JSON twin: https://www.healthaidb.com/software/waystar-coverage-detection.json
Waystar
https://www.waystar.com/our-platform/financial-clearance/coverage-detection/
Waystar Coverage Detection is an automated revenue-cycle solution that finds active, billable patient insurance coverage across the care continuum to reduce self-pay, prevent denials, and recover missed revenue.
A proprietary cloud-based revenue cycle tool that leverages Waystar's claims, eligibility and payer data to automatically search for hidden or missed insurance at pre-service, point-of-service, claim submission, claim follow-up and denial stages. Provides real-time detection, customizable dashboards and reports, integration with eligibility workflows, and automated triggers to reduce denials and increase recovered/payer revenue.
yes
2017
P1791
2025-09-07
proprietary commercial
Contact vendor for pricing, demos and deployment options; no public list prices
enterprise_quote
product
1.0
{
"company_name": "Waystar",
"company_url": "https://www.waystar.com",
"company_offices": [
"United States",
"India",
"Netherlands",
"Mexico",
"United Kingdom"
],
"company_founding": "2017",
"product_url": "https://www.waystar.com/our-platform/financial-clearance/coverage-detection/",
"categories": [
"administrative",
"revenue cycle management",
"financial clearance",
"insurance discovery",
"eligibility verification",
"denial prevention"
],
"market_segment": [
"enterprise",
"smb"
],
"links": [
"https://www.waystar.com/our-platform/financial-clearance/coverage-detection/",
"https://info.waystar.com/rs/578-UTL-676/images/Waystar_CoverageDetection_infoSheet.pdf",
"https://info.waystar.com/coverage_detection_wp.html",
"https://elion.health/products/waystar-coverage-detection",
"https://www.g2.com/products/waystar/reviews",
"https://www.capterra.com/p/45512/ZirMed/reviews/",
"https://www.waystar.com/blog-coverage-detection-101-how-rcm-teams-find-missing-or-hidden-insurance/",
"https://info.waystar.com/value-calculator-finding-active-coverage.html",
"https://www.waystar.com/contact-us/",
"https://investors.waystar.com/node/6756/html"
],
"summary": "Waystar Coverage Detection is an automated revenue-cycle solution that finds active, billable patient insurance coverage across the care continuum to reduce self-pay, prevent denials, and recover missed revenue.",
"description": "A proprietary cloud-based revenue cycle tool that leverages Waystar's claims, eligibility and payer data to automatically search for hidden or missed insurance at pre-service, point-of-service, claim submission, claim follow-up and denial stages. Provides real-time detection, customizable dashboards and reports, integration with eligibility workflows, and automated triggers to reduce denials and increase recovered/payer revenue.",
"target_users": [
"revenue cycle managers",
"patient access/registration 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": "enterprise_quote",
"pricing_details": "Contact vendor for pricing, demos and deployment options; no public list prices",
"license": "proprietary commercial",
"deployment_model": [
"SaaS"
],
"os_platforms": [
"Web"
],
"features": [
"Automated coverage discovery across revenue cycle",
"Real-time coverage detection at registration and point-of-service",
"Automatic initiation from eligibility searches",
"Post-claim and denial-triggered coverage searches",
"Customizable dashboards and reporting",
"Payer/claims and eligibility database-driven matching",
"Auto Coverage Detection (end-to-end workflow automation)",
"Integration with eligibility and claim workflows to reduce denials",
"Actionable active/inactive coverage results"
],
"optional_modules": [
"Auto Coverage Detection (advanced automation)",
"Analytics & reporting (enhanced dashboards)"
],
"integrations": [
"Epic",
"Cerner",
"Meditech",
"Allscripts / Veradigm",
"NextGen",
"Payer connections (commercial and government payers)",
"Practice management / PM systems (wide list supported)"
],
"data_standards": [
"HIPAA transaction sets (ANSI X12, e.g., 270/271 eligibility)",
"EDI (ANSI X12)"
],
"api_available": "yes",
"system_requirements": "",
"compliance": [
"HIPAA",
"HITECH",
"CCPA"
],
"certifications": [],
"security_features": [
"In-transit encryption (SSL/TLS)",
"Firewall protection",
"Application access logs / audit logging",
"User authentication and access controls",
"Physically secure hosting facility"
],
"privacy_features": [
"BAA available",
"Data backup and retention controls",
"Access logging and employee confidentiality agreements"
],
"data_residency": "",
"customers": [
"Cincinnati Children's Hospital",
"Baptist Health",
"Apria Healthcare",
"Innovative Healthcare Systems",
"Preferred Health",
"Various hospital and health system customers",
"Ambulatory practices"
],
"user_reviews": [
"Simple to use for verifications and reports; speeds up insurance verification workflows.",
"Works pretty well for finding hidden coverage, excluding occasional payer outages.",
"Implementation can take months and setup required repeated coordination.",
"Helped recover billable coverage that was missed at registration, improving collections.",
"Useful integration with existing billing programs but watch contract terms and pricing."
],
"ratings": [
"MDClarity: 4.5/5 (aggregated Waystar reviews)",
"G2: multiple user reviews (platform rating available on G2)"
],
"support_channels": [
"email",
"phone",
"chat",
"ticketing",
"community",
"24x7"
],
"training_options": [
"documentation",
"webinars",
"live_online",
"onsite",
"certification"
],
"release_year": "",
"integration_partners": [
"Epic",
"Cerner",
"Meditech",
"Allscripts",
"NextGen",
"Change Healthcare",
"Various payers via EDI (270/271 eligibility transactions)"
],
"id": "P1791",
"slug": "waystar-coverage-detection",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/waystar-coverage-detection.json"
}
}