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FASTER, SMARTER PRIOR AUTHS ARE FINALLY HERE

Get faster approvals at a lower cost with automated prior authorizations from Waystar. Our breakthrough technology integrates with all major EMRs and payer systems, constantly working behind the scenes and gaining speed and accuracy with every exchange. Find out what greater productivity and fewer denials can mean for your team—and for your patients.

Learn more

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GET THE SIMPLE SOLUTION TO ONE OF YOUR BIGGEST CHALLENGES

Prior authorizations are a leading cause of denied claims—a problem that costs providers billions in lost revenue and keeps patients from getting the care they need when they need it. The challenge is only growing as the volume of prior auths increases. Plus, many services don’t require a prior auth, but many billing teams waste valuable time looking into whether or not one is needed.

Artificial Intelligence and RPA technology can help automate the authorization process and free up your staff. What’s more, we can get up and running quickly, with no new personnel required.

Contact us

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UNLOCK YOUR PRIOR AUTH POTENTIAL WITH AI AND RPA

There’s a wealth of powerful data within your EHR—you just need real-time insights and seamless integration to make it actionable. Our Prior Authorization solution, powered by Waystar’s Hubble:

UNLOCK YOUR PRIOR AUTH POTENTIAL WITH AI

There’s a wealth of powerful data within your EHR—you just need real time insights and seamless integration to make it make it actionable. Our Prior Authorization solution, powered by AI:

• Integrates directly with all major HIS and PM
   systems
• Checks whether an authorization is needed
• Anticipates payer behavior, so you can
   predict likelihood of authorization and
   accurate approval timetables 
• Adapts to constantly shifting payer rules and
   requirements
• Works at scale and across specialties
• Built and maintained by our in-house team of
   experts


Request demo

  • Automatically verifies, initiates, statuses and retrieves comprehensive authorization details 
  • Enables efficient, intelligent automation by initiating authorizations at twice the speed of manual processes
  • Integrates directly with all major HIS and PM systems
  • Provides end-to-end authorization platform, including authorizations submissions for unscheduled admissions, as well as auto-generating ABNs or Notice of Non-coverage forms for Medical Necessity
  • Adapts to constantly shifting payer rules and requirements
  • Was built and is maintained by our in-house team of experts

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FASTER, SMARTER PRIOR AUTHS ARE FINALLY HERE

Get faster approvals at a lower cost with automated prior authorizations from Waystar. Our breakthrough technology integrates with all major EMRs and payer systems, constantly working behind the scenes and gaining speed and accuracy with every exchange. Find out what greater productivity and fewer denials can mean for your team—and for your patients.

Learn more

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GET THE SIMPLE SOLUTION TO ONE OF YOUR BIGGEST CHALLENGES

Prior authorizations are a leading cause of denied claims—a problem that costs providers billions in lost revenue and keeps patients from getting the care they need when they need it. The challenge is only growing as the volume of prior auths increases.

Artificial Intelligence and RPA technology can help automate the authorization process and free up your staff. What’s more, we can get up and running quickly, with no new personnel required.

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THE BURDEN OF PRIOR AUTHS:

$14

amount healthcare industry spends on manual prior authorizations per transaction2

21 min

average staff time to secure manual prior authorization2

92%

of physicians say that prior authorization programs have a negative impact on patient clinical outcomes3

$30B

estimated annual cost of prior authorizations for healthcare providers

12.4%

of denials are caused by incomplete or missing authorizations

$11.18

average cost per manual prior

84%

of physicians believe prior authorizations place a high or extremely high burden on them and their staff

FIND OUT HOW MUCH EASIER PRIOR AUTHS CAN BE

$454M

estimated amount providers could save annually by transitioning to electronic prior auth transactions2

300+

direct payer connections

50%

reduction in auth processing time

75%

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75%

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GET EXTRA INSIGHTS

Looking for more information on how our Prior Authorization solution can transform your workflows and your bottom line? Check out our resources to learn more.

Contact us

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How AI can save you from drowning in prior auth problems
> Read now

Prior Authorization data sheet
> Read now

How to know the score when choosing an AI vendor
> Download

GET EXTRA INSIGHTS

Looking for more information on how our Prior Authorization solution can transform your workflows and your bottom line? Check out our resources to learn more.

Contact us

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Sed ut perspiciatis unde omnis
> Download

How AI can save you from drowning in prior auth problems
> Read now

Prior Authorization data sheet
> Download

How to know the score when choosing an AI vendor
> Download

Leveraging AI for Prior Auths: a Frost & Sullivan white paper
> Download

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Feature

Waystar

Other

Details

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Waytstar
Category
Average

Overall Score

95.7

87.3

% Clients Satisfied

73

N/A

Best Vendor Relationship

95.2

84.3

Product

94.2

86

Value

96.9

86.6

Operations

95.5

88.9

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Patient
Financial
Clearance

Revenue
Integrity

Claim
Management

Denial
Management

Contract
Management

Patient
Financial
Experience

Agency
Management

Patient
Insights

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90%

Simo ex expercit officabori sima int

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90%

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CLAIM MANAGEMENT

   

Starter

Simplify Denials Management

Core

Reach Workflow Excellence

Performance

Get visibility into the claim lifecycle

Premium

Achieve Revenue Cycle Automation

Expanded claim lifecycle visibility through date tracking and proof of timely filing reports

Automated front-end claim editing and scrubbing

View and edit claims in customizable workgroups for prioritization and staff assignment

Payer response clarified and simplified with Simple Response™ technology

Hundreds of crowdsourced rules and edits

Claim process lifecycle visibility with date tracking and proof of timely filing reporting

Dashboards and reports for key rev cycle performance and user productivity metrics

Real-time claim status inquiries with approximately 5-7 second payer responses

Make eligibility and benefit coverage inquiries

Leverage 1,200 payer connections

Verify eligibility and co-payments

Quickly and easily enter patient info

Expedite check-in by accessing real-time plan information in seconds

Automated provider enrollment

Denial prevention with automated pre-claim eligibility verification

Streamline denial management

Flexible workgroups and automation to close non-workable denials

Eligibility integration to check patient coverage within denial workflow

Root cause reporting to reduce preventable denials

Robust outcome reporting and dashboards for user-friendly resubmissions and payer follow-up

Simplify appeal processes

Appeals wizard that allows you to create three-step, 100% paperless appeals packages

More than 600 payer appeal templates available and pre-populated with remit and provider data, including proof of timely filling

Custom and dynamic attachments and saved responses streamline submission

Ability to batch 100 similar appeals to same payer

Automate claim status checks

 

Custom schedules to accommodate follow-up workflow

 

Proactive claim status checks based on predictive analytics that determine optimal timing

 

Automatic claim status checks without the need for batch files

 

Early notification of pended claims

 

Payer response clarified and simplified with Simple Response™ technology

 

Ability to work by exception with focused workgroups

 

Visualize your performance and deliver actionable insights

   

Custom dashboards and reports

   

Alerts to drive corrective action when KPIs deviate from target range

   

All-in-one, standardized rev cycle analytics for financial performance clarity

   

Intuitive drill-down capabilities to identify key details in the health of the rev cycle

   

Automate bank reconciliation processes

     

Automated identification of missing or inaccurate deposits and ERAs

     

Streamlined payment posting workflows to avoid posting delays that increase AR days

     

Aggregated reporting for payment information —even if you use more than one bank

     

Convert paper EOBs to electronic files

     

Indexing of checks and documents for historical tracking

     

Automated payment posting and reconciliation

     

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Number of claims you follow up on monthly

<  >

Number of FTEs dedicated to payer follow-up

<  >

Fully loaded annual salary of medical biller

<  >

Total savings per year

$204,327

These numbers are for demonstration only and account for some assumptions. Contact us for a more comprehensive and customized savings estimate.

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Monthly claim volume

<  >

Current denial rate

<  >

Average claim value

<  >

Average number of appeal packages submitted per month

<  >

Total additional revenue recovered per year

$204,327

Total staff hours saved

These numbers are for demonstration only and account for some assumptions. Contact us for a more comprehensive and customized savings estimate.

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Gross patient revenue

Net patient revenue

Patient mix (% Inpatient)

<  >

Payer Mix (% Commercial)

<  >

Payer mix (% Government)

<  >

Payer mix (% Other/self pay)

<  >

Note: The above values need add up to 100%

100%
$1.8M
$2.2M
$3.3M
$7.9M

OUTER RANGE: Likely cash impact range for a system of your size

INNER RANGE: Most probable range given your specific information

Benefit range accounts for benefit to be attained through missing charges, CPT coding errors and DRG assignment errors. This calculator is designed to be educational in nature based upon limited information. It is therefore not a guarantee of performance. 1 HFMA blog, 2016

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Join our clients in reducing rejections
and denials by payers

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