ZirMed
ZirMed is a cloud-based healthcare revenue cycle management platform serving 1M+ US providers and connecting to 5,000+ payers, covering roughly 60% of the US patient population with AltitudeAI-powered agentic, generative, and predictive AI tools across claims, payments, denials, and analytics.
- Company typePrivate
- Founded1999
- HeadquartersLouisville, United States
- Headcount501–1,000
- GTM typeB2B
- OfferingSoftware
What ZirMed does
ZirMed, founded in 1999 and headquartered in Louisville, Kentucky, provides cloud-based revenue cycle management (RCM) software to the US healthcare industry and now operates as a brand/product line within Waystar Health. The platform connects providers to one of the largest payer networks in the United States — 5,202 professional claims payers, 4,650 institutional claims payers, 3,413 remittance payers, and 1,171 eligibility payers — covering an estimated 60% of the US patient population and used by over 1M providers. Core product modules span Financial Clearance (eligibility verification, prior authorization, propensity-to-pay, price transparency), Clinical Integrity + Revenue Capture (prebill anomaly detection, DRG anomaly detection, charge integrity), Claim Management, Payment Management, Denial Recovery, and Analytics + Reporting.
The technology stack rests on the AltitudeAI platform, which layers agentic AI (autonomous workflow execution), generative AI (content generation for productivity and communication), and predictive AI (denial prevention and payment forecasting) across the end-to-end RCM workflow. Differentiated infrastructure includes deep EHR/EMR and proprietary practice-management integrations (94% client-reported satisfaction) and compliance certifications covering HIPAA, HITRUST CSF, SOC 2 Type II, and PCI DSS. The product roadmap is delivered through annual events (True North Client Conference) and a newly formalised Innovation Lab cadence.
The business model combines subscription SaaS (quote-based annual contracts, pricing not publicly disclosed) with transaction-based clearinghouse revenue from claims, eligibility, remittance, and attachment volume. Go-to-market is enterprise-led via direct field sales to large health systems and hospitals, augmented by a mid-market self-serve channel, a billing-services partner program, and EHR-aligned distribution. Quantified outcomes cited on the customer side include $10M+ payment lifts, 300% back-office automation increases, 50% reductions in patient AR days, and 2x increases in patient payments, supporting a value-based selling motion into risk-averse healthcare provider procurement organizations.
ZirMed firmographics
Firmographics- Name
- ZirMed
- Legal name
- Waystar Health
- Website
- https://zirmed.com
- Company type
- Private
- Founded year
- 1999
- Operating status
- Operating
- Headcount range
- 501–1,000 employees
- Short description
- ZirMed is a cloud-based healthcare revenue cycle management platform serving 1M+ US providers and connecting to 5,000+ payers, covering roughly 60% of the US patient population with AltitudeAI-powered agentic, generative, and predictive AI tools across claims, payments, denials, and analytics.
- Ownership category
- akta.pro rank
ZirMed industry classification
Industry- Product category
- Healthcare Revenue Cycle Management Software
- NAICS
- Software Publishers (5132)
- SIC
- Services-Prepackaged Software (7372)
- akta.pro primary industry
- Claims Management, Scrubbing & Clearinghouse (HLACACAB)
- akta.pro secondary industries
- Price Transparency, Estimates & Patient Financial Clearance (HLACACAK), Patient Access, Registration & Intake (Front-End RCM) (HLACACAE), RCM Analytics, Benchmarking & Underpayment Detection (HLACACAL), Patient Billing, Statements & Payment Processing (HLACACAG)
Keywords
Where ZirMed is headquartered
LocationHeadquarters
- HQ city
- Louisville
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
ZirMed business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Infrastructure, Marketing or Sales, Operations
Revenue model
- Subscription SaaS Platform: Cloud-based RCM software delivered as subscription service with platform-wide AI capabilities. Pricing not publicly disclosed, quote-based for enterprise healthcare organizations.
- Transaction-based Clearinghouse: Claims processing services for professional claims (5,202 active payers), institutional claims (4,650 payers), remits (3,413 payers), eligibility (1,171 payers), claims attachments (1,515 payers), estimation (1,171 payers), and claims monitoring (911 payers).
- Healthcare IT Software: Part of the broader Medical Claims Processing Software market projected to grow from $12.12 billion in 2025 to $32.18 billion by 2033 at CAGR of 12.98%, with cloud-based solutions capturing over 60% market share.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Enterprise healthcare organizations |
Go-to-market motion3 records
Distribution channels4 records
Marketing channels10 records
ZirMed product offering
Product offeringCore offering
ZirMed provides a cloud-based healthcare revenue cycle management (RCM) SaaS platform that automates the end-to-end revenue cycle from financial clearance through denial recovery and analytics. The platform serves healthcare providers including health systems, hospitals, physician practices, ambulatory surgery centers, and billing services, processing claims, eligibility verification, payment management, and denial appeals powered by the AltitudeAI suite of agentic, generative, and predictive AI capabilities.
Differentiator
Problem solved
Functional benefit
Products and services
- Financial Clearance Front-end revenue cycle suite delivering insurance benefits verification, price transparency, prior authorization automation, eligibility verification, patient estimation, coverage detection, charity screening, registration QA, advanced propensity to pay, and price transparency for healthcare providers.
- Clinical Integrity + Revenue Capture Mid-cycle revenue capture suite providing utilization management, clinical documentation integrity, prebill anomaly detection, charge integrity, DRG anomaly detection, and Transfer DRG (TDRG) for capturing missing charges and revenue in healthcare organizations.
- Claim Management End-to-end claim management suite providing claim manager, claim attachments, claim monitoring, and Medicare management with automated claim monitoring and streamlined attachments processing for healthcare providers.
- Payment Management Payment processing suite delivering payer reimbursement, remit and deposit management, EOB conversion and payer lockbox, patient reimbursement, patient payments, and agency manager capabilities for healthcare revenue cycle operations.
- Denial Recovery Denial and appeal management suite with recoupment manager for tracking, appealing, and recovering denied claims, helping healthcare providers get paid faster and more fully.
- Analytics + Reporting Analytics and reporting suite providing actionable intelligence from data with analytics, Medicare analytics, and quality and compliance reporting capabilities for healthcare revenue cycle management.
- AltitudeAI Platform Waystar's AI platform powering the entire revenue cycle management suite, providing agentic AI, generative AI, and predictive AI capabilities that automate work, prioritize tasks, and eliminate errors across the end-to-end platform.
Quantifiable outcome
- $10M+ generated in payment lift for Piedmont health system
- +5 more outcomes
Companies that use ZirMed
Customer profileNamed customers16 records
Segments10 records
Ideal customer profiles3 records
ZirMed technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
AI capability8 records
Feature9 records
ZirMed partnerships and signals
Strategic signalPartnerships
Five partnerships are on record, tiered core and strategic.
- EHR/EMR System VendorscoreIntegration partnerships with Electronic Health Record and Electronic Medical Record systems enabling seamless RCM workflows within existing healthcare IT infrastructure. 94% of clients are satisfied with EHR integrations per Third Party Provider Satisfaction Survey.
- Healthcare Payers (Insurance Companies)coreExtensive network of 5,202 professional claims payers, 4,650 institutional claims payers, 3,413 remits, 1,171 eligibility payers covering BC/BS, Medicare, Commercial, Medicaid, DMERC, and Tricare. Active payer connections require enrollment for some payers.
- Practice Management System VendorscoreProprietary System Integration partnerships for physician and specialty practices enabling RCM integration with practice management systems.
- Billing Services PartnerscorePartner program for billing services providers who manage RCM for healthcare clients. Partner login portal available at login.zirmed.com/ui/partners with dedicated partner resources.
- Waystar Early Adopter Program MembersstrategicEarly adopter program providing exclusive access to innovation for selected healthcare organizations to co-develop and test new AI-powered RCM features before general release.
Scale indicators9 records
Recent moves6 records
Expansion highlights5 records
ZirMed competitors and assessment
Company assessmentDirect peers
- Availity: Availity operates a major healthcare clearinghouse and provider-payer collaboration platform. Directly comparable to ZirMed/Waystar in the payer-provider data exchange and eligibility/claims clearinghouse business with similar transaction-fee economics.
- FinThrive: FinThrive is a healthcare revenue cycle management platform formed from the merger of nThrive and Experian's healthcare arm. Competes head-to-head with ZirMed/Waystar across the full RCM stack for hospitals and health systems.
- R1 RCM: R1 RCM is a leading end-to-end healthcare revenue cycle management company serving large health systems and hospitals. Directly comparable to ZirMed/Waystar in target market (enterprise health systems), product breadth (full-stack RCM), and AI-driven automation focus.
- NextGen Healthcare: NextGen Healthcare offers an integrated EHR and RCM platform targeted at ambulatory practices and specialty groups. Directly comparable to ZirMed/Waystar in physician and specialty practice RCM with similar subscription plus transaction-fee economics.
- Athenahealth: Athenahealth provides cloud-based EHR plus integrated practice management and RCM (athenaCollector) primarily to ambulatory providers. Closely comparable to ZirMed/Waystar's ambulatory segment with overlapping claims management, patient billing, and denial workflows.
- Experian Health: Experian Health provides patient access, claims management, and RCM solutions to hospitals and physician practices. Directly comparable to ZirMed/Waystar in patient financial clearance, eligibility verification, and identity management offerings.
Broad incumbents
- Oracle Health (Cerner): Oracle Health (formerly Cerner) provides enterprise EHR with integrated RCM capabilities to large hospital systems globally. Functions as a broad incumbent competitor, particularly for inpatient RCM where Cerner's installed base creates bundled competition.
- Epic Systems: Epic is the dominant EHR vendor for large health systems and increasingly bundles RCM capabilities (Resolute) into its platform. Competes with Waystar as a broad incumbent that health systems may consolidate onto instead of using third-party RCM.
- Optum (Change Healthcare): Optum acquired Change Healthcare to form a clearinghouse and RCM powerhouse within UnitedHealth Group. Competes directly with Waystar in claims clearinghouse, payment integrity, and patient access — with the advantage of payer vertical integration.
Emerging players
- AKASA: AKASA is an AI-native RCM platform focused on automating revenue cycle workflows for health systems using generative and agentic AI. Comparable to ZirMed/Waystar as an emerging AI-driven competitor targeting the same automation pain points, though with narrower product breadth.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
ZirMed social profiles
Digital presenceZirMed compliance and trust
Trust signalCompliance4 records
ZirMed financial estimates
Financial estimateRevenue estimate
Valuation estimate
ZirMed leadership team
Management profileNumber of profiles
Profiles3 records
ZirMed funding detail
Funding detailFunding overview
Funding rounds6 records
Investors2 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
ZirMed M&A and investment
M&A and investmentM&A2 records
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about ZirMed
What does ZirMed do?
ZirMed provides a cloud-based healthcare revenue cycle management (RCM) SaaS platform that automates the end-to-end revenue cycle from financial clearance through denial recovery and analytics. The platform serves healthcare providers including health systems, hospitals, physician practices, ambulatory surgery centers, and billing services, processing claims, eligibility verification, payment management, and denial appeals powered by the AltitudeAI suite of agentic, generative, and predictive AI capabilities.
When was ZirMed founded?
ZirMed was founded in 1999. It employs 501 to 1,000 people.
Where is ZirMed based?
ZirMed is headquartered in Louisville, United States, in the North America region.
How does ZirMed make money?
Three revenue lines are on record. Subscription SaaS Platform is the primary driver. The others are transaction-based Clearinghouse and healthcare IT Software.
Who are ZirMed's main competitors?
Direct peers on record are Availity, FinThrive, R1 RCM, NextGen Healthcare, Athenahealth and Experian Health. Broad incumbents are Oracle Health (Cerner), Epic Systems and Optum (Change Healthcare). AKASA is listed as an emerging player.
Does ZirMed have an API?
Yes. ZirMed exposes a public API. Developer documentation is at developer.waystar.com.
What industry is ZirMed in?
ZirMed's product category is Healthcare Revenue Cycle Management Software. Its primary akta.pro industry code is HLACACAB, Claims Management, Scrubbing & Clearinghouse, with a secondary code of HLACACAK, Price Transparency, Estimates & Patient Financial Clearance. Its NAICS code is 5132 and its SIC code is 7372.