tech Integrations That Work in Any PM & HIS System' message highlights Epic integration. Waystar also lists EHR partners in its clients/partners section. Case studies cite Piedmont and Atlantic Health System as clients benefiting from Waystar's EHR integration.
• MEDITECH (EHR Integration Partner)coreTechnology or IntegrationWaystar technology integrates seamlessly with MEDITECH EHR/PM systems. Highlighted as a featured integration partner with case studies and a dedicated thumbnail ('MEDITECH_Thumb') on the platform page demonstrating Piedmont + Atlantic Health System smart + streamlined EHR integration with Waystar.
• Availity (Clearinghouse Partner)minorChannel Partner/ Reseller/ DistributorListed as a strategic partner in the healthcare EDI market. Availity and Waystar are both participants in the Cooperative Exchange's Da Vinci Trebuchet Clearinghouse-to-Clearinghouse Prior Authorization Pilot Cohort alongside Experian Health, Optum, and TriZetto Provider Solutions.
• Piedmont (Customer + Featured Partner)coreChannel Partner/ Reseller/ DistributorPiedmont is featured as both a customer and partner, with Waystar highlighting Piedmont's success in optimizing end-to-end revenue cycle and generating $10M+ in payment lift. Piedmont also participates as a case study and reference across multiple Waystar marketing materials.

Scale indicators14 records

Recent moves9 records

Expansion highlights6 records

Direct peers

• Optum (UnitedHealth Group) / Change Healthcare: Optum's acquisition of Change Healthcare created the largest direct competitor to Waystar in healthcare RCM, clearinghouse, and payment processing. Both serve U.S. providers and payers with claims management, denial management, and revenue cycle optimization, making them the closest head-to-head competitor.
• Availity: Availity is one of the largest U.S. healthcare clearinghouses and a direct Waystar competitor in eligibility, claims, and payer-provider data exchange. Both participate in the HL7 Da Vinci Trebuchet Clearinghouse-to-Clearinghouse Prior Authorization Pilot Cohort alongside Experian Health, Optum, and TriZetto.
• FinThrive: FinThrive is a direct competitor in healthcare revenue cycle technology, offering end-to-end RCM, claims management, and analytics to U.S. providers. KLAS Research listed FinThrive alongside Waystar as a notable 2026 revenue cycle technology vendor.
• nThrive: nThrive is a direct RCM technology competitor deploying AI platforms for claims processing, medical coding automation, denial management, and revenue cycle optimization — overlapping with Waystar's core product suite across U.S. providers.
• Experian Health: Experian Health competes directly with Waystar in eligibility verification, patient access, and revenue cycle management for U.S. providers. It is also a fellow participant in the HL7 Da Vinci Trebuchet Clearinghouse-to-Clearinghouse Prior Authorization Pilot Cohort.
• TriZetto Provider Solutions (Cognizant): TriZetto is a direct Waystar competitor in healthcare claims management, payer connectivity, and revenue cycle solutions. TriZetto is also a fellow participant in the Da Vinci Trebuchet PA Pilot Cohort and serves many of the same U.S. payer and provider customers.
• Athenahealth: Athenahealth provides EHR-integrated revenue cycle management and patient engagement tools, with strong penetration in the physician practice and ambulatory segments that overlap with Waystar's Physician + Specialty Practices customer base.

Broad incumbents

• Oracle Health (Cerner): Oracle Health (formerly Cerner) is a broad incumbent in the EHR market with growing RCM capabilities, including an expanded Revenue Management Cloud with AI-assisted prior authorization. Competes with Waystar in the provider RCM space but as part of a much broader enterprise health IT portfolio.
• Epic Systems: Epic is the largest U.S. EHR vendor and a Waystar integration partner, but increasingly develops native RCM capabilities that compete with Waystar. As a broad incumbent serving most major U.S. health systems, Epic's RCM roadmap poses a long-term competitive risk to Waystar's installed base.

Emerging players

• Inbox Health: Inbox Health is an emerging AI-powered patient billing and engagement platform serving U.S. healthcare providers, with partial overlap to Waystar's Patientco-acquired patient payments business. Represents a newer entrant attacking the patient financial experience segment of the RCM stack.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights6 records

Customer concentration

• Xx.com/Waystar
• YouTubeyoutube.com/channel/UClK8V4mKfF1_paNzPIUJlHQ
• Facebookfacebook.com/WaystarRCT
• LinkedInlinkedin.com/company/waystar
• Instagraminstagram.com/waystarsoftware

Compliance5 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles13 records

Subsidiaries3 records

Funding overview

Funding rounds4 records

Investors2 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A11 records

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Waystar