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Prior Authorization

Prior Authorization

Prior Authorization


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Avia Summary

Prior Authorization is a solution provided by Waystar which was founded in 2000. It belongs to multiple categories of digital health solutions including Revenue Cycle Management, Prior Authorization, and Patient Billing & Payment.
It has 24 verified clients.
Some other resource(s) that may be helpful in learning about Prior Authorization include: Top Prior Authorization Companies Report | 2023 and Top Patient Billing and Payment Companies Report | 2023
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
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EHR integration

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Use cases and differentiators

With over 300+ payers and a broad array of deployable service lines and patient types, we provide a full cycle automation solution for prior authorization: from pre-scheduled prior auth submission, status checking and denial prevention worklist alerts, as well as medical necessity verification and notification of admission.

Pre-service financial clearance teams, auth cert teams, any prior authorization staff doing medical necessity as well as authorization for services at acute care facilities or OP areas.

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.
Company information

Founded in 2000



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1 review




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Reviewer’s Role
  • End user
  • Project manager
  • IT / Technical support
  • Executive sponsor
  • Internal consultant
  • Other

Reviewer’s Org Size
  • XL ($5B+ NPR)
  • L ($3-5B NPR)
  • M ($1-3B NPR)
  • S ($0.2-1B NPR)
  • XS (< $0.2B NPR)

Reviewer’s Org EMR compatibility

Reviewer’s Org Type
  • AMC
  • Pediatric Facilities
  • ACO
  • Rural Presence

December 1, 2023


December 1, 2023

Blown away with the results

 We deployed Waystar predictive analytics and technology and were actually blown away with the results. Waystar is definitely one of our top vendors and we certainly value the collaboration we have with them. 

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Chris Kiser

Vice President, Executive sponsor working with Prior Authorization at Atrium Health


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