Navicure

What Navicure does

Navicure, founded in 2001 and headquartered in Duluth, Georgia, originated as a cloud-based provider of claims management and patient payment solutions for physician practices and hospitals. Following its combination with ZirMed, the entity operates today as Waystar, a unified healthcare revenue cycle management (RCM) cloud platform serving more than 1 million providers and covering approximately 60% of the U.S. patient population. The platform targets two primary customer segments — physician and specialty practices (including ambulatory surgery centers, billing services, clinical laboratories, durable medical equipment providers, FQHCs, home health/hospice, and skilled nursing facilities) and large health systems/hospitals — addressing revenue cycle pain points such as claim denials, eligibility verification, prior authorization delays, payer reimbursement complexity, and patient payment collection.

Waystar's product surface is organized into six integrated modules: Financial Clearance (eligibility verification, prior authorization, patient estimation, propensity-to-pay, price transparency), Clinical Integrity + Revenue Capture (utilization management, charge integrity, prebill and DRG anomaly detection, transfer DRG), Claim Management (claim monitoring, attachments, Medicare management), Payment Management (payer reimbursement, remit and deposit management, EOB conversion, patient payments), Denial Recovery (denial and appeal management, recoupments), and Analytics + Reporting. All modules are unified under the AltitudeAI platform, which delivers agentic AI (autonomous end-to-end workflow execution), generative AI (content and communication automation), and predictive AI (denial prevention and payment forecasting) capabilities.

The company distributes through a direct enterprise sales motion targeting health systems and hospitals, complemented by self-service client and partner portals for mid-market customers. Waystar maintains HIPAA, SOC 2 Type 2, PCI DSS, and HITRUST CSF certifications, and has been recognized by Best in KLAS 2026 (Patient Access), TIME 100 Most Influential Companies 2026, Inc. Best in Business 2025, and MedTech Breakthrough 2026. Pricing is not publicly disclosed. The company is privately held, employs 251-500 people, and is headquartered in the United States.

Name

Navicure

Legal name

Waystar

Website

https://navicure.com

Company type

Private

Founded year

2001

Operating status

Operating

Headcount range

251–500 employees

Short description

Navicure, operating as Waystar, is a Duluth, GA-based cloud healthcare revenue cycle management platform serving over 1 million providers across the U.S., offering AI-powered claims, payment, denial recovery, and analytics solutions to physician practices and health systems.

Ownership category

akta.pro rank

Product category

Healthcare Revenue Cycle Management

NAICS

Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (51821), Computer Facilities Management Services (541513)

SIC

Services-Prepackaged Software (7372), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Claims Management, Scrubbing & Clearinghouse (HLACACAB)

akta.pro secondary industries

Healthcare Master Data Management (MDM) & Patient/Provider Identity Data (HLACAIAB), Healthcare Billing & Patient Payments Presentment (FSAMAJAH)

Keywords

• Healthcare revenue cycle
• Claims management software
• Patient payment solutions
• Medical billing automation
• Denial management

Headquarters

HQ city

Duluth

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Software

Cost components

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

Distribution channels2 records

Marketing channels6 records

Core offering

Navicure provides cloud-based claims management and patient payment solutions for physician practices and hospitals. Its platform automates the healthcare revenue cycle across financial clearance (eligibility, prior authorization, patient estimation), clinical integrity and revenue capture, claim management, payment management, denial recovery, and analytics and reporting, unified under an AI-powered platform.

Product overview

Waystar offers a unified, end-to-end healthcare revenue cycle management platform with AI-powered capabilities. The platform is organized into six core modules: Financial Clearance (eligibility, prior authorizations, patient estimates), Clinical Integrity + Revenue Capture (charge integrity, anomaly detection), Claim Management (claim processing, Medicare management), Payment Management (reimbursements, patient payments), Denial Recovery (denial prevention, appeals, recoupments), and Analytics + Reporting. All capabilities are unified under the AltitudeAI platform, which provides agentic AI, generative AI, and predictive AI throughout the revenue cycle.

Differentiator

Problem solved

Functional benefit

Brands

• AltitudeAI: AI-powered platform encompassing Agentic AI, Generative AI, and Predictive AI capabilities for healthcare revenue cycle management.

Products and services

• Financial Clearance Verifies insurance benefits, automates prior authorizations, provides price transparency, and supports eligibility verification, patient estimation, coverage detection, charity screening, registration QA, and propensity to pay. Designed for physician practices, specialty practices, and health systems seeking to reduce denials and improve upfront collections.
• Clinical Integrity + Revenue Capture Identifies missing charges and recovers owed revenue through utilization management, clinical documentation integrity, prebill anomaly detection, charge integrity, DRG anomaly detection, and Transfer DRG (TDRG) capabilities. Targeted at hospitals and health systems seeking to capture accurate reimbursement and reduce revenue leakage.
• Claim Management Automates claim monitoring, streamlines attachments, and manages payer remittances through Claim Manager, Claim Attachments, Claim Monitoring, and Medicare Management. Built for healthcare providers to improve first-pass claim acceptance and reduce manual rework.
• Payment Management Manages payer reimbursements, remittance and deposits, patient reimbursements and payments through payer reimbursement, remit and deposit management, EOB conversion with payer lockbox, patient reimbursement, patient payments, and agency manager. Used by hospitals, health systems, and physician practices to consolidate payment workflows.
• Denial Recovery Helps healthcare organizations avoid, track, and appeal denials to accelerate and maximize reimbursement, including denial and appeal management and recoupment manager. Serves physician practices, specialty groups, and health systems seeking to reduce denied claims and recover lost revenue.
• Analytics + Reporting Provides actionable intelligence from revenue cycle data through analytics, Medicare analytics, and quality and compliance reporting. Used by healthcare finance and operations leaders to monitor performance and support decision-making.
• AltitudeAI AI platform that combines agentic AI, generative AI, and predictive AI to automate healthcare revenue cycle workflows, prioritize tasks, and eliminate errors. Powered by a proprietary data network covering 60% of the U.S. patient population. Applicable across financial clearance, clinical integrity, claim, payment, denial, and analytics workflows.

Quantifiable outcome

• $10M+ in payment lift
• +9 more outcomes

Named customers15 records

Segments2 records

Ideal customer profiles2 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability7 records

Feature1 record

Partnerships

One partnership is on record.

• EHR VendorscoreTechnology or IntegrationWaystar has deep integrations with major Electronic Health Record (EHR) systems, with 94% of clients satisfied with EHR integrations. The platform offers proprietary system integration capabilities for seamless data flow between RCM and clinical systems.

Scale indicators8 records

Recent moves5 records

Expansion highlights5 records

Direct peers

• R1 RCM: R1 RCM is a leading end-to-end healthcare revenue cycle management company serving large hospital systems and physician groups, directly competing with Waystar across the full RCM stack.
• Availity: Availity is a major healthcare clearinghouse and payer-provider collaboration platform offering eligibility, claims, and prior authorization — directly overlapping with Waystar's claim management and financial clearance modules.
• Experian Health: Experian Health offers eligibility verification, claims management, patient payments, and identity solutions, competing head-to-head with Waystar across multiple RCM modules for hospitals and physician practices.
• Cotiviti: Cotiviti provides payment accuracy, claims editing, and analytics for payers and providers, overlapping with Waystar's denial prevention, payment integrity, and analytics modules.

Broad incumbents

• Optum (UnitedHealth Group): Optum owns Change Healthcare and provides integrated RCM, claims processing, and payer-side analytics; it competes with Waystar in clearinghouse, denial, and payment workflows at scale.
• Cerner (Oracle Health): Oracle Health's Cerner platform embeds RCM capabilities (claims, billing, patient accounting) within its EHR suite, serving as both a partner and a competitive incumbent to stand-alone RCM platforms like Waystar.
• Epic Systems: Epic's integrated EHR and revenue cycle functionality (Resolute) competes with Waystar in large health systems; while often a Waystar integration partner, Epic increasingly bundles native RCM capabilities.
• NextGen Healthcare: NextGen provides integrated EHR and practice management with embedded RCM for ambulatory and specialty practices, competing with Waystar's physician and specialty practice segment.

Emerging players

• Infinx Healthcare: Infinx delivers AI-powered RCM solutions including prior authorization, eligibility, and patient access — a fast-growing emerging competitor in the same modules where Waystar competes for mid-market and specialty practices.

Regional players

• eClinicalWorks: eClinicalWorks offers EHR with RCM/BPM services primarily to small and mid-sized U.S. physician practices, representing a comparable offering to Waystar's mid-market physician practice segment.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Key highlights7 records

Customer concentration

• Xx.com/navicure
• YouTubeyoutube.com/channel/UClK8V4mKfF1_paNzPIUJlHQ
• Facebookfacebook.com/navicure
• LinkedInlinkedin.com/company/navicure
• Instagraminstagram.com/waystarsoftware

Compliance4 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds2 records

Investors3 records

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

M&A

Investments

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

Frequently asked questions about Navicure