Our solution’s innovative approach: Savings: By seamlessly integrating disease progression prediction into prior authorization decisions, our solution personalizes treatments, saving plans up to one-fifth of medical and administrative expenses within four months and automating up to 85% of decisions. Time: Our agile infrastructure and generative AI-encoded payer policies allow for rapid integration without the need for sensitive information or payer data. Compared to industry standards, we are capable of launching a pilot up to nine months faster and reducing prior authorization time by up to eight days. Explainability: Our platform’s platform's patented chatbot cross-references disease profiles and severity with relevant scientific literature, providing answers to member and provider queries about coverage decisions. Accuracy: Our algorithm approves clinically appropriate care pathways, optimizing member outcomes. Communication: Our platform reduces friction with auto-filled forms and real-time communication with providers through the chatbot feature. The result is a transparent, efficient, and neutral platform that reduces administrative and medical expenses while improving member outcomes.

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: - 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

Many hospitals, health systems, and IDNs have invested in billion dollar EMR/EMRs which are an extraordinary vehicle for clinical and billing functions -- but lack the ability to elevate automation in key business areas such as prior authorization. This is due to their lack of payer connections and the absence of advanced intelligent software. Together, Waystar brings the intelligence that powers today's EMR/EHR platforms and automation efforts.

With nearly a decade in the business of automating prior authorizations, we are known for our internal expertise when it comes to payers, process change, and technology. We believe pushing the envelope in know-how across all 3 is what gives our clients the edge on automation. With more payer connections, more relationships with payers, and greater flexibility in accessing payer data we can access the best and most timely data. We not only seamlessly integrate with EPIC but offer full-stack integration capabilities or a powerful stand-alone application -- all because each patient access team is different. And powered across our Hubble platform (a blend of RPA, machine learning, NLP, and advanced auth rules) we are well positioned to power your automated enterprise.