#USA #Lehi, Utah #Healthcare Payments #Waystar AltitudeAI #Agentic Intelligence

Waystar Introduces Agentic AI: A New Era in Healthcare Payments

Waystar, a leader in healthcare payment software, has announced its latest innovation, agentic intelligence, which is set to revolutionize the revenue cycle management in healthcare. This advancement is built on the foundation of Waystar's AltitudeAI platform, which has already proven effective in reducing claim denials significantly — preventing an impressive $15.5 billion in potential losses in just under a year.

The introduction of agentic intelligence marks a significant milestone for Waystar, emphasizing its commitment to transforming the healthcare industry. This new feature utilizes a network that integrates clinical, financial, and administrative data in a way that has never been done before. By leveraging over 7.5 billion annual transactions and one in three U.S. hospital discharges, Waystar’s connected AI ecosystem is able to optimize healthcare payment processes effectively.

Next-Level Revenue Cycle Management

The move toward an autonomous revenue cycle is a pivotal evolution in how healthcare payments are handled. Agentic intelligence is designed to operate seamlessly within existing workflows, automating tasks and learning from outcomes with minimal human intervention. This not only elevates efficiency but also addresses the pressing problem of administrative burdens that healthcare providers face.

Matt Hawkins, the CEO of Waystar, highlighted the ongoing success of the AltitudeAI platform: “Waystar AltitudeAI has not only prevented billions in denials last year, but it also sets the stage for our ambitious vision of what an autonomous revenue cycle can achieve.” The new agent-based workflows promise to further extend this momentum, unlocking capabilities that can lead to strong client outcomes.

Key Enhancements Powered by Agentic AI

With the rollout of agentic intelligence, several enhancements are expected, including:

• - Streamlined Prior Authorizations: Using proactive clinical justification to secure accurate reimbursements.
• - Denial Prevention: Integrating documentation, coding, and charge capture to maintain a steady cash flow.
• - Automated Correction Recommendations: Making use of historical data to ensure claims are clean and compliant.
• - Intelligence-Powered Clinical Appeals: Accelerating the claims recovery process, enhancing productivity while lowering costs.

Impact on Healthcare Professionals

One of the most important aspects of this innovation is its potential to reduce the workload for healthcare professionals. As the industry braces for a looming nursing shortage by 2030, Waystar's new workflow aims to alleviate some of the administrative strain that nurses experience daily. By utilizing agentic AI to handle tasks like chart reviews and documentation validation, the software will allow healthcare providers to focus more on patient care rather than administrative red tape.

In practical terms, Waystar’s agentic AI can analyze full medical records rapidly, prioritizing pertinent data and pre-populating requests for corrections. Early tests suggest a 40% reduction in manual correction workload, enabling healthcare providers to act faster and with greater confidence.

Over the last decade, Waystar has continuously innovated its platform to tackle the rising denial rates that plague the industry. Following the introduction of AltitudeAI, which incorporates generative AI capabilities, clients have seen not only time savings but also improved rates of denial overturns, providing a compelling case for providers to adopt this advanced technology.

Future Outlook

Waystar’s advancements will take center stage at the upcoming J.P. Morgan Healthcare Conference, where Matt Hawkins is scheduled to present the company’s innovation strategy. This platform marks an exciting chapter for healthcare revenue cycle management, aiming to simplify the payment process for providers while ultimately enhancing patient care.

With these innovations, Waystar continues to pave the way for a future where healthcare providers are unburdened by bureaucracy, allowing them to concentrate on what truly matters - the health and well-being of their patients. By seeking out this path of innovation and automation, Waystar is leading the charge in redefining how healthcare payments are processed and managed across the industry.