Waystar Eligibility

Waystar

AI-powered real-time eligibility verification processing 90M+ transactions monthly across commercial, Medicare, and Medicaid payers.

About Waystar Eligibility

Waystar Eligibility is part of Waystar's comprehensive revenue cycle management platform, leveraging artificial intelligence, robotic process automation, and expansive payer connectivity to provide real-time, highly accurate benefit information. The system proactively prevents rejections and denials with intelligent alerts, identifies coverage gaps and out-of-network risks in real time, and optimizes staff productivity with enriched benefit data. Waystar processes over 90 million transactions monthly and integrates with most major PM/EHR systems including Epic, Cerner, athenahealth, and NextGen to reduce front-desk manual lookups. The platform reduces claim denials by verifying benefits upfront and flags outstanding balances for collection before claims are filed. Waystar is a leading healthcare revenue cycle technology provider formed from the merger of Navicure and ZirMed.

Best For

  • Health systems needing comprehensive eligibility verification
  • Multi-site organizations with high claim volume
  • Practices wanting to reduce front-desk manual lookups
  • Organizations seeking denial prevention tools

Not Ideal For

  • Solo practitioners with low claim volume
  • Practices seeking free or low-cost solutions
  • Small practices with simple eligibility needs

Integrations

EpicCernerathenahealthNextGenAllscriptseClinicalWorks

Pricing

Contact for pricing

Compliance & Security

HIPAAYes
BAA AvailableYes
SOC 2Yes
HITRUSTYes

Always verify compliance directly with the vendor.

Target Audience

Roles

Practice Administrator

Settings

Group Practice

Get Started

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