Eligibility Verification

Waystar’s Eligibility Verification solution automates much of the eligibility process so you can say goodbye to the days of searching and interpreting patient coverage and focus on what really matters: your patients. With our powerful technology, you can:

• Prevent more rejections + denials
• Strengthen front-end collections
• Optimize staff productivity
• Elevate the patient payment experience

What makes Waystar the industry’s most accurate eligibility verification tool?

Getting insurance verification right the first time is crucial. Incorrect or incomplete eligibility has a ripple effect across the revenue cycle, from missed authorizations to reworking denied claims.  

Powered by Waystar’s AI + RPA, our Eligibility Verification tool combs through payer data to curate the most accurate and comprehensive benefit information. With richer coverage detail, staff can easily identify eligibility issues. Plus, our eligibility engine seamlessly integrates with all major EHRs.

Features + benefits

• Superior eligibility results with RPA + expansive payer connectivity
• Plan code matching to mitigate registration errors
• Normalization of payer data for more efficient workflows
• Intelligent alerts with actionable guidance for staff

Enriched benefit data

• Utilize RPA + EDI connections to surface complete response
• Expansive payer connectivity for best data in the market
• Enriched eligibility data when no EDI is available

Automated, intelligent workflow

• Integrated workflow for seamless user experience
• Intelligent warnings + Medicare Advantage plan alerts
• Guided next best user actions

Unparalleled financial clearance operations

• Auto-rechecks eligibility whenever account data is updated
• Benefit information is normalized for ease of consumption
• Self-pay validation for coverage verification

What our users have to say:

“ Before Waystar, we were going to a variety of carrier websites and spending a lot of time on the phone to check eligibility. It was labor intensive. Now we have all our carrier information in one location in our system. ”

- Manager of Revenue Cycle Billing & Coding