Coverage Detection

JSON twin: https://www.healthaidb.com/software/coverage-detection.json

Company Name

Waystar

Product URL

https://www.waystar.com/our-platform/financial-clearance/coverage-detection/

Company URL

https://www.waystar.com

Categories

• administrative Operations
• revenue Cycle
• eligibility Verification
• patient Financial Services
• health Data Analytics
• cloud-based Solutions
• data Integration
• Administrative
• Revenue Cycle Management
• Financial Clearance
• Insurance Verification
• Denial Prevention
• Patient Financial Experience
• Data Analytics
• Automation
• Cloud-based Solution
• Healthcare It Integration

Summary

Waystar's Coverage Detection identifies hidden insurance coverage to enhance revenue and reduce patient financial burden.

Description

Waystar's Coverage Detection solution automates the identification of active, billable insurance coverage that may be overlooked, improving financial outcomes for healthcare providers and reducing patient financial burden. It integrates seamlessly into the revenue cycle, offering real-time coverage detection, customizable dashboards, and automated processes to prevent denials and accelerate payments. The solution leverages an extensive network of payer connections and advanced data analytics to uncover hidden coverage across various touchpoints in the revenue cycle, from pre-service registration to post-claim processing. By automating coverage detection, Waystar helps organizations recover revenue, reduce bad debt, and improve cash flow, all while enhancing the patient experience by minimizing unexpected financial responsibilities. The platform is designed to integrate with existing healthcare IT systems, including electronic health records (EHR) and practice management systems, facilitating a smooth implementation process. Additionally, Waystar's Coverage Detection is compliant with HIPAA and HITECH regulations, ensuring the security and privacy of patient information. The solution is available as a cloud-based software-as-a-service (SaaS) offering, providing scalability and flexibility to meet the needs of various healthcare organizations, from small practices to large health systems. Waystar's Coverage Detection is marketed and supported in the United States and is available in English. The company was founded in 2017 and has offices in the United States. The pricing model for Coverage Detection is subscription-based, with tiered pricing options to accommodate different organizational sizes and needs. Specific pricing details are available upon request from Waystar. The license terms are proprietary, with Waystar retaining ownership of the software and granting users a license to use the service under specified terms and conditions.

Api Available

yes

Certifications

• FDA 510(k)
• CE/MDR
• ONC
• ISO 27001

Company Founding

2017

Company Offices

• United States

Compliance

• HIPAA
• GDPR
• HITECH
• SOC 2
• ISO 27001

Customers

• Psychotherapist
• Verified User in Hospital & Health Care
• Verified User in Medical Practice
• Verified User in Accounting
• Verified User in Mental Health Care

Data Residency

US/EU regions

Data Standards

• FHIR
• HL7 v2
• DICOM
• SNOMED
• ICD-10

Deployment Model

• SaaS

Features

• Automated confirmation of active coverage
• Customizable dashboards and reports for billable transparency
• Actionable results for active and inactive coverage
• Real-time responses for coverage detection
• Automatic initiation from Eligibility solution

Id

SW2486

Integration Partners

• Clearinghouse Integration
• Claims Process Workflow
• Claims Resubmission
• Patient Data Security
• Claims Scrubbing

Integrations

• eClinicalWorks
• Epic
• Cerner
• PACS
• Billing Systems

Languages Supported

• English

Last Updated

2025-10-11

License

proprietary

Market Segment

• enterprise
• smb

Optional Modules

• Auto Coverage Detection
• Eligibility Verification
• Patient Estimation
• Charity Screening
• Claim Management
• Advanced Propensity to Pay

Os Platforms

• Web

Pricing Details

Tiered pricing options; contact vendor for specific pricing information.

Pricing Model

subscription

Privacy Features

• BAA available
• Consent Management
• Anonymization
• Data Minimization

Product Code

SW2486

Product Name

Coverage Detection

Ratings

• 4.4/5 (117 reviews) - G2
• 5.0/5 (1 review) - Capterra
• 4.0/5 (1 review) - Capterra
• 4.5/5 (1 review) - G2
• 5.0/5 (1 review) - G2

Regions Available

• United States

Related Urls

• https://elion.health/products/waystar-coverage-detection

Release Year

2013

Security Features

• Encryption
• RBAC
• SSO/SAML
• Audit Logs
• 2FA
• DLP

Specialties

• Health System/hospital
• Ambulatory Practice
• Ambulatory Surgery Center
• Imaging Center
• Clinical Laboratory
• Home Health
• Hospice
• Skilled Nursing
• Urgent Care
• Federally Qualified Health Center

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• revenue cycle managers
• patient access staff
• billing and claims teams
• accounts receivable staff
• denial management teams
• health system administrators
• billing services

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• Very bad experience with customer service
• Decent
• Waystar making Billing & Collections easier to comprehend.
• Awesome for quick billing!
• Business Manager
• One Stop Shop
• Best for quick billing and managing business

Version

1.0

Alternatives

See related products

Canonical JSON

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  "product_name": "Coverage Detection",
  "company_name": "Waystar",
  "product_url": "https://www.waystar.com/our-platform/financial-clearance/coverage-detection/",
  "company_url": "https://www.waystar.com",
  "related_urls": [
    "https://elion.health/products/waystar-coverage-detection"
  ],
  "product_code": "SW2486",
  "summary": "Waystar's Coverage Detection identifies hidden insurance coverage to enhance revenue and reduce patient financial burden.",
  "description": "Waystar's Coverage Detection solution automates the identification of active, billable insurance coverage that may be overlooked, improving financial outcomes for healthcare providers and reducing patient financial burden. It integrates seamlessly into the revenue cycle, offering real-time coverage detection, customizable dashboards, and automated processes to prevent denials and accelerate payments. The solution leverages an extensive network of payer connections and advanced data analytics to uncover hidden coverage across various touchpoints in the revenue cycle, from pre-service registration to post-claim processing. By automating coverage detection, Waystar helps organizations recover revenue, reduce bad debt, and improve cash flow, all while enhancing the patient experience by minimizing unexpected financial responsibilities. The platform is designed to integrate with existing healthcare IT systems, including electronic health records (EHR) and practice management systems, facilitating a smooth implementation process. Additionally, Waystar's Coverage Detection is compliant with HIPAA and HITECH regulations, ensuring the security and privacy of patient information. The solution is available as a cloud-based software-as-a-service (SaaS) offering, providing scalability and flexibility to meet the needs of various healthcare organizations, from small practices to large health systems. Waystar's Coverage Detection is marketed and supported in the United States and is available in English. The company was founded in 2017 and has offices in the United States. The pricing model for Coverage Detection is subscription-based, with tiered pricing options to accommodate different organizational sizes and needs. Specific pricing details are available upon request from Waystar. The license terms are proprietary, with Waystar retaining ownership of the software and granting users a license to use the service under specified terms and conditions.",
  "categories": [
    "administrative Operations",
    "revenue Cycle",
    "eligibility Verification",
    "patient Financial Services",
    "health Data Analytics",
    "cloud-based Solutions",
    "data Integration",
    "Administrative",
    "Revenue Cycle Management",
    "Financial Clearance",
    "Insurance Verification",
    "Denial Prevention",
    "Patient Financial Experience",
    "Data Analytics",
    "Automation",
    "Cloud-based Solution",
    "Healthcare It Integration"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "revenue cycle managers",
    "patient access staff",
    "billing and claims teams",
    "accounts receivable staff",
    "denial management teams",
    "health system administrators",
    "billing services"
  ],
  "specialties": [
    "Health System/hospital",
    "Ambulatory Practice",
    "Ambulatory Surgery Center",
    "Imaging Center",
    "Clinical Laboratory",
    "Home Health",
    "Hospice",
    "Skilled Nursing",
    "Urgent Care",
    "Federally Qualified Health Center"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "Tiered pricing options; contact vendor for specific pricing information.",
  "license": "proprietary",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2017",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "Automated confirmation of active coverage",
    "Customizable dashboards and reports for billable transparency",
    "Actionable results for active and inactive coverage",
    "Real-time responses for coverage detection",
    "Automatic initiation from Eligibility solution"
  ],
  "optional_modules": [
    "Auto Coverage Detection",
    "Eligibility Verification",
    "Patient Estimation",
    "Charity Screening",
    "Claim Management",
    "Advanced Propensity to Pay"
  ],
  "integrations": [
    "eClinicalWorks",
    "Epic",
    "Cerner",
    "PACS",
    "Billing Systems"
  ],
  "data_standards": [
    "FHIR",
    "HL7 v2",
    "DICOM",
    "SNOMED",
    "ICD-10"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "GDPR",
    "HITECH",
    "SOC 2",
    "ISO 27001"
  ],
  "certifications": [
    "FDA 510(k)",
    "CE/MDR",
    "ONC",
    "ISO 27001"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "Audit Logs",
    "2FA",
    "DLP"
  ],
  "privacy_features": [
    "BAA available",
    "Consent Management",
    "Anonymization",
    "Data Minimization"
  ],
  "data_residency": "US/EU regions",
  "customers": [
    "Psychotherapist",
    "Verified User in Hospital & Health Care",
    "Verified User in Medical Practice",
    "Verified User in Accounting",
    "Verified User in Mental Health Care"
  ],
  "user_reviews": [
    "Very bad experience with customer service",
    "Decent",
    "Waystar making Billing & Collections easier to comprehend.",
    "Awesome for quick billing!",
    "Business Manager",
    "One Stop Shop",
    "Best for quick billing and managing business"
  ],
  "ratings": [
    "4.4/5 (117 reviews) - G2",
    "5.0/5 (1 review) - Capterra",
    "4.0/5 (1 review) - Capterra",
    "4.5/5 (1 review) - G2",
    "5.0/5 (1 review) - G2"
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2013",
  "integration_partners": [
    "Clearinghouse Integration",
    "Claims Process Workflow",
    "Claims Resubmission",
    "Patient Data Security",
    "Claims Scrubbing"
  ],
  "id": "SW2486",
  "slug": "coverage-detection",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/coverage-detection.json"
  }
}